Shorter physician encounter intervals associated with faster BP decrease
For hypertensive patients with diabetes, shorter encounter intervals with physicians may result in a more rapid decrease in BP and earlier BP normalization, according to study results.
Researchers performed a retrospective study of 5,042 patients with diabetes and hypertension who were followed for at least 2 years between 2000 and 2005. Patients were included if they were at least18 years of age, had a documented diagnosis of diabetes and had one or more encounters with a physician in a primary care specialty during the study period where a BP above the recommended treatment target was recorded.
Researchers analyzed distinct periods of continuously-elevated BP, evaluating the association of the average encounter interval with time to BP normalization and rate of BP decrease.
The BP of patients who had an average interval of up to one month between physician encounters normalized after a median of 1.5 months (at the rate of 28.7 mm Hg/month), whereas patients with encounter intervals of more than 1 month had a median time to normalization of 12.2 months at 2.6 mm Hg/month (P<.0001 for all). Median time to BP normalization was 0.7 months vs. 1.9 months for the average encounter interval of up to 2 weeks vs. the interval between 2 weeks and 1 month (P<.0001). The researchers also reported that a one-month increase in the average encounter interval was associated with an HR of 0.764 for BP normalization (P<.0001).
???Based on our findings, optimal encounter intervals may be shorter than what is currently recommended,??? the researchers noted. ???Interventional studies are now needed to confirm the direction of causality in these findings and to provide evidence-based guidance for choosing encounter intervals for the thousands of primary care physicians who care for these patients.???
Turchin A. Hypertension. 2010;doi: 10.1161/HYPERTENSIONAHA.109.148791.
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