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Prevalence of multiple cardiac risk factors in US adults with diabetes

Marianne McCollum1, Samuel L Ellis, Elaine H Morrato

  • 1School of Pharmacy, University of Colorado at Denver and Health Sciences, Denver, CO 80262, USA. Marianne.McCollum@uchsc.edu

Current Medical Research and Opinion
|July 19, 2006
PubMed

Insights

Diabetes significantly increases cardiac risk factors in US adults, with or without co-morbid heart disease. Aggressive management of modifiable risks is crucial for patients with diabetes mellitus (DM) and coronary heart disease (CHD).

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) classifies diabetes mellitus (DM) as a major risk factor for coronary events, equivalent to existing coronary heart disease (CHD).
  • Understanding the prevalence of additional cardiac risk factors in adults with DM is crucial for public health initiatives.
  • The Medical Expenditure Panel Survey (MEPS) provides nationally representative data for such epidemiological studies.

Purpose of the Study:

  • To estimate the national prevalence of additional coronary heart disease (CHD) risk factors in US adults with and without diabetes mellitus (DM).
  • To compare the burden of cardiac risk factors among different subgroups defined by the presence of DM and CHD.

Main Methods:

  • A retrospective analysis of nationally representative 2000 and 2002 Medical Expenditure Panel Survey (MEPS) data was conducted.
  • Adult respondents (n = 44,481) were assessed for diabetes mellitus (DM) and coronary heart disease (CHD) using ICD-9 codes and self-reported diagnoses.
  • Six additional risk factors (hypertension, hypercholesterolemia, smoking, age, obesity, physical inactivity) were evaluated.

Main Results:

  • Adults with DM, regardless of CHD status, exhibited significantly higher mean cardiac risk factor counts compared to those without DM.
  • The group with both CHD and DM had the highest mean risk factor count (3.4).
  • A substantial proportion of adults with DM (81.9%) and those with both DM and CHD (95.1%) had two or more risk factors.

Conclusions:

  • Diabetes mellitus is strongly associated with a high prevalence of cardiac risk factors in US adults, even in the absence of diagnosed heart disease.
  • These findings highlight the extensive public health challenge posed by diabetes and associated cardiovascular risks.
  • Aggressive management of modifiable risk factors in patients with diabetes, through lifestyle changes and pharmacotherapy, is essential and should align with NCEP ATP III guidelines.
Abstract

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