Doctors Sometimes Overtreat Blood Pressure, Researchers Say

Doctors may be overtreating blood pressure in some patients with diabetes, according to new research.

A study of veterans’ hospitals found that doctors were sometimes treating diabetes patients with healthy readings with intensive blood pressure treatment. Diabetes and high blood pressure often go hand in hand, and doctors were following guidelines for patients with diabetes and high blood pressure. Over time, however, patients taking blood pressure medication had lower blood pressure, but the doctors were still prescribing high blood pressure treatment, the researchers found.

Some patients receiving blood pressure medication may not need that medication for an extended period of time, but doctors continue to prescribe it, the researchers said.

The study was conducted by researchers from the Department of Veterans Affairs Ann Arbor Healthcare System and the University of Michigan.

The researchers looked at medical records of nearly 1 million patients with diabetes treated at close to 900 VA medical centers and smaller community-based outpatient clinics. The scientists looked at data from 2009 and 2010. The subjects ranged from age 18 to 75.

More than 33 percent of patients treated at the centers with blood pressure below 130/65 mm Hg were on at least three blood pressure lowering drugs, or were having their drug regimen increased, according to the study. High blood pressure is 140/90 mm Hg or higher, according to the National Institutes of Health. Guidelines do not currently set a lower limit for recommended blood pressure.

A total of 20 percent of the diabetes patients surveyed had normal or low blood pressure. A total of 8 percent of these patients had potential for overtreatment, the study stated. Depending on the facility, between 3 percent and 20 percent of the diabetic patients were possibly being overtreated.

The blood pressure medication could have other effects, the researchers said. If blood pressure is low, patients can experience weakness or dizziness. The study did not conclude whether overtreatment had negative effects.

One of the most popular types of high blood pressure medication are Angiotensin-converting enzyme inhibitors, or ACE inhibitors. These types of medication help blood vessels widen by preventing the hormone angiotensin from affecting blood vessels. Popular ACE inhibitors include Altace (ramipril: , Capoten (captopril:, and Zestril (lisinopril:

The study was published in the journal Archives of Internal Medicine.