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- Title
Racial and ethnic differences in longitudinal blood pressure control in veterans with type 2 diabetes mellitus.
- Authors
Axon, R.; Gebregziabher, Mulugeta; Echols, Carrae; MSPH, Gregory; Egede, Leonard; Axon, R Neal; Msph, Gregory Gilbert; Egede, Leonard E
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusion: </bold>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.
- Subjects
RACIAL differences; BLOOD pressure; PEOPLE with diabetes; DISEASES in veterans; SOCIODEMOGRAPHIC factors
- Publication
JGIM: Journal of General Internal Medicine, 2011, Vol 26, Issue 11, p1278
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1007/s11606-011-1752-3