Family Practice Advance Access published online on October 25, 2007
Family Practice, doi:10.1093/fampra/cmm060
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Practice and patient characteristics related to blood pressure in patients with type 2 diabetes in primary care: a cross-sectional study
a Department of Diabetes
b Renal Unit, Nottingham University Hospitals, Hucknall Road, Nottingham NG5 1PB
c Division of Primary Care, University of Nottingham, Floor 13, Tower Building, University Park, Nottingham NG7 2RD
d Nottingham Primary Care Research Partnership, Hucknall Health Centre, 54 Curtis Street, Hucknall, Nottingham NG15 5JE
e Division of Epidemiology and Public Health, University of Nottingham Medical School, Queens Medical Centre, Nottingham NG7 2UH, UK
Correspondence to Charlotte Bebb, Renal Unit, City Hospital Campus, Nottingham University Hospitals, Hucknall Road, Nottingham NG5 1PB, UK; Email: charlotte.bebb{at}nuh.nhs.uk
Received 19 September 2006; Revised 11 July 2007; Accepted 23 August 2007.
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Abstract |
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Background. Good blood pressure control reduces the risk of long-term complications of diabetes; however, most people with diabetes do not achieve recommended blood pressure targets.
Objective. To quantify the relationships between patient and practice factors and blood pressure in patients with type 2 diabetes.
Methods. A cross-sectional study was carried out in 42 general practices in Nottingham. Participants were 1534 people with type 2 diabetes. Patient characteristics were assessed by a clinical interview and case note review and practice characteristics by questionnaire. The outcome measures were systolic and diastolic blood pressure.
Results. In all, 46% of participants had well-controlled blood pressure (
145/85 mmHg) and 68% were on anti-hypertensive treatment. Systolic and diastolic blood pressure were significantly higher in males overall, in those with a body mass index 
25 kg/m2, and increased with alcohol consumption. Systolic blood pressure increased whereas diastolic blood pressure decreased with increasing age and duration of diabetes. Current smokers and ex-smokers had a significantly lower diastolic blood pressure than those who had never smoked. Patients from practices where blood pressure targets were negotiated with most patients had significantly lower mean systolic and diastolic blood pressure than those where targets were negotiated with few patients.
Conclusions. A number of patient characteristics are associated with blood pressure. Negotiating individual goals for blood pressure may be important in achieving blood pressure control in patients with type 2 diabetes. Further research is required to confirm this finding and to explore the process of negotiating targets.
Keywords. Blood pressure, hypertension, practice organization, primary care, type 2 diabetes.
Bebb C, Coupland C, Stewart J, Kendrick D, Madeley R, Sturrock N and Burden R, for the Nottingham Diabetes Blood Pressure Study. Practice and patient characteristics related to blood pressure in patients with type 2 diabetes in primary care: a cross-sectional study. Family Practice 2007; Pages 1–8 of 8.