title: Trajectory of systolic blood pressure in a low-income, racial-ethnic minority cohort with diabetes and baseline uncontrolled hypertension.
abstract: In two primary care clinics in Texas serving low-income patients, systolic blood pressure (SBP) trajectory was examined during 2 years in patients with diabetes mellitus (mean SBP ≥140 mm Hg: 152 mm Hg±11.2 in the baseline year). Among 860 eligible patients, 62.0% were women, 78.8% were Hispanic, and 41.2% were uninsured. Overall, SBP dropped 0.56 mm Hg per month or 13.4 mm Hg by 24 months. For patients with mean glycated hemoglobin ≥9% in year 1, SBP declined 4.8 mm Hg less by 24 months vs those with glycated hemoglobin <7% (P=.03). Compared with white women, SPB declined 7.2 mm Hg less by 24 months in Hispanic women (P=.03) and 9.6 mm Hg less by 24 months in black men (P=.04). SBP also declined 9.1 mm Hg less by 24 months for patients taking four or more blood pressure drug classes at baseline vs one drug class. In this low-income cohort, clinically complex patients and racial-ethnic minorities had clinically significantly smaller declines in SBP.
authors.affiliation: Division of General Internal Medicine, Duke University, Durham, NC, USA.|Durham Center for Health Services Research and Development in Primary Care, Durham Veterans Affairs Health Care System, Durham, NC, USA.
authors.forename: Leah L
authors.identifier: http://orcid.org/0000-0002-6638-409X
authors.initials: LL
authors.lastname: Zullig
authors.affiliation: Center for Research to Advance Community Health, University of Texas Health Science Center, San Antonio, TX, USA.|Department of Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Liang
authors.affiliation: Center for Research to Advance Community Health, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: Shruthi
authors.initials: S
authors.lastname: Vale Arismendez
authors.affiliation: Center for Research to Advance Community Health, University of Texas Health Science Center, San Antonio, TX, USA.|Department of Epidemiology and Biostatistics, University of Texas Health Science Center, San Antonio, TX, USA.
authors.forename: Aron
authors.initials: A
authors.lastname: Trevino
authors.affiliation: Division of General Internal Medicine, Duke University, Durham, NC, USA.|Durham Center for Health Services Research and Development in Primary Care, Durham Veterans Affairs Health Care System, Durham, NC, USA.|Department of Psychiatry and Behavioral Sciences and School of Nursing, Duke University, Durham, NC, USA.
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.affiliation: Center for Research to Advance Community Health, University of Texas Health Science Center, San Antonio, TX, USA.|Department of Medicine, University of Texas Health San Antonio, San Antonio, TX, USA.
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Turner
mesh_terms: D001741:Black or African American; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D048909:Diabetes Complications / Q000188:drug therapy / Q000208:ethnology*; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006630:Hispanic or Latino; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000208:ethnology*; D015995:Prevalence; D013781:Texas / Q000208:ethnology; D000074822:Treatment Adherence and Compliance / Q000208:ethnology
chemical_list: D000959:Antihypertensive Agents
keywords: Latinos; diabetes mellitus; hypertension; poverty; vulnerable populations