(08-08-12) Differences in Risk Factors for Coronary Heart Disease among Diabetic and Nondiabetic Individuals

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.

Xu J, Lee ET, Peterson LE, Devereux RB, Rhoades ER, Umans JG, Best LG, Howard
WJ, Paranilam J, Howard BV.
Source
Center for Biostatistics (J.X.), The Methodist Hospital Research Institute,
Houston, Texas 77030; Center for American Indian Health Research (E.T.L.),
College of Public Health, University of Oklahoma Health Sciences Center,
Oklahoma City, Oklahoma 73190; Center for Biostatistics (L.E.P.), The Methodist
Hospital Research Institute, Houston, Texas 77030; Weill Cornell Medical
College (R.B.D.), New York, New York 10065; Center for American Indian Health
Research (E.R.R.), College of Public Health, University of Oklahoma Health
Sciences Center, Oklahoma City, Oklahoma 73190; MedStar Health Research
Institute (J.G.U.), Hyattsville, Maryland 20782; Georgetown and Howard
Universities Center for Clinical and Translational Sciences (J.G.U.),
Washington, D.C. 20007; Missouri Breaks Industries Research Inc. (L.G.B.),
Timber Lake, South Dakota 57656; Washington Hospital Center (W.J.H.),
Washington, D.C. 20010; Center for Biostatistics (J.P.), The Methodist Hospital
Research Institute, Houston, Texas 77030; MedStar Health Research Institute (B.
V.H.), Hyattsville, Maryland 20782; and Georgetown and Howard Universities
Center for Clinical and Translational Sciences (B.V.H.), Washington, D.C.
20007.
Abstract
Context:Coronary heart disease (CHD) is the leading cause of death in the
United States.Objective:This study compares differences in risk factors for CHD
in diabetic vs. nondiabetic Strong Heart Study participants.Design:This was an
observational study.Setting:The study was conducted at three centers in
Arizona, Oklahoma, and North and South Dakota.Participants:Data were obtained
from 3563 of 4549 American Indians free of cardiovascular disease at baseline.
Intervention(s):CHD events were ascertained during follow-up.Main Outcome
Measure:CHD events were classified using standardized criteria.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.
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.
PMID: 22802089 [PubMed - as supplied by publisher]


Source: J Clin Endocrinol Metab. 2012 Jul 16. [Epub ahead of print]

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