Blood pressure control key for black diabetics

Keeping blood pressure down is critical for African Americans with type 2 diabetes as high pressures increase the risk of kidney disease progression, according to a report in The American Journal of Medicine.

"Lower blood pressure targets are clearly recommended in patients with diabetes," Dr. Mohamed G. Atta from Johns Hopkins University School of Medicine, Baltimore, told Reuters Health. "Even though physicians are aware of the importance of blood pressure control, they are not as aggressive as you would expect."

Atta and colleagues examined the progression of kidney disease in 186 African American patients with type 2 diabetes participating in Project Sugar, a study of interventions to improve diabetes control. The team specifically looked for demographic and modifiable factors that influence progression.

When the study began, 60 patients had kidneys that leaked small amounts of protein into the urine. During 3 years of follow-up, all of the patients developed more severe leakage problems.

Disease progression was not associated with age, duration of diabetes, underlying heart disease, or the use of cholesterol-lowering drugs, the researchers note. By contrast, progression was associated with the need for blood pressure medications.

"In general, 40 percent of African Americans above the age of 20 have (high blood pressure), highlighting the magnitude of this problem," Atta said. "The message then is to increase awareness, early recognition of the problem, and aggressive interventions."

SOURCE: The American Journal of Medicine, January 2009.