Undertreatment of cardiovascular risk factors among persons with diabetes in the United States.
OBJECTIVE
We examined the extent of control of cardiovascular risk factors and distance from goal for those with uncontrolled levels in a recent sample of U.S. adults with diabetes.


METHODS
In the cross-sectional National Health and Nutrition Examination Survey 2001-2002, 532 (projected to 15.2 million) or 7.3% of adults aged >/=18 years had diabetes. Use of antihypertensive, antidiabetic and antidyslipidemic medications was examined. We determined the proportion of subjects not at goal for blood pressure (BP), lipids and glycosylated hemoglobin (A1C) and examined the distance from goal for those not under control.


RESULTS
Overall, 50.2% of subjects with diabetes were not at goal for A1C, 64.6% for low density lipoprotein-cholesterol (LDL-C), 52.3% for high density lipoprotein-cholesterol (HDL-C), 48.6% for triglycerides and 53.0% BP. Only 5.3% of men and 12.7% of women with diabetes were simultaneously at goal for A1C, LDL-C and BP. Even among those on treatment, most were not at goal for these parameters. Women were more likely to have LDL-C and HDL-C not at goal than men. Non-Hispanic Blacks were more often not at goal for BP and LDL-C. Mean distances from targets were 36mg/dL for LDL-C, 18mmHg for systolic BP, 6mmHg for diastolic BP and 2.0% for A1C in patients not at goal.


CONCLUSIONS
Many U.S. adults with diabetes have sub-optimal control of cardiovascular risk factors and remain far from target goals for BP, lipids and A1C, even if on treatment.
Malik
Shaista
S
Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California, Irvine, CA 92697, USA.
Lopez
Victor
V
Chen
Roland
R
Wu
Wei
W
Wong
Nathan D
ND
D001741:Black or African American / Q000706:statistics & numerical data; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D048909:Diabetes Complications / Q000453:epidemiology / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009749:Nutrition Surveys; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008055:Lipids; D014280:Triglycerides; C517652:hemoglobin A1c protein, human