Blood Pressure Control across Subgroups with Diabetes
Rising prevalence of obesity and sedentary lifestyles in the US contribute to diabetes and hypertension, posing increased health risks. Louisiana's adult population faces a significant challenge, with about 40% estimated to have high blood pressure. This study by Elizabeth Long, a 4th-year LSU medical student, examines blood pressure control in individuals aged 18-85 with both diabetes and hypertension, highlighting interventions and control rates across different subgroups.
Download Presentation
Please find below an Image/Link to download the presentation.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.If you encounter any issues during the download, it is possible that the publisher has removed the file from their server.
You are allowed to download the files provided on this website for personal or commercial use, subject to the condition that they are used lawfully. All files are the property of their respective owners.
The content on the website is provided AS IS for your information and personal use only. It may not be sold, licensed, or shared on other websites without obtaining consent from the author.
E N D
Presentation Transcript
Blood Pressure Control Across Subgroups with Diabetes By Elizabeth Long 4thYear LSU Medical Student
Background There is a rising prevalence of obesity and sedentary lifestyles in the United States, and both are major drivers of diabetes and HTN Over 70% of individuals with diabetes 18 years of age or older have hypertension The coexistence of HTN and diabetes in patients greatly increases their risk for cardiovascular disease, cerebrovascular accidents, retinopathy, nephropathy Louisiana s estimated percentage of adults with high BP ~40% of the total state population (vs US total percentage ~32%) This estimate in Louisiana is also ~14% higher than it was 20 years ago
Background Population of Interest: Members of the population turning 18-85 years of age who had a diagnosis of HTN and diabetes What percentage had their BP adequately controlled (<140/90 mmHg) across different subgroups? 2023 Prospective Rates for Controlling Blood Pressure Measure: Total: 14,782 patients in the measure Controlled: 5883 39.80% Admin 2023 Final Rate: 60.80% *after chart review
ACLA Current Interventions Some examples of current ACLA interventions for those w/ diabetes/hypertension: Care Card Member Incentive $10 annually for completing all three: hemoglobin A1C (HbA1c) testing, dilated eye exam, and kidney screening Population Health Disease Management Mailing to those newly diagnosed w/ diabetes Collaborations with faith groups and/or local wellness centers with hosting eye clinics/nutritional counseling
The Population Total Population of Interest: 9413 Controlled: 4038 Not Controlled: 5375 Sex Male: 3243 Controlled: 1314 Not Controlled: 1929 Female: 6170 Controlled: 2724 Not Controlled: 3446
Blood Pressure Control in Diabetics with Hypertension Controlled , 43% Not Controlled, 57%
Blood Pressure Control in Female vs. Male Diabetics with Hypertension 45% 44% 44% 44% 43% 43% 42% 42% 41% 41% 41% 40% 40% Females Males % Controlled
Across the State of Louisiana Urban Total Population: 6570 Controlled: 2984 Not Controlled: 3586 Rural Total Population: 2802 Controlled: 1038 Not Controlled: 1764
Blood Pressure Control in Diabetics with Hypertension in Urban Vs Rural Pops. 50% 45% 45% 40% 37% 35% 30% 25% 20% 15% 10% 5% 0% Rural Urban % Controlled
Blood Pressure Control in Diabetics with Hypertension in Urban Parishes 90% 83% 80% 68%69% 70% 50% 50%51% 51%52%53%54%56%57% 57%60%61% 60% 50% 39%40%43% 43% 40% 32%35% 24%25%28% 28% 30% 17% 20% 10% 0% % Controlled
Blood Pressure Control in Diabetics with Hypertension in Rural Parishes 70% 62%62% 60% 28%28%28%30%32%34%36%37%38%38%40%43%43%44%44%45%46%47%49%50%52%52% 50% 40% 30% 23% 18%18% 20% 10%11%13%14% 10% 0% Saint Mary Saint Landry Vernon Avoyelles Beauregard Allen Saint James Morehouse Acadia Claiborne Evangeline Sabine Concordia Assumption East Carroll Jackson Catahoula Natchitoches Franklin Washington Winn Iberia La Salle Caldwell Richland Lincoln Vermilion Tangipahoa Webster Bienville Jefferson Davis % Controlled
Blood Pressure Control in Diabetics by Race Black or African American: 5160 Controlled: 2140 Not Controlled: 3020 White: 3424 Controlled: 1502 Not Controlled: 1921 Asian: 145 Controlled: 80 Not Controlled: 65 American Indian or Alaskan Native: 78 Controlled: 41 Not Controlled: 37 Unknown Race: 476 Controlled: 208 Not Controlled: 268 Two or More Races: 123 Controlled: 41 Not Controlled: 37
Blood Pressure Control in Diabetics by Race 60% 55% 53% 52% 50% 44% 44% 41% 40% 30% 20% 10% 0% Black or African American White Unknown Race Two or More Races American Indian and Alaskan Native Asian % Controlled
Blood Pressure Control in Diabetics with other Co-Morbidities Tobacco User: 3171 Those that responded Yes to tobacco use Controlled: 1377 Not Controlled: 1749 Chronic Kidney Disease: 760 Controlled: 336 Not Controlled: 424 Atherosclerosis: 168 Controlled: 80 Not Controlled: 88
Blood Pressure Control in Diabetics with Hypertension and other High-Risk Co-Morbidity 49% 48% 48% 47% 46% 45% 44% 44% 43% 43% 42% 41% 40% Tobacco Use Chronic Kidney Disease Atherosclerosis % Controlled
Blood Pressure Control in Diabetics by Age Age 18-24: 381 Controlled: 172 Not Controlled: 209 Age 25-34: 1010 Controlled: 436 Not Controlled: 574 Age 35-44: 1940 Controlled: 781 Not Controlled: 1159 Age 45-54: 2613 Controlled: 1086 Not Controlled: 1527 Age 55-64: 3373 Controlled: 1515 Not Controlled: 1858 Age 65-75: 95 Controlled: 47 Not Controlled: 48
Blood Pressure Control in Diabetics by Age Group 60% 49% 50% 45% 45% 43% 42% 40% 40% 30% 20% 10% 0% Age 18-24 Age 25-34 Age 35-44 Age 45-54 Age 55-64 Age 65-75 % Controlled
Summary & Recommendations There is a greater number of urban parishes with percent controlled at or above 50% than rural parishes Less optimal BP control seen in rural and/or Black/African American communities ACLA currently has ongoing education campaign for those newly diagnosed with diabetes in rural areas, and is investigating root-cause barriers specific to African Americans Continue to facilitate these campaigns, and also cater to those with HTN
Summary & Recommendations Higher % BP control in those with atherosclerosis compared to other high-risk groups Why are those with atherosclerosis more successful with controlling their BP? Are those with CKD, for example, more prone to difficulty with BP control? Out of the racial groups analyzed, Asians had the best percent control Analyze what factors make this group successful Younger age groups with diabetes tend to have lower % controlled HTN compared to older populations Consider more social media campaigns to reach out to younger patients with diabetes
Acknowledgements & Sources Special thanks to Dr. Randolph, Rene Wells, Dana Smith, and Shea Good for all their help with drafting, data collections, and answering my many question! Khangura DS, Waqar Salam M, Brietzke SA, Sowers JR. Hypertension in Diabetes. PubMed. Published August 7, 2021. https://www.ncbi.nlm.nih.gov/books/NBK279027/. Hypertension | La Dept. of Health. La.gov. Published 2023. https://ldh.la.gov/page/hypertension ACLA Clinical Quality Improvement Activity ACLA Data
Blood Pressure Control in Diabetics with Hypertension in Rural Parishes 70% 62%62% 60% 28%28%28%30%32%34%36%37%38%38%40%43%43%44%44%45%46%47%49%50%52%52% 50% 40% 30% 23% 18%18% 20% 10%11%13%14% 10% 0% Saint Mary Saint Landry Vernon Avoyelles Beauregard Allen Saint James Morehouse Acadia Claiborne Evangeline Sabine Concordia Assumption East Carroll Jackson Catahoula Natchitoches Franklin Washington Winn Iberia La Salle Caldwell Richland Lincoln Vermilion Tangipahoa Webster Bienville Jefferson Davis % Controlled
Blood Pressure Control in Diabetics with Hypertension in Urban Parishes 90% 83% 80% 68%69% 70% 50% 50%51% 51%52%53%54%56%57% 57%60%61% 60% 50% 39%40%43% 43% 40% 32%35% 24%25%28% 28% 30% 17% 20% 10% 0% % Controlled
