Factors Associated with Control of Hypertension, Hypercholesterolemia, and Diabetes Among Low-Income Women in West Virginia

Background: Adequate control of cardiovascular risk factors, such as hypertension, hypercholesterolemia, and diabetes, requires management. Low-income women living in rural areas with limited health services may experience special challenges in managing chronic conditions. Methods: In 2008, we conducted an analysis of the baseline, cross-sectional survey of 733 uninsured, low-income, rural women aged 40-64 years participating in the Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) project in West Virginia to characterize prevalence, treatment, and control of hypertension, hypercholesterolemia, and diabetes. Data were collected from 2004 to 2007. Results: About 56% of the women had hypertension (38% of which was untreated or uncontrolled), 45% had hypercholesterolemia (31% of which was untreated or uncontrolled), and 19% had diabetes (26% of which was untreated or uncontrolled). Multivariable analyses showed that those with a regular physician were less likely than those without a physician to have uncontrolled hypertension (adjusted odds ratio [AOR] 0.34, 95% CI 0.13-0.88) and hypercholesterolemia (AOR 0.14, 95% CI 0.04-0.47). Education level was also a significant predictor for uncontrolled hypertension, and physical activity level (measured by total metabolic equivalent [ MET] hours) significantly predicted uncontrolled hypercholesterolemia (AOR 1.01, 95% CI 1.001-1.02). For diabetes, race/ethnicity was the main predictor; white women were less likely than other groups to have untreated or uncontrolled diabetes. Conclusions: High proportions of women in the WV-WISEWOMAN project had uncontrolled hypertension, hypercholesterolemia, and diabetes at baseline. These study results should be used to inform programs seeking to increase access to health services in order to reduce consequences of uncontrolled chronic conditions.