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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Risk Factor Modification for Vascular Disease in North Carolina Prisons.

Patrick C M Brown1, Katherine G Welch-Mabon2, Elizabeth B Dreesen1

  • 1Department of Surgery, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA.

Journal of Correctional Health Care : the Official Journal of the National Commission on Correctional Health Care
|October 7, 2025
PubMed
Summary

This study found that while incarcerated patients with vascular disease in North Carolina often received guideline-concordant care for hypertension and diabetes, gaps existed in prescribing antiplatelet agents and statins.

Keywords:
aortic aneurysmatherosclerosiscorrectional health careevidence-based guidelinesperipheral artery diseasevascular medicine

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Area of Science:

  • Vascular Surgery
  • Cardiology
  • Public Health
  • Health Policy

Background:

  • The healthcare needs of the US incarcerated population are increasing, necessitating effective management within correctional facilities.
  • Adherence to cardiovascular risk factor management guidelines in this population is not well-documented.

Purpose of the Study:

  • To evaluate adherence to prescribing guidelines for vascular risk factors in incarcerated patients referred for vascular surgery evaluation.
  • To identify gaps in the management of hypertension, diabetes, hyperlipidemia, and atherosclerotic disease in this specific patient group.

Main Methods:

  • Retrospective review of medical records for 57 incarcerated patients with noncoronary atherosclerotic disease.
  • Data collected between 2019 and 2023 in North Carolina.
  • Analysis of prescribing patterns for antiplatelet agents, statins, antihypertensives, and antihyperglycemics.

Main Results:

  • At referral, 66.6% received antiplatelet agents, 61.4% received statins, and 49.1% received both.
  • 82.5% had hypertension, with 87.2% prescribed antihypertensives.
  • 50.8% had diabetes, with 72.4% prescribed antihyperglycemics.
  • 43.9% had hyperlipidemia, with 84.0% prescribed lipid-lowering medication.

Conclusions:

  • Treatment for hypertension and diabetes in this incarcerated cohort was largely guideline-concordant.
  • Significant gaps were identified in the appropriate prescribing of statins and antiplatelet agents for vascular risk reduction.
  • Improved adherence to guidelines for lipid-lowering and antiplatelet therapy is needed for incarcerated patients with atherosclerotic disease.