January 1, 2004Journal of Clinical Hypertension
A Statewide Primary Care Approach to Cardiovascular Risk Factor Control in High‐Risk Diabetic and Nondiabetic Patients With Hypertension
Key result
Among high-risk hypertensive patients, all three risk factors were controlled in only 6.6% of diabetics, with higher rates in whites than African Americans (14.8% vs 1.6%, p<0.001).
Population
3,460 high-risk hypertensive patients managed by 57 primary care providers in a statewide program.
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
Poor multifactorial control persists despite prescriptions; leaves open effective strategies to address racial disparities in high-risk diabetics.
Study Design
Type
Cross-Sectional (n=3,460)
Multicenter
Yes
Structured PICO
P
Population
3,460 high-risk hypertensive patients, including 2,199 with diabetes and 1,261 with clinical cardiovascular disease, evaluated for cardiovascular risk factor control in primary care.
E
Exposure
Statewide primary care program to monitor cardiovascular risk factor control
O
Outcome
Control rates of blood pressure, low-density lipoprotein (LDL) cholesterol, and glycosylated hemoglobin (HbA1c)surrogate
Main Result
Absolute Event Rate: 89.9% vs 70.8%
p-value: p=<0.05
Despite high rates of evidence-based medication prescription, simultaneous control of multiple cardiovascular risk factors remains extremely low in high-risk primary care patients, with significant racial disparities.
Cite This Study
Basile et al. (2004) conducted a cross-sectional in High-risk hypertension (n=3,460). Diabetes vs. Nondiabetes was evaluated on Prescription of an angiotensin-converting enzyme inhibitor, angiotensin receptor blocker, or both (p=<0.05). Among high-risk hypertensive patients, all three risk factors were controlled in only 6.6% of diabetics, with higher rates in whites than African Americans (14.8% vs 1.6%, p<0.001).