Background— Despite progress, many hypertensive patients remain uncontrolled. Defining characteristics of uncontrolled hypertensives may facilitate efforts to improve blood pressure control. Methods and Results— Subjects included 13 375 adults from National Health Nutrition Examination Surveys (NHANESs) subdivided into 1988 1994, 1999 2004, 2005 2008. Uncontrolled hypertension was defined as ≥140/≥90 mm Hg apparent treatment-resistant (aTRH) when subjects reported taking ≥3 antihypertensive...

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Background One in 3 US adults has high blood pressure, or hypertension. As prior projections suggest hypertension is the costliest of all cardiovascular diseases, it important to define current state healthcare expenditures related Methods and Results We used a nationally representative database, Medical Expenditure Panel Survey, calculate estimated annual expenditure for patients with measure trends longitudinally over 12‐year period. A 2‐part model was estimate adjusted incremental...

OBJECTIVE To examine the longitudinal effects of medication nonadherence (MNA) on key costs and estimate potential savings from increased adherence using a novel methodology that accounts for shared correlation among cost categories. RESEARCH DESIGN AND METHODS Veterans with type 2 diabetes (740,195) were followed January 2002 until death, loss to follow-up, or December 2006. A multivariate, generalized, linear, mixed modeling approach was used assess differential effect MNA, defined as...

We performed a retrospective analysis of national cohort veterans with diabetes to better understand regional, geographic, and racial/ethnic variation in control as measured by HbA(1c).A study was conducted 690,968 receiving prescriptions for insulin or oral hypoglycemic agents 2002 that were followed over 5-year period. The main outcome measures HbA(1c) levels (as continuous dichotomized at ≥8.0%).Relative non-Hispanic whites (NHWs), remained 0.25% higher blacks (NHBs), 0.31% Hispanics,...

BACKGROUND: Medication adherence, a critical component of glycemic control for patients with type 2 diabetes, differs by race/ethnicity. However, few studies have examined regional and rural/urban differences in medication adherence whether racial/ethnic persist after controlling these differences. OBJECTIVE: To examine regional, rural/urban, national sample veterans diabetes. METHODS: We performed cohort study diabetes (N = 690,968) receiving prescriptions insulin or oral hypoglycemic...

Hypertension (HTN) is a prevalent and important risk factor for both cardiovascular all-cause mortality. Depression often present in hypertensive patients has also been associated with increased mortality risk. The aim of this study was to evaluate the association depressive symptoms ischemic heart disease (IHD) among adults self-reported HTN.We studied 10,025 participants National Health Nutrition Epidemiologic Follow-up Study (NHANES I) who were alive interviewed 1982 had complete data...

J Clin Hypertens (Greenwich). 2010;12:698–705. © 2010 Wiley Periodicals, Inc. Hypertension is prevalent in the population at large and among hospitalized patients. Little has been reported regarding attitudes patterns of care physicians managing nonemergent elevated blood pressure (BP) inpatients. Resident internal medicine (IM), family (FM), surgery were surveyed inpatient BP management. One hundred eighty‐one questionnaires completed across 3 sites. Respondents generally considered control...

The aim of the study was to examine whether depression impacts medication nonadherence (MNA) over time and determine if race has a differential impact on MNA in patients with type 2 diabetes comorbid depression. Generalized estimating equations were used longitudinal national cohort 740,197 veterans diabetes. main outcome defined by <80% possession ratio for medications. primary independent variable Analyses adjusted nature data covariates including age, sex, marital status, rural/urban...

Geographic and racial/ethnic disparities related to diabetes control treatment have not previously been examined at the national level.

J Clin Hypertens (Greenwich) Treatment of hypertension among hospitalized patients represents an opportunity to improve blood pressure recognition and treatment. To address this issue, the authors examined patterns antihypertensive medication prescribing 5668 hypertensive inpatients. Outcomes were treatment with any first‐line therapy, defined as angiotensin‐converting enzyme inhibitors, β‐blockers, thiazide diuretics, or calcium channel blockers. Logistic regression models adjusting for...

Purpose To assess the impact of mental health visits (MHV) on cost care for Veterans with diabetes and comorbid conditions. Methods A national cohort 120,852 at least one diagnosis (i.e., substance abuse, depression or psychoses) in 2002 was followed through 2006. Outcomes were pharmacy, inpatient outpatient costs 2012 dollars. Results Least-square covariate adjusted estimates from joint model total VA number MHV using December 31, value dollars indicate that relative to those fewer MHV, 3+...

Increasing scrutiny of hospital readmission rates has spurred a wide variety quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is statewide learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other organizations. Measures...