1. Diabetes and age-related demographic differences in risk factor control
- Author
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Angelo Sinopoli, Jiexiang Li, Brent M. Egan, and Tamara E. Wolfman
- Subjects
Adult ,Male ,Gerontology ,Ethnic group ,Blood Pressure ,Risk Assessment ,Article ,Age Distribution ,Risk Factors ,Age related ,Diabetes mellitus ,Diabetes Mellitus ,Ethnicity ,Prevalence ,Internal Medicine ,Humans ,Medicine ,Risk factor ,Aged ,Retrospective Studies ,business.industry ,Age Factors ,Retrospective cohort study ,Middle Aged ,Nutrition Surveys ,medicine.disease ,United States ,Health equity ,Blood pressure ,Hypertension ,Female ,Cardiology and Cardiovascular Medicine ,Risk assessment ,business - Abstract
Disparate vascular outcomes in diabetes by race and/or ethnicity may reflect differential risk factor control, especially pre-Medicare. Assess concurrent target attainment for glycohemoglobin7%, non-high density lipoprotein-cholesterol130 mg/dL, and blood pressure140/90 mm Hg in white, black, and Hispanic diabetics65 years and ≥65 years of age. The National Health and Nutrition Examination Surveys 1999-2010 data were analyzed on diagnosed and undiagnosed diabetics ≥18 years old. Concurrent target attainment was higher in whites (18.7%) than blacks (13.4% [P = .02] and Hispanics [10.3%, P.001]65 years but not ≥65 years of age; 20.0% vs. 15.9% [P = .13], 19.5% [P = .88]). Disparities in health care insurance among younger whites, blacks, and Hispanics, respectively, (87.4% vs. 81.1%, P.01; 68.0%, P.001) and infrequent health care (0-1 visits/y; 14.3% vs. 15.0%, P = not significant; 32.0%, P.001) declined with age. Cholesterol treatment predicted concurrent control in both age groups (multivariable odds ratio2, P.001). Risk factor awareness and treatment were lower in Hispanics than whites. When treated, diabetes and hypertension control were greater in whites than blacks or Hispanics. Concurrent risk factor control is low in all diabetics and could improve with greater statin use. Insuring younger adults, especially Hispanic, could raise risk factor awareness and treatment. Improving treatment effectiveness in younger black and Hispanic diabetics could promote equitable risk factor control.
- Published
- 2014