Faculty Articles

A Comparison of the Use of Clinical-Guideline-Recommended Antihypertensive Regimens in Mexican American, Non-Hispanic Black, and Non-Hispanic White Adults With Type 2 Diabetes and Hypertension in the United States: NHANES 2003-2012

Publication Title

The Diabetes Educator

Publisher

American Association of Diabetes Educators

ISSN

1554-6063

Publication Date

4-1-2016

Keywords

adult, African Americans, antihypertensive agents, diabetes mellitus, type 2, European continental ancestry group, female, guideline adherence, healthcare disparities, humans, hypertension, male, Mexican Americans, middle aged, nutrition surveys, practice guidelines as topic, United States

Abstract

Purpose: The purpose of this study was to determine the use of clinical-guideline-recommended antihypertensive regimens among Mexican Americans (MAs) and non-Hispanic blacks and whites with type 2 diabetes and hypertension.

Methods: A secondary data analysis based on National Health and Nutrition Examination Survey 2003-2012 cohort data included 1857 noninstitutionalized civilian MA, black, and white adults with type 2 diabetes and hypertension. Unadjusted and adjusted 2-way analysis of variance models evaluated whether there was a difference in the use of recommended antihypertensive regimens across race/ethnic group.

Results: There was no difference in the use of recommended regimens across race/ethnic group (MAs, 79.1%; blacks, 81.7%; whites, 82.3%). Similarly, there was no difference between blood pressure goal levels and the use of recommended therapies across race/ethnicity (P = .632). Mexican Americans were least likely and blacks most likely to be on 3 or more antihypertensive drug classes (16.8% vs 28%). Furthermore, MAs were least likely to be on recommended add-on therapies such as calcium channel blockers and diuretics.

Conclusion: Racial/ethnic medication use disparities were observed when looking at the number of antihypertensive drug classes per patient regimen, and add-on therapy use was evaluated. Along with lifestyle modifications, frequent antihypertensive regimen reassessment is necessary.

DOI

10.1177/0145721716666680

Volume

42

Issue

6

First Page

739

Last Page

747

Disciplines

Medicine and Health Sciences | Pharmacy and Pharmaceutical Sciences

Peer Reviewed

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