Elevated blood pressure among U.S. adults with diabetes, 1988-1994.

BACKGROUND: Recent guidelines and clinical trial results emphasize the importance of controlling blood pressure among people with diabetes. We estimated the prevalence of elevated blood pressure among U.S. adults with diagnosed diabetes, and examined the extent to which elevated blood pressure is being treated and controlled.
METHODS: The Third National Health and Nutrition Examination Survey (1988-1994), a probability survey of the civilian, non-institutionalized population of the United States, consisted of an interview and physical examination, which included blood pressure measurement. Survey participants included 1507 adults (aged > or = 18 years) with self-reported diabetes. Among people with self-reported diabetes, we estimated elevated blood pressure (mean blood pressure of > or = 130/85 mm Hg or use of antihypertensive medication); awareness (prior diagnosis of hypertension); treatment (antihypertensive medication use); and control (mean blood pressure of <130/85 or <140/90).
RESULTS: In the 1988-1994 period, 71% (95% confidence interval [CI]=+/-4.4%) of all U.S. adults with diabetes had elevated blood pressure. The prevalence of elevated blood pressure increased with age and was high among both men and women and among Mexican Americans, non-Hispanic blacks, and non-Hispanic whites. Among those with elevated blood pressure, 71% (95% CI=+/-4.1%) were aware and 57% (95% CI=+/-4.2%) were treated, but only 12% (95% CI=+/-3.2%) had mean blood pressure <130/85 and 45% (95% CI=+/-4.9%) had mean blood pressure <140/90. Control of blood pressure was least common among older people.
CONCLUSIONS: All people with diabetes-regardless of age, gender, and race and ethnicity-may benefit from efforts to prevent hypertension. The control of elevated blood pressure is inadequate and broad-based efforts are needed to improve blood pressure control.