Research from Brigham and Women’s Hospital (BWH) found that for patients with diabetes, more frequent doctor visits helped lower their high blood pressure to a normal level more quickly than patients who waited longer between visits. These findings are published in the May 24, 2010 issue of Hypertension: Journal of the American Heart Association.
Current guidelines from the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommend that patients with high blood pressure be reevaluated within one month. However, typical intervals between doctor visits are longer, potentially posing challenges for treating high blood pressure. “In addition to the guidelines, we hoped to provide a demonstration of how effective more frequent doctor visits could be in lowering high blood pressure in diabetics,” said lead study author Alexander Turchin, MD, MS, Director of Informatics Research in the Division of Endocrinology at BWH.
The researchers examined the relationship between frequency of visits with a primary care physician and the effect on patients’ blood pressure. The study followed 5,042 diabetics with high blood pressure for up to five years and found that patients who visited their primary care physicians at intervals of one month or less saw their blood pressure decline to normal after an average of one and one half months. Patients that waited more than a month between visits saw their blood pressure return to normal only after an average of twelve months.
“Primary care physicians are typically the first line of defense in detecting and helping patients manage their blood pressure,” explained Dr. Turchin, emphasizing the importance of PCP involvement in blood pressure regulation at a time when the US is seeing a shortage of PCPs.
To address this issue, the researchers introduce the potential of using telemedicine techniques- communication through e-mail, telephone, fax or Internet-based tools- to help monitor blood pressure. “Patients could measure their blood pressure at home and report to their physicians and see physicians more frequently as needed,” explained Dr. Turchin. Researchers also suggest another approach enlisting help from non-physician providers, such as physician assistants, nurse practitioners and clinical pharmacists.
The study was funded by the Agency for Healthcare Research and Quality and the Diabetes Action Research and Education Foundation.