Longitudinal ethnic differences in multiple cardiovascular risk factor control in a cohort of US adults with diabetes

Aim: To examine longitudinal differences in multiple cardiovascular risk factor control (glycemia, blood pressure, and lipids) by race/ethnicity. Methods: Data were analyzed on a cohort of 11,203 veterans with type 2 diabetes. Primary outcome was odds of none of the risk factors out of control vs. having at least one out of control (HbA1c > 8.0%, BP > 140/90 mmHg, and LDL > 100 mg/dL). Secondary outcome was odds of having none out of control vs. having one, two or three risk factors out of control, respectively. Generalized linear mixed models assessed the relationship between race/ethnicity and multiple risk factor control adjusted for covariates. Results: Adjusted models for primary outcome showed that NHB had two-fold (95% CI 1.8-2.3) and Hispanics had 48% higher (95% CI 1.3-1.7) odds of multiple risk factors out of control over time compared to NHW. Adjusted models for secondary outcome showed that NHB and Hispanics also had higher odds of having one, two, and three risk factors out of control over time compared to NHW. Conclusions: Ethnic minority veterans with diabetes are less likely to have multiple cardiovascular risk factor control over time compared to whites. Thus, greater risk reduction efforts are needed to reduce the heavier disease burden among ethnic minorities. (C) 2011 Elsevier Ireland Ltd. All rights reserved.