Tip sheet Annals of Internal Medicine, April 4, 2006

3 Annals of Internal Medicine Articles and an Editorial Look at How Well Americans and Their Doctors Are Controlling Chronic Diseases

1.) Diabetes Care Has Improved in Past 10 Years, but Americans Have a Long Way to Go

According to a new study, diabetes care in the past 10 years has improved, but, still, two in five people with diabetes have poor control of cholesterol, one in three have poor blood pressure control and one in five has poor control of blood sugar levels (Article, p. 465).

Researchers, using data from two national population-based surveys, looked at the proportion of Americans with diabetes who had adequate control of blood sugar, blood pressure and cholesterol levels, and who had recommended yearly eye and foot examinations.

This article in its entirety is available to the public at www.annals.org.

2) People with Mild Hypertension Can Successfully Make and Sustain Lifestyle Changes That Reduce Risk for Heart Disease

In an 18-month study to measure the effect of positive lifestyle changes on blood pressure control, 810 adult volunteers with borderline or mild hypertension were assigned to one of three groups:
a. repeated counseling with specific goals for how much weight to lose, how much to exercise and how much salt and alcohol to consume;
b.) counseling plus instructions for eating a DASH diet (Dietary Approaches to Stop Hypertension), which recommends quantities of fruits and vegetables and low-fat dairy products and low amounts of fat and salt;
c.) advice only on lifestyle change (Article, p. 485).

Participants in the first two counseling groups lost more weight, had better diets and were less likely to have hypertension after 18 months than those who got only advice. These groups had lower blood pressure than the advice-only group, but the differences were not statistically significant.

Authors say that lifest

Contact: Susan Anderson
American College of Physicians

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