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)   18 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

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin

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