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糖尿病の心血管合併症の傾向について
Caroline S Fox1, Sean Coady, Paul D Sorlie
1National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass 01702-5827, USA. foxca@nhlbi.nih.gov
JAMA
|November 25, 2004
まとめ
糖尿病の成人では,糖尿病のない人と同じく,心血管疾患 (CVD) の発生率がほぼ50%減少した. しかし,心血管疾患の絶対的なリスクは,糖尿病患者の場合,依然として高くなります.
科学分野:
- 心臓病学 心臓病学
- エンドクリノロジー エンドクリノロジー
- 公衆衛生は公衆衛生である.
背景:
- 心血管疾患 (CVD) 死亡率は減少しているが,糖尿病と非糖尿病の成人の間でCVDリスクの比較的な低下は不明である.
- これらの傾向を理解することは,公衆衛生戦略と患者ケアにとって極めて重要です.
研究 の 目的:
- 1950年から1995年の間に,糖尿病と糖尿病のない成人が,インシデントCVDの同様の減少を経験したかどうかを調査する.
- 糖尿病と非糖尿病の集団における異なる期間におけるCVD発生率の動向を比較する.
主な方法:
- 45歳から64歳までのフレミングハム心臓研究コホート (オリジナルと子孫) の分析.
- 前期 (1950年−1966年) と後期 (1977年−1995年) のCVD発生率 (心筋梗塞,冠動脈疾患による死亡,脳卒中) の比較.
- 前期には4118人 (糖尿病は113人),後期には4063人 (糖尿病は317人) が参加した.
主要な成果:
- 糖尿病の参加者の中で,CVDの発生率は49.3%減少しました (10,000人年あたり286.4から146.9に).
- 糖尿病のない参加者の中で,CVDの発生率は35.4%減少した (84.6から1万人年あたり54.3に減少した).
- インシデントCVDに対する糖尿病の予測値は,2つの期間間で有意に異なるものではありませんでした.
結論:
- 糖尿病と非糖尿病の両方の成人では,心血管疾患の発生率が著しく低下し,介護の全体的な進歩から同様の利点が示唆されています.
- 類似した相対的な減少にもかかわらず,CVDの絶対リスクは,糖尿病の個人に大幅に高いままです.
- CVDリスク因子のさらなる研究と積極的な管理は,糖尿病患者の増加したCVDリスクを軽減するために不可欠です.
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