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Diabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality.

TitleDiabetes mellitus: subclinical cardiovascular disease and risk of incident cardiovascular disease and all-cause mortality.
Publication TypeJournal Article
Year of Publication2000
AuthorsKuller, LH, Velentgas, P, Barzilay, J, Beauchamp, NJ, O'Leary, DH, Savage, PJ
JournalArterioscler Thromb Vasc Biol
Volume20
Issue3
Pagination823-9
Date Published2000 Mar
ISSN1079-5642
KeywordsAged, Arteriosclerosis, Coronary Disease, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Humans, Incidence, Male, Multivariate Analysis, Myocardial Infarction, Prevalence, Proportional Hazards Models, Risk Factors, Sex Distribution, Stroke
Abstract<p>Previously diagnosed diabetes mellitus, newly diagnosed diabetes mellitus, and impaired glucose tolerance are important determinants of the risk of clinical cardiovascular disease (CVD). We have evaluated the relation of patients with subclinical CVD, diabetes, and impaired glucose tolerance and "normal" subjects and the risk of clinical CVD in the Cardiovascular Health Study. Diabetes (1343), impaired glucose tolerance (1433), and normal (2421) were defined by World Health Organization criteria at baseline in 1989 to 1990. The average follow-up was 6.4 years (mean age 73 years). Diabetics had a higher prevalence of clinical and subclinical CVD at baseline. Compared with diabetes in the absence of subclinical disease, the presence of subclinical CVD and diabetes was associated with significant increased adjusted relative risk of death (1.5, CI 0.93 to 2.41), relative risk of incident coronary heart disease (1.99, CI 1.25 to 3.19), and incident myocardial infarction (1.93, CI 0.96 to 3.91). The risk of clinical events was greater for participants with a history of diabetes compared with newly diagnosed diabetics at baseline. Compared with nondiabetic nonhypertensive subjects without subclinical disease, patients with a combination of diabetes, hypertension, and subclinical disease had a 12-fold increased risk of stroke. Fasting blood glucose levels were a weak predictor of incident coronary heart disease as were most other risk factors. Subclinical CVD was the primary determinant of clinical CVD among diabetics in the Cardiovascular Health Study.</p>
DOI10.1161/01.atv.20.3.823
Alternate JournalArterioscler Thromb Vasc Biol
PubMed ID10712409
Grant ListHC-85082 / HC / NHLBI NIH HHS / United States