Faculty Collaboration Database

Racial and ethnic differences in longitudinal blood pressure control in veterans with type 2 diabetes mellitus. J Gen Intern Med 2011 Nov;26(11):1278-83

Date

06/15/2011

Pubmed ID

21671132

Pubmed Central ID

PMC3208462

DOI

10.1007/s11606-011-1752-3

Scopus ID

2-s2.0-80755189949 (requires institutional sign-in at Scopus site)   19 Citations

Abstract

BACKGROUND: Few studies have examined racial/ethnic differences in blood pressure (BP) control over time, especially in an equal access system. We examined racial/ethnic differences in longitudinal BP control in Veterans with type 2 diabetes.

METHODS: We collected data on a retrospective cohort of 5,319 Veterans with type 2 diabetes and initially uncontrolled BP followed from 1996 to 2006 at a Veterans Administration (VA) facility in the southeastern United States. The mean blood pressure value for each subject for each year was used for the analysis with BP control defined as <140/<90 mmHg. The primary outcome measure was proportion with controlled BP. The main predictor variable was race/ethnicity categorized as non-Hispanic White (NHW), non-Hispanic Black (NHB), or Hispanic/Other (H/O). Other covariates included age, gender, employment, marital status, service connectedness, and ICD-9 coded medical and psychiatric comorbidities. Generalized linear mixed models were used to assess the relationship between race/ethnicity and BP control after adjusting for covariates.

RESULTS: Mean follow-up was 5.0 years. The sample was 46% NHW, 26% NHB, 19% H/O, and 9% unknown. The average age was 68 years. In the final model, after adjusting for covariates, NHB race (OR = 1.38, 95%CI: 1.2, 1.6) and H/O race (OR = 1.57, 95% CI: 1.3, 1.8) were associated with increased likelihood of poor BP control (>140/>90 mmHg) over time compared to NHW patients.

CONCLUSION: Ethnic minority Veterans with type 2 diabetes have significantly increased odds of poor BP control over ∼5 years of follow-up compared to their non-Hispanic White counterparts independent of sociodemographic factors and comorbidity patterns.

Author List

Axon RN, Gebregziabher M, Echols C, Msph GG, Egede LE

MESH terms used to index this publication - Major topics in bold

Aged
Blood Pressure
Diabetes Mellitus, Type 2
Female
Humans
Hypertension
Longitudinal Studies
Male
Multivariate Analysis
Retrospective Studies
Risk Factors
United States
United States Department of Veterans Affairs
Veterans