Patients with type 2 diabetes mellitus and hypertensionare at increased risk of cardiovascular events andchronic renal failure requiring dialysis.1 In Canada, the risk of progression to end-stage renal disease among such people is 7 times higher in the First Nations population than in the non-native...
| Main Authors: | , , , , , , , |
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| Other Authors: | |
| Format: | Text |
| Language: | English |
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| Online Access: | http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.631.7330 http://www.cmaj.ca/content/174/9/1267.full.pdf |
| Summary: | Patients with type 2 diabetes mellitus and hypertensionare at increased risk of cardiovascular events andchronic renal failure requiring dialysis.1 In Canada, the risk of progression to end-stage renal disease among such people is 7 times higher in the First Nations population than in the non-native population.2 Although effective strategies exist for treating hypertension, in First Nations populations treatment of hypertension is challenging because of reduced access to ambulatory care and a hesitancy regarding modern disease management strategies.3 Clinical studies in hyperten-sion have shown that high rates of blood pressure control are attainable;4 in the research setting, nurse-implemented algo-rithms supervised by a physician have been found to con-tribute to efficacious blood pressure control.5 In 1998 the Diabetes Risk Evaluation and Microalbumi-nuria (DREAM 1) study was initiated at the request of the Battlefords Tribal Council Indian Health Services to assess the prevalence of risk factors for end-stage renal disease (ESRD) among First Nations people with type 2 diabetes in the Battle-fords region of northern Saskatchewan.6 In 2000 the DREAM 2 pilot study demonstrated a reduction of systolic blood pressure when home care nurses measured blood pres-sure at regular intervals and notified the patient’s family physi-cian.6 In this article, we report the findings of the DREAM 3 study, which was designed to evaluate the effect on blood pressure control of an algorithm of pharmacologic therapy implemented by home care nurses in a community setting. Methods This was a randomized, prospective, open-label study with 2 parallel groups. We recruited First Nations people registered |
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