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(Circulation. 2008;117:1353.)
© 2008 American Heart Association, Inc.

Clinical Summaries

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Improving Hypertension Control in Diabetes Mellitus: The Effects of Collaborative and Proactive Health Communication

 
Uncontrolled hypertension is the primary risk factor for the macrovascular complications of diabetes mellitus. Clinical trials have demonstrated reductions in cardiovascular morbidity when high blood pressure is controlled. Despite the availability of numerous treatments, hypertension remains uncontrolled in more than half of all diabetic individuals receiving treatment. Communication that facilitates patient–clinician collaboration when setting goals and treatment plans may overcome barriers to hypertension control in routine diabetes care. We assessed particular characteristics of patient–clinician communication to determine their associations with hypertension control in diabetes care independent of patient characteristics, medication adherence, and self-management behaviors. Three communication factors had significant associations with hypertension control. Two factors, patients’ preference for shared decision making with their clinician and proactive communication with their clinician about abnormal results after blood pressure self-monitoring, had direct independent associations with hypertension control. A third factor, collaborative communication by clinicians when setting treatment goals, had an indirect effect on hypertension control. The impact of this factor was most apparent when a patient did not endorse a shared decision-making style. This study provides preliminary evidence that patient–clinician communication can facilitate collaborative blood pressure goals and proactive recognition by patients of inadequate treatment. Collaborative communication during clinical encounters initiated by patients or clinicians may improve rates of hypertension control in diabetes care independent of medication adherence. See p 1361.

	Reversal of Global Apoptosis and Regional Stress Kinase Activation by Cardiac Resynchronization

 
Cardiac resynchronization therapy (CRT) is arguably the most important therapeutic advance in heart failure treatment since the turn of the 21st century. It is used in patients with discoordinate contraction from . . . [Full Text of this Article]