Cardiovascular risk management of different ethnic groups with type 2 diabetes in primary care in New Zealand.
OBJECTIVE
To examine cardiovascular preventive and renal protective treatment for different ethnic groups with diabetes in primary care.


METHODS
The study population included patients with type 2 diabetes attending an annual review in New Zealand primary care during 2004. Primary care data were linked to hospital admission data to identify previous cardiovascular disease (CVD). For those without previous CVD, 5-year cardiovascular risk was calculated. Proportions on, and predictors of appropriate treatment according to guidelines were investigated.


RESULTS
Data were available on 29,179 patients. Maori and Pacific participants had high rates of obesity, poor glycaemic control and albuminuria. Two thirds of all participants with previous CVD (68% of Maori and 70% of Pacific) and 44% with high CVD risk received appropriate CVD treatment; 73% of Maori, 62% of Pacific and 65% of European patients with albuminuria received ACE-inhibitors. Those with high CVD risk were more likely, and those that were young were less likely, to receive anti-hypertensive and lipid-lowering treatment after controlling for other factors.


CONCLUSIONS
Maori and Pacific people were receiving similar high rates of appropriate CVD and renal preventive drug therapy to Europeans, but their prevalence of smoking, obesity, raised HbA1c and albuminuria were substantially higher. Non-drug components of preventive care also need to be addressed to reduce major ethnic disparities in diabetes-related morbidity and mortality in New Zealand.
Elley
C Raina
CR
Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand. c.elley@auckland.ac.nz
Kenealy
Tim
T
Robinson
Elizabeth
E
Bramley
Dale
D
Selak
Vanessa
V
Drury
Paul L
PL
Kerse
Ngaire
N
Pearson
Janet
J
Lay-Yee
Roy
R
Arroll
Bruce
B
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D012307:Risk Factors; D044465:White People
D000959:Antihypertensive Agents