Effectiveness of longitudinal community management of pre-diabetic patients with hypertension: Beijing Community Diabetes Study 13

Abstract

Objective To evaluate the effectiveness of longitudinal community management of pre-diabetic patients with hypertension. Methods Two hundred and eighty three pre-diabetic patients with hypertension were recruited in Beijing Community Diabetes Study from seven communities of Beijing, and the patients received longitudinal community management from July 2008 to July 2011.The blood pressure, blood glucose, blood lipids were measured; and the antihypertensive medication, blood pressure control and other indicators were examined before and after management. Results During the 3-year period, 39 cases dropped off and 244 patients completed the study.Compared with the baseline levels, systolic blood pressure [(126±9) vs. (130±14) mmHg, 1 mmHg=0.133 kPa], diastolic blood pressure [(75±7) vs. (77±9) mmHg], fasting glucose [(5.7±1.0) vs. (6.0± 0.8) mmol/L], postprandial glucose [(7.8±1.8) vs. (8.2±2.3) mmol/L], uric acid [(313±77) vs. (329±88) μmol/L], LDL-C [(2.9±0.8) vs. (3.1±0.9) mmol/L] were significantly decreased (t=4.535, 4.699, 4.383, 3.363, 3.548, 2.016, P 0.05) after the management. The proportion of non-drug treatment patients rose from 16% to 22%, because of medication withdrawing after effective lifestyle management.The blood pressure control rate was significantly increased (36% vs.25%, χ2=7.043, P 0.05). The proportion of patients who reached all three goal of blood glucose, blood pressure and blood lipids increased significantly (12% vs. 5%, χ2=8.441, P<0.01). Conclusion The longitudinal community management may improve rational antihypertensive drug use and increase control rate of blood pressure, blood glucose and blood lipids in some extent for pre-diabetic patients; the management should be focused on all risk factors of vascular diseases not just on the blood glucose alone. Key words: Prediabetic state; Hypertension; Disease managment