Trajectory of systolic blood pressure in a low-income, racial-ethnic minority cohort with diabetes and baseline uncontrolled hypertension.

Abstract

In two primary care clinics in Texas serving low-income patients, systolic blood pressure (SBP) trajectory was examined during 2years in patients with diabetes mellitus (mean SBP ≥140mm Hg: 152mm Hg±11.2 in the baseline year). Among 860 eligible patients, 62.0% were women, 78.8% were Hispanic, and 41.2% were uninsured. Overall, SBP dropped 0.56mm Hg per month or 13.4mm Hg by 24months. For patients with mean glycated hemoglobin ≥9% in year 1, SBP declined 4.8mm Hg less by 24months vs those with glycated hemoglobin <7% (P=.03). Compared with white women, SPB declined 7.2mm Hg less by 24months in Hispanic women (P=.03) and 9.6mm Hg less by 24months in black men (P=.04). SBP also declined 9.1mm Hg less by 24months for patients taking four or more blood pressure drug classes at baseline vs one drug class. In this low-income cohort, clinically complex patients and racial-ethnic minorities had clinically significantly smaller declines in SBP.