Karen M Goldstein1, S Dee Melnyk2, Leah L Zullig3, Karen M Stechuchak4, Eugene Oddone5, Lori A Bastian6, Susan Rakley7, Maren K Olsen8, Hayden B Bosworth9. 1. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina. Electronic address: karen.goldstein@va.gov. 2. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina. 3. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Health Policy and Management, University of North Carolina, Chapel Hill, North Carolina. 4. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina. 5. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina. 6. VA Connecticut Healthcare System, Newington, Connecticut; University of Connecticut Health Center, Farmington, Connecticut. 7. Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina. 8. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina. 9. Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina; Departments of Psychiatry and School of Nursing, Duke University, Durham, North Carolina.
Abstract
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors compared with non-veteran women; however, little is known about gender and racial differences in cardiovascular risk factor control among veterans. METHODS: We used analysis of variance, adjusting for age, to compare gender and racial differences in three risk factors that predispose to CVD (diabetes, hypertension, and hyperlipidemia) in a cohort of high-risk veterans eligible for enrollment in a clinical trial, including 23,955 men and 1,010 women. FINDINGS: Low-density lipoprotein (LDL) values were higher in women veterans than men with age-adjusted estimated mean values of 111.7 versus 97.6 mg/dL (p < .01). Blood pressures (BPs) were higher among African-American than White female veterans with age-adjusted estimated mean systolic BPs of 136.3 versus 133.5 mmHg, respectively (p < .01), and diastolic BPs of 82.4 versus 78.9 mmHg (p < .01). African-American veterans with diabetes had worse BP, LDL values, and hemoglobin A1c levels, although the differences were only significant among men. CONCLUSIONS: Female veterans have higher LDL cholesterol levels than male veterans and African-American veterans have higher BP, LDL cholesterol, and A1c levels than Whites after adjusting for age. Further examination of CVD gender and racial disparities in this population may help to develop targeted treatments and strategies applicable to the general population. Published by Elsevier Inc.
BACKGROUND:Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors compared with non-veteran women; however, little is known about gender and racial differences in cardiovascular risk factor control among veterans. METHODS: We used analysis of variance, adjusting for age, to compare gender and racial differences in three risk factors that predispose to CVD (diabetes, hypertension, and hyperlipidemia) in a cohort of high-risk veterans eligible for enrollment in a clinical trial, including 23,955 men and 1,010 women. FINDINGS: Low-density lipoprotein (LDL) values were higher in women veterans than men with age-adjusted estimated mean values of 111.7 versus 97.6 mg/dL (p < .01). Blood pressures (BPs) were higher among African-American than White female veterans with age-adjusted estimated mean systolic BPs of 136.3 versus 133.5 mmHg, respectively (p < .01), and diastolic BPs of 82.4 versus 78.9 mmHg (p < .01). African-American veterans with diabetes had worse BP, LDL values, and hemoglobin A1c levels, although the differences were only significant among men. CONCLUSIONS: Female veterans have higher LDL cholesterol levels than male veterans and African-American veterans have higher BP, LDL cholesterol, and A1c levels than Whites after adjusting for age. Further examination of CVD gender and racial disparities in this population may help to develop targeted treatments and strategies applicable to the general population. Published by Elsevier Inc.
Authors: Karen M Goldstein; Karen M Stechuchak; Leah L Zullig; Eugene Z Oddone; Maren K Olsen; Felicia A McCant; Lori A Bastian; Bryan C Batch; Hayden B Bosworth Journal: J Womens Health (Larchmt) Date: 2017-02-13 Impact factor: 2.681
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