Is the Association of Diabetes With Uncontrolled Blood Pressure Stronger in Mexican Americans and Blacks Than in Whites Among Diagnosed Hypertensive Patients?

被引:10
作者
Liu, Xuefeng [1 ]
Song, Ping [2 ]
机构
[1] E Tennessee State Univ, Coll Publ Hlth, Dept Biostat & Epidemiol, Johnson City, TN 37614 USA
[2] Univ Oklahoma, Hlth Sci Ctr, Coll Med, Dept Internal Med, Oklahoma City, OK 73190 USA
关键词
blood pressure; diabetes; diagnosed hypertension; hypertension; isolated uncontrolled diastolic blood pressure; isolated uncontrolled systolic blood pressure; racial disparity; uncontrolled blood pressure; ISOLATED SYSTOLIC HYPERTENSION; INCIDENT HEART-FAILURE; CHRONIC KIDNEY-DISEASE; NATIONAL-HEALTH; RISK-FACTORS; PREVALENCE; EPIDEMIOLOGY; DISPARITIES; MORTALITY; TRENDS;
D O I
10.1093/ajh/hpt109
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Clinical evidence shows that diabetes may provoke uncontrolled blood pressure (BP) in hypertensive patients. However, racial differences in the associations of diabetes with uncontrolled BP outcomes among diagnosed hypertensive patients have not been evaluated. A total of 6,134 diagnosed hypertensive subjects aged 20 years were collected from the National Health and Nutrition Examination Survey 19992008 with a stratified multistage design. Odds ratios (ORs) and relative ORs of uncontrolled BP and effect differences in continuous BP for diabetes over race/ethnicity were derived using weighted logistic regression and linear regression models. Compared with participants who did not have diabetes, non-Hispanic black participants with diabetes had a 138% higher chance of having uncontrolled BP, Mexican participants with diabetes had a 60% higher chance of having uncontrolled BP, and non-Hispanic white participants with diabetes had a 161% higher chances of having uncontrolled BP. The association of diabetes with uncontrolled BP was lower in Mexican Americans than in non-Hispanic blacks and whites (Mexican Americans vs. non-Hispanic blacks: relative OR 0.55, 95% confidence interval (CI) 0.370.82; Mexican Americans vs. non-Hispanic whites: relative OR 0.53, 95% CI 0.350.80) and the association of diabetes with isolated uncontrolled systolic BP was lower in Mexican Americans than in non-Hispanic whites (Mexican Americans vs. non-Hispanic whites: relative OR 0.62, 95% CI 0.400.96). Mexican Americans have a stronger associaton of diabetes with decreased systolic BP and diastolic BP than non-Hispanic whites, and a stronger association of diabetes with decreased diastolic BP than non-Hispanic blacks. The association of diabetes with uncontrolled BP outcomes is lower despite higher prevalence of diabetes in Mexican Americans than in non-Hispanic whites. The stronger association of diabetes with BP outcomes in whites should be of clinical concern, considering they account for the majority of the hypertensive population in the United States.
引用
收藏
页码:1328 / 1334
页数:7
相关论文
共 33 条
[21]   Hypertension in adults across the age spectrum - Current outcomes and control in the community [J].
Lloyd-Jones, DM ;
Evans, JC ;
Levy, D .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (04) :466-472
[22]   Differences in diabetes prevalence, incidence, and mortality among the elderly of four racial/ethnic groups: Whites, blacks, Hispanics, and Asians [J].
McBean, AM ;
Li, SL ;
Gilbertson, DT ;
Collins, AJ .
DIABETES CARE, 2004, 27 (10) :2317-2324
[23]  
National Health and Nutrition Examination Survey, 1999, PHYS EX PROC MAN
[24]  
National Health and Nutrition Examination Survey, PHYS EX PROC MAN
[25]  
National Health and Nutrition Examination Survey, 2007, PHYS EX PROC MAN
[26]  
National Health and Nutrition Examination Survey, 2003, PHYS EX PROC MAN
[27]   Counseling African Americans to Control Hypertension (CAATCH) Trial A Multi-Level Intervention to Improve Blood Pressure Control in Hypertensive Blacks [J].
Ogedegbe, Gbenga ;
Tobin, Jonathan N. ;
Fernandez, Senaida ;
Gerin, William ;
Diaz-Gloster, Marleny ;
Cassells, Andrea ;
Khalida, Chamanara ;
Pickering, Thomas ;
Schoenthaler, Antoinette ;
Ravenell, Joseph .
CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, 2009, 2 (03) :249-256
[28]   Prevalence, treatment, and control of diagnosed diabetes in the US National Health and Nutrition Examination Survey 1999-2004 [J].
Ong, Kwok Leung ;
Cheung, Bernard M. Y. ;
Wong, Louisa Y. F. ;
Wat, Nelson M. S. ;
Tan, Kathryn C. B. ;
Lam, Karen S. L. .
ANNALS OF EPIDEMIOLOGY, 2008, 18 (03) :222-229
[29]   Diastolic Pressure in Type 2 Diabetes Can target systolic pressure be reached without "diastolic hypotension"? [J].
Osher, Etty ;
Stern, Naftall .
DIABETES CARE, 2008, 31 :S249-S254
[30]   Level of Systolic Blood Pressure Within the Normal Range and Risk of Recurrent Stroke [J].
Ovbiagele, Bruce ;
Diener, Hans-Christophe ;
Yusuf, Salim ;
Martin, Renee H. ;
Cotton, Daniel ;
Vinisko, Richard ;
Donnan, Geoffrey A. ;
Bath, Philip M. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2011, 306 (19) :2137-2144