Open AccessHypertension control after an initial cardiac event among Medicare patients with diabetes mellitus: A multidisciplinary group practice observational study
Author(s) -
Chaddha Ashish,
Smith Maureen A.,
Palta Mari,
Johnson Heather M.
Publication year - 2018
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/jch.13282
Subject(s) - medicine , diabetes mellitus , guideline , observational study , emergency medicine , intensive care medicine , hazard ratio , population , retrospective cohort study , disease , specialty , proportional hazards model , physical therapy , family medicine , confidence interval , environmental health , pathology , endocrinology
Patients with diabetes mellitus and cardiovascular disease have a high risk of mortality and/or recurrent cardiovascular events. Hypertension control is critical for secondary prevention of cardiovascular events. The objective was to determine rates and predictors of achieving hypertension control among Medicare patients with diabetes and uncontrolled hypertension after hospital discharge for an initial cardiac event. A retrospective analysis of linked electronic health record and Medicare data was performed. The primary outcome was hypertension control within 1 year after hospital discharge for an initial cardiac event. Cox proportional hazard models assessed sociodemographics, medications, utilization, and comorbidities as predictors of control. Medicare patients with diabetes were more likely to achieve hypertension control when prescribed beta‐blockers at discharge or with a history of more specialty visits. Adults ≥ 80 were more likely to achieve control with diuretics. These findings demonstrate the importance of implementing guideline‐directed multidisciplinary care in this complex and high‐risk population.