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 said in an interview.
During a fellowship, 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 that relies on medical records 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% to 21%. The prevalence in 2004 was greatest in Germany, at 25%.
The Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure VII goal of a systolic BP below 130 mm Hg was achieved by only 41% of American diabetic cardiovascular patients. European rates were far lower: 24% in the United Kingdom, 19% in Germany, 18% in Spain, 16% in France, and 12% in Italy, Mr. Steinberg said.