Trends in utilization of lipid- and blood pressure-lowering agents and goal attainment among the U.S. diabetic population, 1999-2008

Cardiovasc Diabetol. 2011 Apr 17;10:31. doi: 10.1186/1475-2840-10-31.

Abstract

Background: For patients with diabetes, clinical practice guidelines recommend treating to a low-density lipoprotein cholesterol (LDL-C) goal of < 2.59 mmol/L (100 mg/dL) and a blood pressure (BP) target of <130/80 mmHg. This analysis assessed recent trends in the utilization of lipid-lowering and BP-lowering agents, as well as LDL-C and BP goal attainment, in the U.S. adult diabetic population.

Methods: 9,167 men and nonpregnant women aged ≥ 20 years were identified from the fasting subsample of the 1999-2008 National Health and Nutritional Examination Survey. Diabetes was identified in 1,214 participants by self report, self-reported use of insulin or oral medications for diabetes, or fasting glucose ≥ 6.99 mmol/L (126 mg/dL).

Results: The prevalence of diagnosed or undiagnosed diabetes increased significantly over the past decade, from 7.4% in 1999-2000 to 11.9% in 2007-2008 (P = 0.0007). During this period, the use of lipid-lowering agents by participants with diabetes increased from 19.5% to 42.2% (P < 0.0001), and the proportion at LDL-C goal increased from 29.7% to 54.4% (P < 0.0001). Although there was a significant increase in antihypertensive medication use (from 35.4% to 58.9%; P < 0.0001), there was no significant change in the proportion of participants at BP goal (from 47.6% to 55.1%; P = 0.1333) or prevalence of hypertension (from 66.6% to 74.2%; P = 0.3724).

Conclusions: The proportion of diabetic individuals taking lipid- and BP-lowering agents has increased significantly in recent years. However, while there has been a significant improvement in LDL-C goal attainment, nearly one-half of all U.S. adults with diabetes are not at recommended LDL-C or BP treatment goals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antihypertensive Agents / therapeutic use*
  • Biomarkers / blood
  • Blood Pressure / drug effects
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / prevention & control*
  • Cholesterol, LDL / blood*
  • Cross-Sectional Studies
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / blood
  • Dyslipidemias / drug therapy*
  • Dyslipidemias / epidemiology
  • Female
  • Guideline Adherence
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / physiopathology
  • Hypolipidemic Agents / therapeutic use*
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians'* / statistics & numerical data
  • Prevalence
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology

Substances

  • Antihypertensive Agents
  • Biomarkers
  • Cholesterol, LDL
  • Hypolipidemic Agents