BARCELONA — Only two in five Americans with type 2 diabetes and cardiovascular disease—and just one in five in European countries—meet current blood pressure goals, Benjamin A. Steinberg reported at the joint meeting of the European Society of Cardiology and the World Heart Federation.
These findings from a huge contemporary international database underscore the urgent need for physicians to do much better at identifying and controlling high blood pressure in this very-high-risk population, Mr. Steinberg stressed in an interview.
During a year-long fellowship to conduct cardiovascular research, Mr. Steinberg, a medical student at Johns Hopkins University, Baltimore, analyzed the CardioMonitor database for 1998–2004. CardioMonitor is an annual survey of outpatients with cardiovascular disease in multiple countries. The survey relies on medical records that are provided by primary care physicians and cardiologists.
For the years 1998–2004 excluding 2002, when the survey wasn't conducted, the CardioMonitor database included nearly 155,000 patients with cardiovascular disease in the United States and five European nations. A total of 23,139 of them also had type 2 diabetes.
The prevalence of diabetes among cardiovascular patients rose during the years of the study, in some countries quite markedly. For example, the reported prevalence of type 2 diabetes among patients with cardiovascular disease doubled in France and the United Kingdom between 1998 and 2004, while in the United States, it climbed from 15.1% to 20.5%. The prevalence in 2004 was greatest in Germany, at 24.9%. In Spain it was 19.5%, up from 11.8% in 1998, while in Italy the prevalence of type 2 diabetes among cardiovascular patients was just 9.6% in 2004.
The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure VII (JNC-VII) goal of a systolic blood pressure below 130 mm Hg was achieved by only 41% of American diabetic cardiovascular patients. European rates were far lower, Dr. Steinberg continued. (See box.)
The less stringent European Society of Cardiology blood pressure target in place in 2004—a systolic pressure below 140 mm Hg—was met by 72% of American patients, 53% in the United Kingdom, 49% in Spain, 47% in France, 44% in Germany, and 33% in Italy.
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