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Short Delay in Treating Blood Pressure Safe for Diabetics: Study

January 10, 2012
By

MONDAY, Jan. 9 (HealthDay News) — Waiting up to a year to treat high
blood pressure in a person with diabetes is probably not harmful, but
waiting many years to get blood pressure under control could result in
serious complications, new research indicates.

In the study, published online Jan. 9 in the Journal of General
Internal Medicine
, researchers from the University of Chicago
suggested that the one-year delay could give patients time to make certain
lifestyle changes that could help correct the problem, such as limiting
their salt intake, exercising or losing weight.

The study also suggests that delays in lowering blood pressure among
patients with diabetes are not uncommon. Some patients may not have access
to health care, while others may not follow through on their treatment,
they explained.

Still, other experts were cautious, noting that prompt control of blood
pressure with medications can prevent serious cardiovascular trouble.

In the study, a team led by Dr. Neda Laiteerapong used a simulated
model with a theoretical population of adults in their 50s newly diagnosed
with type 2 diabetes.

The researchers found that a lifetime of uncontrolled blood pressure
increased complications significantly, or by 1,855 events per 10,000
patients. It also reduced their life expectancy by almost one year.

In contrast, a one-year delay in controlling blood pressure resulted in
only a minor increase in the number of complications and reduced life
expectancy by only two days.

However, waiting very long before treatment wasn’t advised. The study
authors found that 10 years or more of delays in the treatment of high
blood pressure could lead to serious health problems, including greater
risk for stroke and heart attack.

“Among middle-aged adults with diabetes, the harms of a one-year delay
in managing blood pressure may be small. Health care providers may wish to
focus on diabetes management alone in the first year after diagnosis, to
help patients establish effective self-management and lifestyle
modification,” Laiteerapong and colleagues wrote in a journal news
release.

Experts said the findings add to the debate on when to initiate
therapy, but questioned the authors’ conclusions.

The study “contributes to the ongoing discussion about blood pressure
targets and the importance of blood pressure control in people who have
diabetes,” said Dr. Ronald Tamler, clinical director of the Mount Sinai
Diabetes Center in New York City.

“However, we should not forget that this latest study is merely a
computer simulation. Studies have shown that uncontrolled blood pressure
in real patients with diabetes is still a source of concern and may
lead to complications, such as heart disease, stroke and kidney disease,”
added Tamler, who is also assistant professor of medicine at the
center.

One cardiologist added that quick action in getting blood pressure
under control can be life-saving, and he questioned whether waiting for
lifestyle changes to occur was advisable.

Dr. Henry Black, clinical professor of cardiology at NYU Langone
Medical Center in New York City, said that many studies have shown “that
prompt control of blood pressure reduces events, although neither
of these studies were specifically aimed at patients with diabetes,
although many of the study volunteers had diabetes mellitus.”

According to Black, most trials have found changes in lifestyle to be
less effective than drug therapy in reining in high blood pressure. That
means that, “dithering with ‘lifestyle changes’ . . . will delay getting
effective treatment to these high-risk individuals,” he said. “The time
wasted focusing on control of diabetes with lifestyle changes is a bad
bargain, if blood pressure is pushed to the back burner.”

More information

The U.S. National Heart, Lung, and Blood Institute has more about lowering
blood pressure
.

Article source: http://news.yahoo.com/short-delay-treating-blood-pressure-safe-diabetics-study-140409905.html

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