Race rural residence, and control of diabetes and hypertension
Race rural residence, and control of diabetes and hypertension
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DOI：
10.1370/afm.119
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发表时间：
2004-11-01
影响因子：
4.4
通讯作者：
Pearson, WS
中科院分区：
文献类型：
--
作者：
Mainous, AG;King, DE;Pearson, WS
非裔美国人患糖尿病和高血压的风险增加，而农村居民历来获得护理的机会减少。目前尚不清楚生活在农村地区和非裔美国人是否会增加糖尿病和高血压的诊断和控制风险。本研究的目的是检查确诊的糖尿病和高血压的患病率，以及控制这两种情况下，农村和城市的非洲裔美国人和whites.METHODS我们进行了第三次全国健康和营养检查调查（1988-1994）的分析。非西班牙裔非裔美国人和20岁及以上的非西班牙裔白色成年人根据农村或城市居住地进行分类（n = 11，755）。调查的结果是以前诊断的糖尿病和高血压和控制糖尿病和hypertension.Results的患病率为4.5%的城市白人，6.5%的农村白人，6.0%的城市非洲裔美国人，9.5%的农村非洲裔美国人。在确诊为糖尿病的患者中，33%的农村白人、43%的城市白人、45%的城市非洲裔美国人和61%的农村非洲裔美国人的糖化血红蛋白（HbA（1c））水平为8%或更高（P <0.01）。在确诊为高血压的患者中，11%的农村白人、13%的城市白人、20%的城市非洲裔美国人和23%的农村非洲裔美国人舒张压大于90 mmHg（P <0.01）。在控制相关变量的回归模型中，包括身体质量指数，健康状况，获得护理，教育，收入和保险，与农村非洲裔美国人相比，农村和城市白人更有可能有更好的血糖控制和舒张压控制。城市非洲裔美国人也有更好的糖尿病控制比农村AfricanAmerican.CONCLUSIONS在这个全国代表性的样本，农村非洲裔美国人的风险增加，缺乏糖尿病和高血压的控制。
PURPOSE African Americans are at increased risk for diabetes mellitus and hypertension, and rural residents have historically had decreased access to care. It is unclear whether living in a rural area and being African American confers added risks for diagnosis and control of diabetes and hypertension. The purpose of this study was to examine the prevalence of diagnosed diabetes and hypertension, as well as control of both conditions, among rural and urban African Americans and whites.METHODS We conducted an analysis of the Third National Health and Nutrition Examination Survey (1988-1994). Non-Hispanic African Americans and non-Hispanic white adults 20 years and older were classified according to rural or urban residence (n = 11,755). Investigated outcomes were previously diagnosed diabetes mellitus and hypertension and control of diabetes and hypertension.RESULTS The prevalence of diagnosed diabetes was 4.5% for urban whites, 6.5% for rural whites, 6.0% for urban African Americans, and 9.5% for rural African' Americans. Among patients with diagnosed diabetes, 33% of rural whites, 43% of urban whites, 45% of urban African American, and 61% of rural African Americans had glycosylated hemoglobin (HbA(1c)) levels of 8% or higher (P < .01). Among patients with diagnosed hypertension, 11% of rural whites, 13% of urban whites, 20% of urban African Americans, and 23% of rural African Americans had diastolic blood pressure greater than 90 mmHg (P < .01). In regression models controlling for relevant variables, including body mass index, health status, access to care, education, income, and insurance, compared with rural African Americans, rural and urban whites were significantly more likely to have better glycemic control and diastolic blood pressure control. Urban African Americans also had better diabetes control than rural African Americans.CONCLUSIONS In this nationally representative sample, rural African Americans are at increased risk for a lack of control of diabetes and hypertension.