Determinants of sustained uncontrolled blood pressure in a national cohort of persons with diabetes
Document Type
Article
Publication Date
2-1-2006
Abstract
Background: Randomized clinical trials have demonstrated that strict blood pressure (BP) control in diabetes reduces cardiovascular morbidity and mortality. Previous observational studies have confirmed that hypertension is inadequately controlled in the general population of the United States. In this study we evaluated the prevalence and determinants of severe, sustained, uncontrolled hypertension in a national cohort of persons with diabetes. Methods: We identified 64,105 veterans from the national Veterans Administration diabetes registry for whom BP, survey, laboratory, and medication data were available. Using mean BP from three visits in fiscal year 2000, we determined the prevalence of sustained BP readings <160/100, <140/90, or <130/80 mm Hg. We determined predictors of the three thresholds using demographic variables, self-reported medical comorbidities, estimated glomerular filtration rate, and number of BP-lowering medications. Results: Over a mean interval of 131.0 days (±81.4), we found that 6,347 (9.9%) of the 64,105 veterans with diabetes had mean BP <160/100 mm Hg. Similarly 25,924 (40.4%) had a mean BP <140/90 mm Hg, and 38,296 (59.7%) had a mean BP <130/80 mm Hg. Independent predictors of mean BP <160/100 mm Hg included age, ethnicity, education level, cardiovascular comorbidities, alcohol use, and number of BP-lowering medications. Conclusions: Administrative databases can be used to identify patients with sustained uncontrolled hypertension within health care systems. Our findings suggest important patient-level factors that can be targeted for quality improvement programs in diabetes. © 2006 American Journal of Hypertension, Ltd.
Identifier
33644810308 (Scopus)
Publication Title
American Journal of Hypertension
External Full Text Location
https://doi.org/10.1016/j.amjhyper.2005.06.032
ISSN
08957061
PubMed ID
16448886
First Page
161
Last Page
169
Issue
2
Volume
19
Grant
RCD 000211
Fund Ref
Health Services Research and Development
Recommended Citation
Greenberg, Jeffrey D.; Tiwari, Anjali; Rajan, Mangala; Miller, Donald; Natarajan, Sundar; and Pogach, Leonard, "Determinants of sustained uncontrolled blood pressure in a national cohort of persons with diabetes" (2006). Faculty Publications. 19072.
https://digitalcommons.njit.edu/fac_pubs/19072
