Abstract P164: Lipid Management in Diabetes: the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Abstract

Background: The Look Ahead trial recently showed that lifestyle intervention did not lower the risk of coronary heart disease (CHD) events in diabetes, emphasizing the importance of risk factor control. This is particularly important for blacks, who have higher risks of CHD mortality than whites. We examined race-sex differences in the prevalence, awareness, treatment and control of hyperlipidemia in a large national biracial cohort with diabetes.

Methods: REGARDS recruited 30,239 black and white participants ≥ 45 years of age from the 48 continental US from 2003-2007. Telephone interviews were followed by in-home visits. This analysis included participants with physician/nurse diagnosed diabetes or treatment with diabetes medication or insulin. Hyperlipidemia was defined as low density lipoprotein cholesterol >100 mg/dL or statin use. We described the prevalence, awareness, treatment, and control of hyperlipidemia and calculated prevalence ratios and 95% confidence intervals comparing white men (WM) with other race-sex groups, adjusted for factors that influence health services use (sociodemographics, access to care, severity of diabetes, functional status, obesity, depressive symptoms and elevated high density lipoprotein cholesterol).

Results: The race-sex distribution of the 6,497 participants with diabetes is shown in the Table. Although the prevalence of hyperlipidemia was 80-84% across race-sex groups, more white women (WW) (78%) and fewer black men (BM) (64%) were aware of their hyperlipidemia compared with WM (72%) and black women (BW) (71%). Compared to WM (80%) all other race-sex groups were less treated (WW 70%, BM 72%, BW 69%) and among the treated, less controlled (WM 77%, WW 71%, BM 62%, BW 54%). Results were similar after adjustment (Table).

Conclusion: These disparities in treatment and control of hyperlipidemia in diabetes warrant further investigation, particularly among blacks, who are especially burdened by diabetes.

Table. Prevalence ratios (95% CI) for hyperlipidemia prevalence, awareness, treatment, and control among participants with diabetes in REGARDS, n = 6,497.