Background
Methods
Setting and Patients
BMI Measurement
Risk Factor, CVD, and Diabetes Measurement
Statistical Analysis
Results
BMI Documentation and Characteristics of Patients with Documented BMI
Clinic | N | BMI | Height Documented | Weight Documented |
---|---|---|---|---|
% | % | % | ||
1
|
3,027
| 93.5 | 94.1 | 99.1 |
2
|
4,559
| 89.8 | 95.7 | 91.6 |
3
|
3,274
| 86.9 | 87.5 | 99.1 |
4
|
3,989
| 85.8 | 94.5 | 87.4 |
5
|
1,344
| 75.1 | 75.2 | 99.5 |
6
|
7,747
| 65.8 | 66.0 | 99.0 |
7
|
21,299
| 64.0 | 65.8 | 96.1 |
8
|
3,962
| 55.4 | 55.8 | 98.7 |
9
|
12,919
| 50.2 | 55.4 | 71.1 |
10
|
4,781
| 41.9 | 44.4 | 78.4 |
11
|
8,052
| 38.2 | 38.3 | 99.0 |
12
|
4,994
| 34.0 | 35.7 | 88.9 |
Total
|
48,376
|
60.5
|
63.0
|
90.9
|
Characteristic | BMI Documented | 48,376 | BMI not Documented | 31,571 | P value | ||
---|---|---|---|---|---|---|---|
Clinic | n | % | <0.0001 | ||||
1
| 2,830 | 5.9 | 197 | 0.6 | |||
2
| 4,093 | 8.5 | 466 | 1.5 | |||
3
| 2,844 | 5.9 | 430 | 1.4 | |||
4
| 3,421 | 7.1 | 568 | 1.8 | |||
5
| 1,009 | 2.1 | 335 | 1.1 | |||
6
| 5,095 | 10.5 | 2,652 | 8.4 | |||
7
| 13,630 | 28.2 | 7,669 | 24.3 | |||
8
| 2,194 | 4.5 | 1,768 | 5.6 | |||
9
| 6,489 | 13.4 | 6,431 | 20.4 | |||
10
| 2,003 | 4.1 | 2,778 | 8.8 | |||
11
| 3,073 | 6.4 | 4,979 | 15.8 | |||
12
| 1,696 | 3.5 | 3,298 | 10.5 | |||
Age
|
mean years
| 51 | 53 | <0.0001 | |||
Women
| n | % | 31,412 | 64.9 | 15,986 | 50.6 | <0.0001 |
Race
| n | % | <0.0001 | ||||
White
| 37,625 | 77.8 | 25,264 | 80.0 | |||
Asian
| 2,057 | 4.3 | 1,426 | 4.5 | |||
Black
| 2,908 | 6.0 | 1,464 | 4.6 | |||
Hispanic
| 4,123 | 8.5 | 2,397 | 7.6 | |||
Number of PCP visits
|
mean
|
range
| 4.2 | (2-61) | 3.9 | (2-56) | <0.0001 |
Commercial Insurance or Medicare
|
n
|
%
| 42,740 | 88.4 | 27,522 | 87.2 | <0.0001 |
History of CVD
|
n
|
%
| 7,298 | 15.1 | 4,989 | 15.8 | 0.0060 |
History of diabetes
|
n
|
%
| 5,872 | 12.1 | 3,453 | 10.9 | <0.0001 |
History of hypertension
|
n
|
%
| 22,121 | 45.7 | 14,698 | 46.6 | 0.02 |
History of dyslipidemia
|
n
|
%
| 25,698 | 53.1 | 17,133 | 54.3 | 0.002 |
HbA1c
|
%
| 6.7 | 6.8 | 0.0001 | |||
Blood pressure
|
mean mmHg
| 122/75 | 123/74 | <0.0001 | |||
Total cholesterol
| mean mg/dL (mmol/L) | 188.1 (4.87) | 188.5 (4.88) | 0.29 | |||
LDL
| mean mg/dL (mmol/L) | 104.1 (2.70) | 105 (2.72) | 0.001 | |||
HDL
| mean mg/dL (mmol/L) | 59.3 (1.54) | 57.8 (1.50) | <0.0001 | |||
Triglyceride level
| mean mg/dL (mmol/L) | 127.8 (1.44) | 132.6 (1.50) | <0.0001 | |||
Casual glucose
| mean mg/dL (mmol/L) | 101.8 (5.65) | 100.8 (5.59) | 0.0007 | |||
Fasting glucose
| mean mg/dL (mmol/L) | 102.4 (5.68) | 100.9 (5.60) | 0.0007 | |||
Risk factor documentation
|
Total n
|
%
| |||||
Blood Pressure
| 64,204 | 80.3 | 37,489 | 77.5 | 26,715 | 84.6 | <0.0001 |
LDL
| 55,210 | 69.1 | 33,788 | 69.8 | 21,422 | 67.9 | <0.0001 |
Casual glucose
| 56,984 | 71.3 | 35,125 | 72.6 | 21,859 | 69.2 | <0.0001 |
Fasting glucose
| 21,533 | 26.9 | 13,533 | 28.0 | 8,000 | 25.3 | <0.0001 |
HbA1c
| 14,252 | 17.8 | 9,367 | 19.4 | 4,885 | 15.5 | <0.0001 |
Total cholesterol
| 58,951 | 73.7 | 36,247 | 74.9 | 22,704 | 71.9 | <0.0001 |
HDL
| 58,373 | 73.0 | 35,874 | 74.2 | 22,499 | 71.3 | <0.0001 |
Triglycerides
| 55,948 | 70.0 | 34,247 | 70.8 | 21,701 | 68.7 | <0.0001 |
Risk factor control in those with documented risk factor
|
Total n
|
%
| |||||
Blood Pressure <130 and < 85 mmHg
| 46,748 | 72.8 | 27,212 | 72.6 | 19,536 | 73.1 | 0.13 |
LDL <130 mg/dL
| 43,369 | 78.6 | 26,656 | 78.9 | 16,713 | 78.0 | 0.015 |
Casual glucose < 200 mg/dL
| 55,642 | 97.6 | 34,231 | 97.5 | 21,411 | 98.0 | 0.0001 |
Fasting glucose < 100 mg/dL
| 13,782 | 64.0 | 8,574 | 63.4 | 5,208 | 65.1 | 0.01 |
HbA1c <7%
| 9,638 | 67.6 | 6,463 | 69.0 | 3,175 | 65.0 | <0.0001 |
Total cholesterol <200 mg/dL
| 37,279 | 63.2 | 22,952 | 63.3 | 14,327 | 63.1 | 0.59 |
HDL >35 mg/dL (male) and >40 mg/dL (female)
| 52,971 | 90.8 | 32,742 | 91.3 | 20,229 | 89.9 | <0.0001 |
Triglycerides <150 mg/dL
| 48,188 | 86.1 | 29,675 | 86.7 | 18,513 | 85.3 | <0.0001 |
Characteristic | Obese | n = 14,290 | Overweight | n = 16,402 | Normal | n = 16,936 | P value | |
---|---|---|---|---|---|---|---|---|
Age
|
(mean years)
| 53 | 53 | 48 | <0.0001 | |||
Number of PCP visits
|
(mean)
| 4.7 | 4.2 | 3.9 | <0.0001 | |||
Women
|
n (%)
| 8,565 | 59.9 | 8,899 | 54.3 | 13,272 | 78.4 | <0.0001 |
Race*
|
n (%)
| <0.0001 | ||||||
White
| 10,712 | 75.0 | 12,674 | 77.3 | 13,655 | 80.6 | ||
Asian
| 179 | 1.3 | 567 | 3.5 | 1,229 | 7.3 | ||
Black
| 1,244 | 8.7 | 989 | 6.0 | 649 | 3.8 | ||
Hispanic
| 1,722 | 12.1 | 1,561 | 9.5 | 811 | 4.8 | ||
Private Insurance or Medicare
|
n (%)
| 12,104 | 84.7 | 14,502 | 88.4 | 15,467 | 91.3 | <0.0001 |
History of CVD
|
n (%)
| 2,647 | 18.5 | 2,699 | 16.5 | 1,862 | 11.0 | <0.0001 |
History of diabetes
|
n (%)
| 3,238 | 22.7 | 1,789 | 10.9 | 824 | 4.9 | <0.0001 |
History of hypertension
|
n (%)
| 9,116 | 63.8 | 7,895 | 48.1 | 4,931 | 29.1 | <0.0001 |
History of dyslipidemia
|
n (%)
| 9,235 | 64.6 | 9,495 | 57.9 | 6,769 | 40.0 | <0.0001 |
Documentation and Control of Risk Factors
Risk Factor Documentation | Total | n = 47,628 | Obese | n = 14,290 | Overweight | n = 16,402 | Normal | n = 16,936 | P value |
---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | ||
BP
| 36,934 | 77.6 | 10,900 | 76.3 | 12,890 | 78.6 | 13,144 | 77.6 | <0.0001 |
LDL
| 33,427 | 70.2 | 11,239 | 78.7 | 12,013 | 73.2 | 10,175 | 60.1 | <0.0001 |
Casual Glucose
| 34,589 | 72.6 | 11,216 | 78.5 | 11,901 | 72.6 | 11,472 | 67.7 | <0.0001 |
Fasting Glucose
| 13,421 | 28.2 | 5,347 | 37.4 | 4,804 | 29.3 | 3,270 | 19.3 | <0.0001 |
Risk Factor Control
|
Total
|
Obese
|
Overweight
|
Normal
|
P value
| ||||
n
|
%
|
n
|
%
|
n
|
%
|
n
|
%
| ||
BP <130 and < 85 mmHg
| 26,736 | 72.4 | 6,801 | 62.4 | 9,202 | 71.4 | 10,733 | 81.7 | <0.0001 |
LDL <130 mg/dL
| 26,328 | 78.8 | 8,777 | 78.1 | 9,273 | 77.2 | 8,278 | 81.4 | <0.0001 |
Casual glucose < 200 mg/dL
| 33,698 | 97.4 | 10,707 | 95.5 | 11,635 | 97.8 | 11,356 | 99.0 | <0.0001 |
Fasting glucose < 100 mg/dL
| 8,482 | 63.2 | 2,753 | 51.5 | 3,146 | 65.5 | 2,583 | 79.0 | <0.0001 |
Risk Factors | Total | Obese | n = 14,290 | Overweight | n = 16,402 | Normal Weight | n = 16,936 | P value | |
---|---|---|---|---|---|---|---|---|---|
History of CVD | n | % | n | % | n | % | n | % | |
H/O CVD n = 7,208
|
H/O CVD N = 2,647
|
H/O CVD N = 2,699
|
H/O CVD N = 1,862
| ||||||
NO H/O CVD n = 40,420
|
No H/O CVD N = 11,643
|
NO H/O CVD N = 13,703
|
NO H/O CVD N = 15,074
| ||||||
BP
|
n = 10,900
|
n = 12,890
|
n = 13,144
| ||||||
H/O CVD
| 5,297 | 73.5 | 1,931 | 73.0 | 1,991 | 73.8 | 1,375 | 73.9 | 0.26 |
NO H/O CVD
| 31,637 | 78.3 | 8,969 | 77.0 | 10,899 | 79.5 | 11,769 | 78.1 | |
LDL
|
n = 11,239
|
n = 12,013
|
n = 10,175
| ||||||
H/O CVD
| 6,199 | 86.0 | 2,393 | 90.4 | 2,358 | 87.4 | 1,448 | 77.8 | 0.15 |
NO H/O CVD
| 27,228 | 67.4 | 8,846 | 76.0 | 9,655 | 70.5 | 8,727 | 57.9 | |
Casual glucose
|
n = 11,216
|
n = 11,901
|
n = 11,472
| ||||||
H/O CVD
| 6,305 | 87.5 | 2,355 | 89.0 | 2,322 | 86.0 | 1,628 | 87.4 | 0.0001 |
NO H/O CVD
| 28,284 | 70.0 | 8,861 | 76.1 | 9,579 | 69.9 | 9,844 | 65.3 | |
Fasting glucose
|
n = 5,347
|
n = 4,804
|
n = 3,270
| ||||||
H/O CVD
| 2,741 | 38.0 | 1,158 | 43.8 | 1,023 | 37.9 | 560 | 30.1 | <0.0001 |
NO H/O CVD
| 10,680 | 26.4 | 4,189 | 36.0 | 3,781 | 27.6 | 2,710 | 18.0 | |
All 3 risk factors
|
n = 8,247
|
n = 8,797
|
n = 6,986
| ||||||
H/O CVD
| 4,417 | 61.3 | 1,696 | 64.1 | 1,693 | 62.7 | 1,028 | 55.2 | <0.0001 |
NO H/O CVD
| 19,613 | 48.5 | 6,551 | 56.3 | 7,104 | 51.8 | 5,958 | 39.5 | |
History of DM
| n | % | n | % | n | % | |||
H/O diabetes n = 5,851
|
H/O diabetes N = 3,238
|
H/O diabetes N = 1,789
|
H/O diabetes N = 824
| ||||||
NO H/O diabetes
n = 41,777
|
NO H/O diabetes N = 11,052
|
NO H/O diabetes N = 14,613
|
NO H/O diabetes N = 16,112
| ||||||
BP
|
n = 10,900
|
n = 12,890
|
n = 13,144
| ||||||
H/O diabetes
| 4,398 | 75.2 | 2,447 | 75.6 | 1,366 | 76.4 | 585 | 71.0 | 0.002 |
NO H/O diabetes
| 32,536 | 77.9 | 8,453 | 76.5 | 11,524 | 78.9 | 12,559 | 78.0 | |
LDL
|
n = 11,239
|
n = 12,013
|
n = 10,175
| ||||||
H/O diabetes
| 5,285 | 90.3 | 2,963 | 91.5 | 1,617 | 90.4 | 705 | 86.2 | 0.51 |
NO H/O diabetes
| 28,142 | 67.4 | 8,276 | 74.9 | 10,396 | 71.1 | 9,470 | 58.8 | |
Casual glucose
|
n = 11,216
|
n = 11,901
|
n = 11,472
| ||||||
H/O diabetes
| 5,225 | 89.3 | 2,884 | 89.1 | 1,596 | 89.2 | 745 | 90.4 | <0.0001 |
NO H/O diabetes
| 29,634 | 70.9 | 8,332 | 75.4 | 10,305 | 70.5 | 10,727 | 66.6 | |
Fasting glucose
|
n = 5,347
|
n = 4,804
|
n = 3,270
| ||||||
H/O diabetes
| 2,736 | 46.8 | 1,619 | 50.0 | 812 | 45.4 | 305 | 37.0 | 0.003 |
NO H/O diabetes
| 10,685 | 25.6 | 3,728 | 33.7 | 3,992 | 27.3 | 2,965 | 18.4 | |
All 3 risk factors
|
n = 8,247
|
n = 8,797
|
n = 6,986
| ||||||
H/O diabetes
| 3,936 | 67.3 | 2,197 | 67.9 | 1,240 | 69.3 | 499 | 60.6 | 0.001 |
NO H/O diabetes
| 20,094 | 48.1 | 6,050 | 54.7 | 7,557 | 51.7 | 6,487 | 40.3 |
Outcome | Total Documented | Total Controlled | Obese | Overweight | Normal | P value | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
History of CVD | n | % | n | % | n | % | n | % | n | % | |
H/O CVD n = 7,208 | |||||||||||
NO H/O CVD n = 40,420 | |||||||||||
BP < 130 and < 85 mmHg | H/O CVD N = 1,931 | H/O CVD N = 1,991 | H/O CVD N = 1,375 | ||||||||
NO H/O CVD 8,969 | NO H/O CVD N = 10,899 | NO H/O CVD N = 11,769 | |||||||||
n = 6,801 | n = 9,202 | n = 10,733 | |||||||||
H/O CVD | 5,297 | 73.5 | 3,338 | 63.0 | 1,155 | 59.8 | 1,256 | 63.1 | 927 | 67.4 | <0.0001 |
NO H/O CVD | 31,637 | 78.3 | 23,399 | 74.0 | 5,647 | 63.0 | 7,946 | 72.9 | 9,806 | 83.3 | |
LDL < 130 md/dL | H/O CVD N = 2,393 | H/O CVD N = 2,358 | H/O CVD N = 1,448 | ||||||||
NO H/O CVD N = 8,846 | NO H/O CVD N = 9,655 | NO H/O CVD N = 6,989 | |||||||||
n = 8,777 | n = 9,273 | n = 8,278 | |||||||||
H/O CVD | 6,199 | 86.0 | 5,515 | 89.0 | 2,152 | 89.9 | 2,074 | 88.0 | 1,289 | 89.0 | 0.002 |
NO H/O CVD | 27,228 | 67.4 | 20,813 | 76.4 | 6,625 | 74.9 | 7,199 | 74.6 | 6,989 | 80.1 | |
Casual glucose < 200 mg/dL | H/O CVD N = 2,355 | H/O CVD N = 2,322 | H/O CVD N = 1,628 | ||||||||
NO H/O CVD N = 8,861 | NO H/O CVD N = 9,579 | NO H/O CVD N = 9,844 | |||||||||
n = 10,707 | n = 11,635 | n = 11,356 | |||||||||
H/O CVD | 6,305 | 87.5 | 5,979 | 94.8 | 2,173 | 92.3 | 2,218 | 95.5 | 1,588 | 97.5 | 0.13 |
NO H/O CVD | 28,284 | 70.0 | 27,719 | 98.0 | 8,534 | 96.3 | 9,417 | 98.3 | 9,768 | 99.2 | |
Fasting glucose < 100 mg/dL | H/O CVD N = 1,158 | H/O CVD N = 1,023 | H/O CVD N = 560 | ||||||||
NO H/O CVD N = 4,189 | NO H/O CVD N = 3,781 | NO H/O CVD N = 2,710 | |||||||||
n = 2,753 | n = 3,146 | n = 2,583 | |||||||||
H/O CVD | 2,741 | 38.0 | 1,325 | 48.3 | 415 | 35.8 | 561 | 54.8 | 349 | 62.3 | 0.0005 |
NO H/O CVD | 10,680 | 26.4 | 7,157 | 67.0 | 2,338 | 55.8 | 2,585 | 68.4 | 2,234 | 82.4 | |
All 3 risk factors | H/O CVD N = 829 | H/O CVD N = 1,693 | H/O CVD N = 1,028 | ||||||||
NO H/O CVD N = 2,767 | NO H/O CVD N = 7,104 | NO H/O CVD N = 5,958 | |||||||||
n = 3,596 | n = 4,344 | n = 4,327 | |||||||||
H/O CVD | 4,417 | 61.3 | 2,252 | 51.0 | 829 | 48.9 | 850 | 50.2 | 573 | 55.7 | <0.0001 |
NO H/O CVD | 19,613 | 48.5 | 10,015 | 51.1 | 2,767 | 42.2 | 3,494 | 49.2 | 3,754 | 63.0 | |
History of diabetes | |||||||||||
H/O diabetes n = 5,851 | |||||||||||
NO H/O diabetes n = 41,777 | |||||||||||
BP < 130 and < 85 mmHg | H/O diabetes N = 2,447 | H/O diabetes N = 1,366 | H/O diabetes N = 585 | ||||||||
NO H/O diabetes 8,453 | NO H/O diabetes N = 11,524 | NO H/O diabetes N = 12,559 | |||||||||
n = 6,801 | n = 9,202 | n = 10,733 | |||||||||
H/O diabetes | 4,398 | 75.2 | 2,775 | 63.1 | 1,476 | 60.3 | 919 | 67.3 | 380 | 65.0 | <0.0001 |
NO H/O diabetes | 32,536 | 77.9 | 23,961 | 73.6 | 5,325 | 63.0 | 8,283 | 71.9 | 10,353 | 82 | |
LDL < 130 md/dL | H/O diabetes N = 2,963 | H/O diabetes N = 1,617 | H/O diabetes N = 705 | ||||||||
NO H/O diabetes N = 8,276 | NO H/O diabetes N = 10,396 | NO H/O diabetes N = 9,470 | |||||||||
n = 8,777 | n = 9,273 | n = 8,278 | |||||||||
H/O diabetes | 5,285 | 90.3 | 4,746 | 89.8 | 2,635 | 88.9 | 1,462 | 90.4 | 649 | 92.1 | 0.57 |
NO H/O diabetes | 28,142 | 67.4 | 21,583 | 76.7 | 6,143 | 74.2 | 7,811 | 75.1 | 7,629 | 80.6 | |
Casual glucose < 200 mg/dL | H/O diabetes N = 2,884 | H/O diabetes N = 1,596 | H/O diabetes N = 745 | ||||||||
NO H/O diabetes N = 8,332 | NO H/O diabetes N = 10,305 | NO H/O diabetes N = 10,727 | |||||||||
n = 10,707 | n = 11,635 | n = 11,356 | |||||||||
H/O diabetes | 5,225 | 89.3 | 4,383 | 83.9 | 2,400 | 83.2 | 1,342 | 84.1 | 641 | 86.0 | 0.015 |
NO H/O diabetes | 29,634 | 70.9 | 29,315 | 98.9 | 8,307 | 99.7 | 10,293 | 99.9 | 10,715 | 99.9 | |
Fasting glucose < 100 mg/dL | H/O diabetes N = 1,619 | H/O diabetes N = 812 | H/O diabetes N = 305 | 0.24 | |||||||
NO H/O diabetes N = 3,728 | NO H/O diabetes N = 3,992 | NO H/O diabetes 2,965 | |||||||||
n = 2,753 | n = 3,146 | n = 2,583 | |||||||||
H/O diabetes | 2,736 | 46.8 | 554 | 20.2 | 285 | 17.6 | 170 | 20.9 | 99 | 32.5 | |
NO H/O diabetes | 10,685 | 25.6 | 7,928 | 74.2 | 2,468 | 66.2 | 2,976 | 74.6 | 2,484 | 83.8 | |
All 3 risk factors | H/O diabetes N = 2,197 | H/O diabetes N = 1,240 | H/O diabetes N = 499 | <0.0001 | |||||||
NO H/O diabetes N = 6,050 | NO H/O diabetes N = 7,557 | NO H/O diabetes N = 6,487 | |||||||||
n = 3,596 | n = 4,344 | n = 4,327 | |||||||||
H/O diabetes | 3,936 | 67.3 | 1,754 | 44.6 | 929 | 42.3 | 587 | 47.3 | 238 | 47.7 | |
NO H/O diabetes | 20,094 | 48.1 | 10,513 | 52.3 | 2,667 | 44.1 | 3,757 | 49.7 | 4,089 | 63.0 |