4.5 Article

HEMOGLOBIN A1C, BLOOD PRESSURE, AND LDL-CHOLESTEROL CONTROL AMONG HISPANIC/LATINO ADULTS WITH DIABETES: RESULTS FROM THE HISPANIC COMMUNITY HEALTH STUDY/STUDY OF LATINOS (HCHS/SOL)

Journal

ENDOCRINE PRACTICE
Volume 23, Issue 10, Pages 1232-1253

Publisher

AMER ASSOC CLINICAL ENDOCRINOLOGISTS
DOI: 10.4158/EP171765.OR

Keywords

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Funding

  1. National Heart, Lung, and Blood Institute [N01-HC65233]
  2. University of Miami [N01-HC65234]
  3. Albert Einstein College of Medicine [N01-HC65235]
  4. Northwestern University [N01-HC65236]
  5. San Diego State University [N01-HC65237]
  6. National Institutes of Health (NIH) institutes, centers, and offices
  7. National Institute of Diabetes and Digestive and Kidney Diseases [GS-10F-0381L]
  8. National Institute on Minority Health and Health Disparities
  9. National Institute on Deafness and Other Communication Disorders
  10. National Institute of Dental and Craniofacial Research
  11. National Institute of Diabetes and Digestive and Kidney Diseases
  12. National Institute of Neurological Disorders and Stroke
  13. NIH Office of Dietary Supplements

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Objective: To determine the prevalence of Hispanic/Latino adults with diabetes who meet target hemoglobin A1c, blood pressure (BP), and low-density-lipoprotein cholesterol (LDL-C) recommendations, and angiotensin-converting enzyme (ACE) inhibitors/angiotensin receptor blocker (ARB) and statin medication use by heritage and sociodemographic and diabetes-related characteristics. Methods: Data were cross-sectional, collected between 2008 and 2011, and included adults age 18 to 74 years who reported a physician diagnosis of diabetes in the Hispanic Community Health Study/Study of Latinos (N = 2,148). Chi-square tests compared the prevalence of hemoglobin A1c, BP, and LDL-C targets and ACE/ARB and statin use across participant characteristics. Predictive margins regression was used to determine the prevalence adjusted for sociodemographic characteristics. Results: The overall prevalence of A1c <7.0% (53 mmol/mol), BP <130/80 mm Hg, and LDL-C <100 mg/dL was 43.0, 48.7, and 36.6%, respectively, with 8.4% meeting all three targets. Younger adults aged 18 to 39 years with diabetes were less likely to have A1c <7.0% (53 mmol/mol) or LDL-C <100 mg/dL compared to those aged 65 to 74 years; younger adults were more likely to have BP <130/80 mm Hg (P<.05 for all). Individuals of Mexican heritage were significantly less likely to have A1c <7.0% (53 mmol/mol) compared to those with Cuban heritage, but they were more likely to have BP <130/80 mm Hg compared to those with Dominican, Cuban, or Puerto Rican heritage (P<.05 for all); there was no difference in LDL-C by heritage. Overall, 38.2% of adults with diabetes were taking a statin, and 50.5% were taking ACE/ARB medications. Conclusion: Hemoglobin A1c, BP, and LDL-C control are suboptimal among Hispanic/Latinos with diabetes living in the U.S. With 8.4% meeting all three recommendations, substantial opportunity exists to improve diabetes control in this population.

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