Blood pressure control in an African American sample with diabetes mellitus in an urban eye clinic

Abstract

The adequate control of blood pressure in patients with diabetes mellitus (DM) is important to limit the ocular and systemic complications of the disease. Hypertension in African Americans is among the highest in the world. This cross-sectional study reports the level of blood pressure control in a small sample of African American patients with DM at an urban eye care facility using the criteria defined by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VII). Five attending faculty members of the Illinois College of Optometry identified 234 African American patients with a diagnosis of DM over a period of 16 months. Blood pressure readings were recorded once at the time of their visit and were classified as controlled or uncontrolled based on the JNC VII cutoff of blood pressure less than 130/80 mmHg. Among the 234 African American patients in this study, 174 (74.4%) reported having DM and hypertension, and 60 (25.6%) reported having DM without hypertension. Of the patients with DM and a self-reported diagnosis of hypertension, 13.2% were controlled. Of the patients with diabetes without a self-reported diagnosis of hypertension, 26.7% were found to be adequately controlled. For the pooled data of 234 patients with diabetes, 16.7% met the JNC VII guidelines. The inadequate control of blood pressure in the African American population with DM is associated with increased disability and death from cardiovascular and renal disease. The results of this small cross-sectional study are consistent with those of other studies that show poor control of blood pressure in African American patients who have DM. Preventable blindness secondary to accelerated diabetic retinopathy from uncontrolled hypertension is a concern to all eye care practitioners.