Abstract
OBJECTIVE: The objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes with or without CV disease (CVD) associated with inadequately controlled glycated hemoglobin (A1C), high LDL cholesterol (LDL-C), high blood pressure (BP), and current smoking. RESEARCH DESIGN AND METHODS: Study subjects included 859,617 adults with diabetes enrolled for more than 6 months during 2005-2011 in a network of 11 U.S. integrated health care organizations. Inadequate risk factor control was classified as LDL-C ≥100 mg/dL, A1C ≥7% (53 mmol/mol), BP ≥140/90 mm Hg, or smoking. Major CV events were based on primary hospital discharge diagnoses for myocardial infarction (MI) and acute coronary syndrome (ACS), stroke, or heart failure (HF). Five-year incidence rates, rate ratios, and average attributable fractions were estimated using multivariable Poisson regression models. RESULTS: Mean (SD) age at baseline was 59 (14) years; 48% of subjects were female, 45% were white, and 31% had CVD. Mean follow-up was 59 months. Event rates per 100 person-years for adults with diabetes and CVD versus those without CVD were 6.0 vs. 1.7 for MI/ACS, 5.3 vs. 1.5 for stroke, 8.4 vs. 1.2 for HF, 18.1 vs. 40 for all CV events, and 23.5 vs. 5.0 for all-cause mortality. The percentages of CV events and deaths associated with inadequate risk factor control were 11% and 3%, respectively, for those with CVD and 34% and 7%, respectively, for those without CVD. CONCLUSIONS: Additional attention to traditional CV risk factors could yield further substantive reductions in CV events and mortality in adults with diabetes.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 905-912 |
| Number of pages | 8 |
| Journal | Diabetes Care |
| Volume | 38 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2015 |
Fingerprint
ASJC Scopus subject areas
- Internal Medicine
- Endocrinology, Diabetes and Metabolism
- Advanced and Specialized Nursing
Cite this
Preventable major cardiovascular events associated with uncontrolled glucose, blood pressure, and lipids and active smoking in adults with diabetes with and without cardiovascular disease : A contemporary analysis. / Vazquez-Benitez, Gabriela; Desai, Jay R.; Xu, Stanley; Goodrich, Glenn K.; Schroeder, Emily B.; Nichols, Gregory A.; Segal, Jodi; Butler, Melissa G.; Karter, Andrew J.; Steiner, John F.; Newton, Katherine M.; Morales, Leo S.; Pathak, Ram D.; Thomas, Abraham; Reynolds, Kristi; Kirchner, H. Lester; Waitzfelder, Beth; Lafata, Jennifer Elston; Adibhatla, Renuka; Xu, Zhiyuan; O'Connor, Patrick J.
In: Diabetes Care, Vol. 38, No. 5, 01.05.2015, p. 905-912.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Preventable major cardiovascular events associated with uncontrolled glucose, blood pressure, and lipids and active smoking in adults with diabetes with and without cardiovascular disease
T2 - A contemporary analysis
AU - Vazquez-Benitez, Gabriela
AU - Desai, Jay R.
AU - Xu, Stanley
AU - Goodrich, Glenn K.
AU - Schroeder, Emily B.
AU - Nichols, Gregory A.
AU - Segal, Jodi
AU - Butler, Melissa G.
AU - Karter, Andrew J.
AU - Steiner, John F.
AU - Newton, Katherine M.
AU - Morales, Leo S.
AU - Pathak, Ram D.
AU - Thomas, Abraham
AU - Reynolds, Kristi
AU - Kirchner, H. Lester
AU - Waitzfelder, Beth
AU - Lafata, Jennifer Elston
AU - Adibhatla, Renuka
AU - Xu, Zhiyuan
AU - O'Connor, Patrick J.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - OBJECTIVE: The objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes with or without CV disease (CVD) associated with inadequately controlled glycated hemoglobin (A1C), high LDL cholesterol (LDL-C), high blood pressure (BP), and current smoking. RESEARCH DESIGN AND METHODS: Study subjects included 859,617 adults with diabetes enrolled for more than 6 months during 2005-2011 in a network of 11 U.S. integrated health care organizations. Inadequate risk factor control was classified as LDL-C ≥100 mg/dL, A1C ≥7% (53 mmol/mol), BP ≥140/90 mm Hg, or smoking. Major CV events were based on primary hospital discharge diagnoses for myocardial infarction (MI) and acute coronary syndrome (ACS), stroke, or heart failure (HF). Five-year incidence rates, rate ratios, and average attributable fractions were estimated using multivariable Poisson regression models. RESULTS: Mean (SD) age at baseline was 59 (14) years; 48% of subjects were female, 45% were white, and 31% had CVD. Mean follow-up was 59 months. Event rates per 100 person-years for adults with diabetes and CVD versus those without CVD were 6.0 vs. 1.7 for MI/ACS, 5.3 vs. 1.5 for stroke, 8.4 vs. 1.2 for HF, 18.1 vs. 40 for all CV events, and 23.5 vs. 5.0 for all-cause mortality. The percentages of CV events and deaths associated with inadequate risk factor control were 11% and 3%, respectively, for those with CVD and 34% and 7%, respectively, for those without CVD. CONCLUSIONS: Additional attention to traditional CV risk factors could yield further substantive reductions in CV events and mortality in adults with diabetes.
AB - OBJECTIVE: The objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes with or without CV disease (CVD) associated with inadequately controlled glycated hemoglobin (A1C), high LDL cholesterol (LDL-C), high blood pressure (BP), and current smoking. RESEARCH DESIGN AND METHODS: Study subjects included 859,617 adults with diabetes enrolled for more than 6 months during 2005-2011 in a network of 11 U.S. integrated health care organizations. Inadequate risk factor control was classified as LDL-C ≥100 mg/dL, A1C ≥7% (53 mmol/mol), BP ≥140/90 mm Hg, or smoking. Major CV events were based on primary hospital discharge diagnoses for myocardial infarction (MI) and acute coronary syndrome (ACS), stroke, or heart failure (HF). Five-year incidence rates, rate ratios, and average attributable fractions were estimated using multivariable Poisson regression models. RESULTS: Mean (SD) age at baseline was 59 (14) years; 48% of subjects were female, 45% were white, and 31% had CVD. Mean follow-up was 59 months. Event rates per 100 person-years for adults with diabetes and CVD versus those without CVD were 6.0 vs. 1.7 for MI/ACS, 5.3 vs. 1.5 for stroke, 8.4 vs. 1.2 for HF, 18.1 vs. 40 for all CV events, and 23.5 vs. 5.0 for all-cause mortality. The percentages of CV events and deaths associated with inadequate risk factor control were 11% and 3%, respectively, for those with CVD and 34% and 7%, respectively, for those without CVD. CONCLUSIONS: Additional attention to traditional CV risk factors could yield further substantive reductions in CV events and mortality in adults with diabetes.
UR - http://www.scopus.com/inward/record.url?scp=84946731475&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84946731475&partnerID=8YFLogxK
U2 - 10.2337/dc14-1877
DO - 10.2337/dc14-1877
M3 - Article
C2 - 25710922
AN - SCOPUS:84946731475
VL - 38
SP - 905
EP - 912
JO - Diabetes Care
JF - Diabetes Care
SN - 1935-5548
IS - 5
ER -