%0 Journal Article %J Diabetes Care %D 2006 %T New-onset diabetes and risk of all-cause and cardiovascular mortality: the Cardiovascular Health Study. %A Smith, Nicholas L %A Barzilay, Joshua I %A Kronmal, Richard %A Lumley, Thomas %A Enquobahrie, Daniel %A Psaty, Bruce M %K Aged %K Aged, 80 and over %K Atherosclerosis %K Blood Glucose %K Cardiovascular Diseases %K Diabetes Complications %K Diabetes Mellitus %K Follow-Up Studies %K Humans %K Kaplan-Meier Estimate %K Risk Factors %K Survival Rate %K Time Factors %X

OBJECTIVE: Cardiovascular risk associated with new-onset diabetes is not well characterized. We hypothesized that risk of all-cause and cardiovascular mortality would be similar among participants with and without new-onset diabetes in the first years of follow-up and rise over time for new-onset diabetes.

RESEARCH DESIGN AND METHODS: The Cardiovascular Health Study (CHS) is a longitudinal study of cardiovascular risk factors in adults aged > or =65 years. We used CHS participants to define a cohort (n = 282) with new-onset diabetes during 11 years of follow-up. New-onset diabetes was defined by initiation of antidiabetes medication or by fasting plasma glucose >125 mg/dl among CHS participants without diabetes at study entry. Three CHS participants without diabetes were matched for age, sex, and race to each participant with new-onset diabetes at the time of diabetes identification (n = 837). Survival analysis provided adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality.

RESULTS: During a median of 5.9 years of follow-up, there were 352 deaths, of which 41% were cardiovascular. In adjusted analyses, new-onset diabetes was associated with an HR of 1.9 (95% CI 1.4-2.5) for all-cause and 2.2 (1.4-3.4) for cardiovascular mortality compared with no diabetes. Mortality risks were elevated within 2 years of onset, especially cardiovascular risk (4.3 [95% CI 1.7-10.8]), and did not increase over time.

CONCLUSIONS: Our findings indicate that there may be a mortality differential soon after diabetes onset in older adults and suggest that long-term macrovascular damage from atherosclerosis may not be primarily responsible for increased risk.

%B Diabetes Care %V 29 %P 2012-7 %8 2006 Sep %G eng %N 9 %1 https://www.ncbi.nlm.nih.gov/pubmed/16936145?dopt=Abstract %R 10.2337/dc06-0574