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Coronary heart disease risk equivalence in diabetes depends on concomitant risk factors

Barbara V Howard1, Lyle G Best, James M Galloway

  • 1MedStar Research Institute, Washington, DC, USA. barbara.v.howard@medstar.net

Diabetes Care
|January 31, 2006
PubMed

Insights

Diabetes significantly increases coronary heart disease (CHD) risk, especially when multiple risk factors are present. Focusing on the overall risk factor profile is crucial for managing cardiovascular disease (CVD) in diabetic patients.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Diabetes is often considered a CHD risk equivalent, prompting aggressive treatment goals.
  • The impact of diabetes on cardiovascular disease (CVD) risk, particularly coronary heart disease (CHD), requires further population-based investigation.

Purpose of the Study:

  • To investigate the influence of single and multiple risk factors on the 10-year cumulative incidence of fatal and nonfatal CHD and CVD.
  • To compare CHD and CVD incidence in diabetic versus nondiabetic individuals, with and without pre-existing cardiovascular conditions.

Main Methods:

  • A population-based study of 4,549 individuals (men and women) with a high prevalence of diabetes.
  • Analysis of 10-year cumulative incidence of CHD and CVD, stratified by diabetes status, sex, and presence of other risk factors.

Main Results:

  • Diabetes significantly increased CHD risk in both sexes (HR 1.99 for men, 2.93 for women).
  • Diabetic individuals with multiple risk factors exhibited a 10-year CHD incidence exceeding 40%, comparable to nondiabetic individuals with prior CHD.
  • Similar patterns were observed for cardiovascular disease (CVD) and in separate analyses by sex.

Conclusions:

  • The rate of CHD in diabetes varies widely based on population and co-existing risk factors.
  • Diabetic individuals with multiple risk factors face a CHD incidence equivalent to patients with established CHD.
  • Treatment targets should consider the entire risk factor profile, not solely the presence of diabetes.
Abstract

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