Long-Term and Recent Progress in Blood Pressure Levels Among U.S. AdultsWith Diagnosed Diabetes, 1988–2008

OBJECTIVE—To examine whether there were long-term (between 1988–1994 and 2001– 2008) and recent (between 2001–2004 and 2005–2008) changes in blood pressure (BP) levels among U.S. adults with diagnosed diabetes. RESEARCHDESIGNANDMETHODS—Using data fromNational Health andNutrition Examination Surveys (NHANES), we examined changes in BP distributions, mean BPs, and proportion with BP,140/90 mmHg. RESULTS—Between 1988–1994 and 2001–2008, for adults with diabetes, mean BPs decreased from 135/72 mmHg to 131/69 mmHg (P, 0.01) and the proportion with BP,140/90 mmHg increased from 64 to 69 % (P = 0.01). Although hypertension prevalence in-creased, hypertension awareness, treatment, and control improved. However, there was no evidence of improvement for adults 20–44 years old. Between 2001–2004 and 2005–2008, there were no significant changes in BP levels. CONCLUSIONS—BP levels among adults with diabetes improved between 1988–1994 and 2001–2008, but the progress stalled between 2001–2004 and 2005–2008. The lack of improve-ment among young adults is concerning. Diabetes Care 34:1579–1581, 2011 Hypertension is particularly deleteri-ous for people with diabetes be-cause it confers 2;3 times the risk for cardiovascular morbidity and mortal-ity as for people without diabetes (1,2). Studies demonstrated that blood pressure (BP) control is crucial to reduce vascular complications and improve survival for people with diabetes (3,4). The propor-tion of people with diabetes with poorly controlled BP declined considerably be-tween the 1970s and the 1990s (5). How-ever, in recent studies using the National Health and Nutrition Examination Sur-veys (NHANES) data, no improvements in BP levels among adults with diabetes were observed from 1988–1994 to early 2000s (6) or from 1999 to 2006 (7). We updated prior studies with the most re-cent NHANES 2007–2008 data to exam-ine long-term (between 1988–1994 and 2001–2008) and recent (between 2001– 2004 and 2005–2008) changes in BP levels among U.S. adults with diagnosed diabetes