Differences in risk factors for coronary heart disease among diabetic and nondiabetic individuals from a population with high rates of diabetes: the Strong Heart Study.

MedStar author(s):
Citation: Journal of Clinical Endocrinology & Metabolism. 97(10):3766-74, 2012 Oct.PMID: 22802089Institution: MedStar Health Research Institute | MedStar Washington Hospital CenterDepartment: Medicine/General Internal MedicineForm of publication: Journal ArticleMedline article type(s): Comparative Study | Journal Article | Research Support, N.I.H., ExtramuralSubject headings: *Coronary Disease/eh [Ethnology] | *Coronary Disease/mo [Mortality] | *Diabetes Mellitus/eh [Ethnology] | *Diabetes Mellitus/mo [Mortality] | *Indians, North American/sn [Statistics & Numerical Data] | Aged | Female | Follow-Up Studies | Humans | Hypertension/eh [Ethnology] | Hypertension/mo [Mortality] | Incidence | Male | Middle Aged | Morbidity | Multivariate Analysis | Myocardial Infarction/eh [Ethnology] | Myocardial Infarction/mo [Mortality] | Prevalence | Proportional Hazards Models | Risk FactorsYear: 2012Local holdings: Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0021-972X
Name of journal: The Journal of clinical endocrinology and metabolismAbstract: CONCLUSIONS: In addition to higher incidence rates of CHD events in persons with diabetes compared with those without, the two groups differed in CHD risk factors. These differences must be recognized in estimating CHD risk and managing risk factors.CONTEXT: Coronary heart disease (CHD) is the leading cause of death in the United States.DESIGN: This was an observational study.INTERVENTION(S): CHD events were ascertained during follow-up.MAIN OUTCOME MEASURE: CHD events were classified using standardized criteria.OBJECTIVE: This study compares differences in risk factors for CHD in diabetic vs. nondiabetic Strong Heart Study participants.PARTICIPANTS: Data were obtained from 3563 of 4549 American Indians free of cardiovascular disease at baseline.RESULTS: In diabetic and nondiabetic participants, 545 and 216 CHD events, respectively, were ascertained during follow-up (21,194 and 22,990 person-years); age- and sex-adjusted incidence rates of CHD were higher for the diabetic group (27.5 vs. 12.1 per 1,000 person-years). Risk factors for incident CHD common to both groups included older age, male sex, prehypertension or hypertension, and elevated low-density lipoprotein cholesterol. Risk factors specific to the diabetic group were lower high-density lipoprotein cholesterol, current smoking, macroalbuminuria, lower estimated glomerular filtration rate, use of diabetes medication, and longer duration of diabetes. Higher body mass index was a risk factor only for the nondiabetic group. The association of male sex and CHD was greater in those without diabetes than in those with diabetes.SETTING: The study was conducted at three centers in Arizona, Oklahoma, and North and South Dakota.All authors: Best LG, Devereux RB, Howard BV, Howard WJ, Lee ET, Paranilam J, Peterson LE, Rhoades ER, Umans JG, Xu JFiscal year: FY2013Digital Object Identifier: Date added to catalog: 2013-09-17
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 22802089 Available 22802089

Available online from MWHC library: 1997 - present, Available in print through MWHC library: 1999 - 2006

CONCLUSIONS: In addition to higher incidence rates of CHD events in persons with diabetes compared with those without, the two groups differed in CHD risk factors. These differences must be recognized in estimating CHD risk and managing risk factors.

CONTEXT: Coronary heart disease (CHD) is the leading cause of death in the United States.

DESIGN: This was an observational study.

INTERVENTION(S): CHD events were ascertained during follow-up.

MAIN OUTCOME MEASURE: CHD events were classified using standardized criteria.

OBJECTIVE: This study compares differences in risk factors for CHD in diabetic vs. nondiabetic Strong Heart Study participants.

PARTICIPANTS: Data were obtained from 3563 of 4549 American Indians free of cardiovascular disease at baseline.

RESULTS: In diabetic and nondiabetic participants, 545 and 216 CHD events, respectively, were ascertained during follow-up (21,194 and 22,990 person-years); age- and sex-adjusted incidence rates of CHD were higher for the diabetic group (27.5 vs. 12.1 per 1,000 person-years). Risk factors for incident CHD common to both groups included older age, male sex, prehypertension or hypertension, and elevated low-density lipoprotein cholesterol. Risk factors specific to the diabetic group were lower high-density lipoprotein cholesterol, current smoking, macroalbuminuria, lower estimated glomerular filtration rate, use of diabetes medication, and longer duration of diabetes. Higher body mass index was a risk factor only for the nondiabetic group. The association of male sex and CHD was greater in those without diabetes than in those with diabetes.

SETTING: The study was conducted at three centers in Arizona, Oklahoma, and North and South Dakota.

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