American Journal of Epidemiology Advance Access published online on April 5, 2006
American Journal of Epidemiology, doi:10.1093/aje/kwj124
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1 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA
* To whom correspondence should be addressed. Rates of hypertension, high low density lipoprotein (LDL) cholesterol, and diabetes mellitus awareness, treatment, and control for persons with a history of myocardial infarction and stroke were compared by using two nationally representative samples of the US population: the Third National Health and Nutrition Examination Survey in 1988-1994 (n = 1,004) and the National Health and Nutrition Examination Survey in 1999-2002 (n = 512). Estimated numbers of adult myocardial infarction and stroke survivors increased from 6.32 to 6.78 million and from 3.85 to 4.96 million, respectively. Among such survivors, awareness of a previous diagnosis of hypertension and prevalence of self-reported diabetes mellitus remained stable while awareness of high LDL cholesterol increased from 43.3% to 60.2% (p < 0.01). Among those aware of their diagnosis, pharmacologic treatment for high LDL cholesterol increased from 33.1% to 78.4% and pharmacologic treatment for diabetes mellitus increased from 80.0% to 93.6% during this time (each p < 0.01), while pharmacologic treatment for hypertension increased nonsignificantly. Among those receiving pharmacologic treatment, hypertension and high LDL cholesterol control increased from 48.9% to 59.3% (p = 0.05) and from 5.1% to 33.1% (p < 0.01), respectively. In contrast, glycemic control among diabetics decreased from 45.0% to 33.2% (p = 0.20). The number of US myocardial infarction and stroke survivors increased between 1988-1994 and 1999-2002, and substantial improvements occurred in the awareness, treatment, and control of high LDL cholesterol in this population.
Received October 10, 2005
Accepted December 21, 2005
ORIGINAL CONTRIBUTIONS
Trends in the Prevalence, Awareness, Treatment, and Control of Cardiovascular Disease Risk Factors among Noninstitutionalized Patients with a History of Myocardial Infarction and Stroke
Paul Muntner 1 *,
Karen B. DeSalvo 1,
Rachel P. Wildman 2,
Paolo Raggi 3,
Jiang He 1,
and
Paul K. Whelton 1
2 Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
3 Department of Medicine, Tulane University School of Medicine, New Orleans, LA
Paul Muntner, E-mail: pmuntner{at}tulane.edu
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