Abstract P215: Evidence Of Terminal Digit Preference In Veterans Affairs Midwest Region Primary Care Clinics

Objective: This study examined terminal digit preference (TDP) and its association with BP control in Veterans Affairs Midwest region clinics. Methods: TDP was examined in 517,668 BP values from 202,781 Veterans age 18 to 85 years during primary care visits from January 1, 2019 to March 1, 2020 across eight Midwest region sites. Presence of TDP was examined using a goodness of fit test with 10 bins. BP control (<140/90 mmHg or <130/80 mmHg) was assessed in 98,433 Veterans with diagnosed hypertension based on last clinic visit vital signs. Spearman correlation coefficients examined the association of TDP with BP control. Results: Mean age was 65.9 (standard deviation [SD]15.7) years, 93.9% (188, 586/202,781) were male; race was White in 78.1% (153,372/202,781), Black or African American in 16.3% (33, 053/202,781), and Asian in 0.5% (1,014/202, 781). For SBP measurements, significant TDP (P<0.001) for digit 8 was noted in all 8 sites ranging from 12.6% (6,839/54,279) to 21.2% (18,124/85,493). For DBP measurements, significant TDP was noted (P<0.001) for digit 0 ranging from 13.5% (7,327/54,276) to 32.7% (27,956/85,493). Among the 8 sites, BP control rates (<140/90 mmHg) ranged from 72.2% (5,947/8,237) to 81.0% (15,405/19,019) while BP < 130/80 mmHg among Veterans with high CVD risk (n=179, 074) ranged from 33.6% (4,960/14,762) to 45.5% (8,204/18,233). Both SBP TDP for digit 8 (r=0.80; P<0.05) and DBP TDP for digit 0 (r=0.73; p < 0.05) were significantly and positively correlated with BP control. Conclusion: Our data show presence of BP TDP in the Midwest region VA sites. The correlation of TDP with BP control rates raises concerns about ability to accurately assess BP control in these sites.