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New-onset diabetes and risk of all-cause and cardiovascular mortality: the Cardiovascular Health Study.
Tuesday,2012-11-06 12:07 America/Los_Angeles — eenright
| Title | New-onset diabetes and risk of all-cause and cardiovascular mortality: the Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2006 |
| Authors | Smith, NL, Barzilay, JI, Kronmal, R, Lumley, T, Enquobahrie, D, Psaty, BM |
| Journal | Diabetes Care |
| Volume | 29 |
| Issue | 9 |
| Pagination | 2012-7 |
| Date Published | 2006 Sep |
| ISSN | 0149-5992 |
| Keywords | Aged, Aged, 80 and over, Atherosclerosis, Blood Glucose, Cardiovascular Diseases, Diabetes Complications, Diabetes Mellitus, Follow-Up Studies, Humans, Kaplan-Meier Estimate, Risk Factors, Survival Rate, Time Factors |
| Abstract | <p><b>OBJECTIVE: </b>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.</p><p><b>RESEARCH DESIGN AND METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSIONS: </b>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.</p> |
| DOI | 10.2337/dc06-0574 |
| Alternate Journal | Diabetes Care |
| PubMed ID | 16936145 |
| Grant List | N01 HC 35129 / HC / NHLBI NIH HHS / United States N01 HC 55222 / HC / NHLBI NIH HHS / United States N01 HC 85079 / HC / NHLBI NIH HHS / United States N01 HC 85086 / HC / NHLBI NIH HHS / United States N0Q HC 14103 / HC / NHLBI NIH HHS / United States R01 AG 09556 / AG / NIA NIH HHS / United States R01 HL 73410 / HL / NHLBI NIH HHS / United States U01 HL 080295 / HL / NHLBI NIH HHS / United States |