Lifestyle Modification to Improve Blood Pressure Control in Individuals With Diabetes
Is physician advice effective?
- Leonard E. Egede, MD, MS
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, Charleston, South Carolina
Abstract
OBJECTIVE—To determine the effectiveness of physician advice on hypertension-related lifestyle modification in individuals with diabetes.
RESEARCH DESIGN AND METHODS—Data on adults with one or more physician visit in the 1998 National Health Interview Survey (NHIS) were analyzed (diabetes, n = 1,609; no diabetes, n = 19,672). The proportion with hypertension who received physician advice to lose weight, increase physical activity, or take antihypertensive medications and the proportion who reported adhering to advice were compared by diabetes status. Logistic regression was used to identify factors associated with receipt of physician advice and adherence to advice by diabetes status controlling for covariates. Then, logistic regression was also used to determine the extent to which patient adherence among people with diabetes differed by age, sex, and race/ethnicity, controlling for other covariates. STATA statistical software was used for all analyses to account for the complex survey design of NHIS.
RESULTS—Controlling for covariates, individuals with diabetes were more likely to receive advice (odds ratio [OR] 1.94 for weight loss, 1.99 for exercise, and 2.16 for medications). Adherence was more likely in individuals with diabetes (OR 1.40 for losing weight and 2.16 for taking medications). Adherence in people with diabetes did not differ by sex or race/ethnicity. Subjects 18–44 years old were least likely to report losing weight (OR 0.15) or taking medications (0.31) compared with subjects ≥65 years old.
CONCLUSIONS—Physician advice appears effective at changing hypertension-related lifestyles in people with diabetes regardless of sex or race/ethnicity. However, advice on increasing physical activity does not seem as effective.
Footnotes
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Address correspondence and reprint requests to Leonard E. Egede, MD, MS, Medical University of South Carolina, Division of General Internal Medicine and Geriatrics, McClennan-Banks Adult Primary Care Clinic, 4th Floor, 326 Calhoun St., PO Box 25010, Charleston, SC 29425. E-mail: egedel{at}musc.edu.
Received for publication 24 July 2002 and accepted in revised form 4 December 2002.
The contents of this article are solely the responsibility of the author and do not necessarily represent the official views of the Agency for Health Care Research and Quality or the Centers for Disease Control and Prevention.
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