TY - JOUR
T1 - Prevalence of clinical and isolated subclinical cardiovascular disease in older adults with glucose disorders
T2 - The cardiovascular health study
AU - Barzilay, Joshua I.
AU - Spiekerman, Charles F.
AU - Kuller, Lewis H.
AU - Burke, Gregory L.
AU - Bittner, Vera
AU - Gottdiener, John S.
AU - Brancati, Fred L.
AU - Orchard, Trevor J.
AU - O'Leary, Daniel H.
AU - Savage, Peter J.
PY - 2001
Y1 - 2001
N2 - OBJECTIVE- Clinical cardiovascular disease (CVD) is highly prevalent among people with diabetes. However, there is little information regarding the prevalence of subclinical CVD and its relation to clinical CVD in diabetes and in the glucose disorders that precede diabetes. RESEARCH DESIGN AND METHODS- Participants in the Cardiovascular Health Study, aged S65 years (n = 5, 888), underwent vascular and metabolic testing. Individuals with known disease in the coronary, cerebral, or peripheral circulations were considered to have clinical disease. Those without any clinical disease in whom CVD was detected by ultrasonography, electrocardiography, or ankle arm index in any of the three vascular beds were considered to have isolated subclinical disease. RESULTS- Approximately 30% of the cohort had clinical disease, and ∼60% of the remainder had isolated subclinical disease. In those with normal glucose status, isolated subclinical disease made up most of the total CVD. With increasing glucose severity, the proportion of total CVD that was clinical disease increased; 75% of men and 66% of women with normal fasting glucose status had either clinical or subclinical CVD. Among those with known diabetes, the prevalence was -88% (odds ratio [OR] 2.46 for men and 4.22 for women, P < 0.0001). There were intermediate prevalences and ORs for those with impaired fasting glucose status and newly diagnosed diabetes. CONCLUSIONS- Isolated subclinical CVD is common among older adults. Glucose disorders are associated with an increased prevalence of total CVD and an increased proportion of clinical disease relative to subclinical disease.
AB - OBJECTIVE- Clinical cardiovascular disease (CVD) is highly prevalent among people with diabetes. However, there is little information regarding the prevalence of subclinical CVD and its relation to clinical CVD in diabetes and in the glucose disorders that precede diabetes. RESEARCH DESIGN AND METHODS- Participants in the Cardiovascular Health Study, aged S65 years (n = 5, 888), underwent vascular and metabolic testing. Individuals with known disease in the coronary, cerebral, or peripheral circulations were considered to have clinical disease. Those without any clinical disease in whom CVD was detected by ultrasonography, electrocardiography, or ankle arm index in any of the three vascular beds were considered to have isolated subclinical disease. RESULTS- Approximately 30% of the cohort had clinical disease, and ∼60% of the remainder had isolated subclinical disease. In those with normal glucose status, isolated subclinical disease made up most of the total CVD. With increasing glucose severity, the proportion of total CVD that was clinical disease increased; 75% of men and 66% of women with normal fasting glucose status had either clinical or subclinical CVD. Among those with known diabetes, the prevalence was -88% (odds ratio [OR] 2.46 for men and 4.22 for women, P < 0.0001). There were intermediate prevalences and ORs for those with impaired fasting glucose status and newly diagnosed diabetes. CONCLUSIONS- Isolated subclinical CVD is common among older adults. Glucose disorders are associated with an increased prevalence of total CVD and an increased proportion of clinical disease relative to subclinical disease.
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U2 - 10.2337/diacare.24.7.1233
DO - 10.2337/diacare.24.7.1233
M3 - Article
C2 - 11423508
AN - SCOPUS:0035404052
SN - 0149-5992
VL - 24
SP - 1233
EP - 1239
JO - Diabetes care
JF - Diabetes care
IS - 7
ER -