Cardiovascular comorbidities among public health clinic patients with diabetes: the Urban Diabetics Study

BMC Public Health. 2005 Feb 8;5:15. doi: 10.1186/1471-2458-5-15.

Abstract

Background: We sought to determine the frequency and distribution of cardiovascular comorbidities in a large cohort of low-income patients with diabetes who had received primary care for diabetes at municipal health clinics.

Methods: Outpatient data from the Philadelphia Health Care Centers was linked with hospital discharge data from all Pennsylvania hospitals and death certificates.

Results: Among 10,095 primary care patients with diabetes, with a mean observation period of 4.6 years (2.8 after diabetes diagnosis), 2,693 (14.3%) were diagnosed with heart disease, including 270 (1.4%) with myocardial infarction and 912 (4.8%) with congestive heart failure. Cerebrovascular disease was diagnosed in 588 patients (3.1%). Over 77% of diabetic patients were diagnosed with hypertension. Incidence rates of new complications ranged from 0.6 per 100 person years for myocardial infarction to 26.5 per 100 person years for hypertension. Non-Hispanic whites had higher rates of myocardial infarction, and Hispanics and Asians had fewer comorbid conditions than African Americans and non-Hispanic whites.

Conclusion: Cardiovascular comorbidities were common both before and after diabetes diagnosis in this low-income cohort, but not substantially different from mixed-income managed care populations, perhaps as a consequence of access to primary care and pharmacy services.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases / classification
  • Cardiovascular Diseases / ethnology*
  • Cardiovascular Diseases / mortality
  • Child
  • Child, Preschool
  • Community Health Centers / statistics & numerical data*
  • Comorbidity
  • Death Certificates
  • Diabetic Angiopathies / ethnology*
  • Diabetic Angiopathies / therapy
  • Diagnosis-Related Groups
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Patient Discharge
  • Pennsylvania / epidemiology
  • Primary Health Care / statistics & numerical data*
  • Urban Population / statistics & numerical data