title: Heart matters: Gender and racial differences cardiovascular disease risk factor control among veterans.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors compared with non-veteran women; however, little is known about gender and racial differences in cardiovascular risk factor control among veterans.
  
  
  METHODS
  We used analysis of variance, adjusting for age, to compare gender and racial differences in three risk factors that predispose to CVD (diabetes, hypertension, and hyperlipidemia) in a cohort of high-risk veterans eligible for enrollment in a clinical trial, including 23,955 men and 1,010 women.
  
  
  RESULTS
  Low-density lipoprotein (LDL) values were higher in women veterans than men with age-adjusted estimated mean values of 111.7 versus 97.6 mg/dL (p < .01). Blood pressures (BPs) were higher among African-American than White female veterans with age-adjusted estimated mean systolic BPs of 136.3 versus 133.5 mmHg, respectively (p < .01), and diastolic BPs of 82.4 versus 78.9 mmHg (p < .01). African-American veterans with diabetes had worse BP, LDL values, and hemoglobin A1c levels, although the differences were only significant among men.
  
  
  CONCLUSIONS
  Female veterans have higher LDL cholesterol levels than male veterans and African-American veterans have higher BP, LDL cholesterol, and A1c levels than Whites after adjusting for age. Further examination of CVD gender and racial disparities in this population may help to develop targeted treatments and strategies applicable to the general population.
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina. Electronic address: karen.goldstein@va.gov.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Goldstein
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina.
authors.forename: S Dee
authors.initials: SD
authors.lastname: Melnyk
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Health Policy and Management, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Leah L
authors.initials: LL
authors.lastname: Zullig
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stechuchak
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina.
authors.forename: Eugene
authors.initials: E
authors.lastname: Oddone
authors.affiliation: VA Connecticut Healthcare System, Newington, Connecticut; University of Connecticut Health Center, Farmington, Connecticut.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.affiliation: Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina.
authors.forename: Susan
authors.initials: S
authors.lastname: Rakley
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina.
authors.forename: Maren K
authors.initials: MK
authors.lastname: Olsen
authors.affiliation: Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina; Departments of Psychiatry and School of Nursing, Duke University, Durham, North Carolina.
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
mesh_terms: D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000208:ethnology* / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D054624:Health Status Disparities; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000208:ethnology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D014768:Virginia / Q000453:epidemiology; D044465:White People
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin