Generic Medications and Blood Pressure Control in Diabetic Hypertensive Subjects Results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

OBJECTIVEdTo investigate temporal improvements in blood pressure (BP) control in sub-jects with diabetes and policy changes regarding generic antihypertensives. RESEARCH DESIGN AND METHODSdIn a cross-sectional study we used logistic regression models to investigate the temporal relationship between access to generic antihyper-tensive medications and BP control (,130/80mmHg) in 5,375 subjects (mean age, 666 9 years; 61 % African American) with diabetes and hypertension (HTN) enrolled in the national Results from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study between 2003 and 2007. At enrollment, BP was measured and medications in the home determined by medication label review by a trained professional. Generic antihypertensive medication status was ascertained from the U.S. Food and Drug Administration. RESULTSdThe percentage of subjects accessing generically available antihypertensive med-ications increased significantly from 66 % in 2003 to 81 % in 2007 (P, 0.0001), and the odds of achieving a BP,130/80 mmHg in 2007 was 66 % higher (odds ratio 1.66 [95 % CI 1.30–2.10]) than in 2003.Nevertheless,,50%of participants achieved this goal. African American race,male sex, limited income, and medication nonadherence were significant predictors of inadequate B