Age and gender differences in the impact of diabetes on the prevalence of ischemic heart disease: a population-based register study

Wiréhn, Ann-Britt; Östgren, Carl Johan; Carstensen, John

doi:10.1016/j.diabres.2007.10.009

Cited by 17 publications

(17 citation statements)

References 26 publications

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“…Data were obtained from the Care Data Warehouse in Östergötland [8]. This data register collects information about health care visits sent monthly from all public and private health care units in the county.…”

Section: Methodsmentioning

confidence: 99%

Distance to hospital and socioeconomic status influence secondary health care use

Zieliński

Borgqúist

Halling

2013

Scandinavian Journal of Primary Health Care

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ObjectiveThe aim of this study was to investigate how distance to hospital and socioeconomic status (SES) influence the use of secondary health care (SHC) when taking comorbidity into account.Design and settingA register-based study in Östergötland County.SubjectsThe adult population of Östergötland County.Main outcome measuresOdds of SHC use in the population and rates of SHC use by patients were studied after taking into account comorbidity level assigned using the Adjusted Clinical Groups (ACG) Case-Mix System. The baseline for analysis of SES was individuals with the lowest education level (level 1) and the lowest income (1st quartile).ResultsThe study showed both positive and negative association between SES and use of SHC. The risk of incurring SHC costs was 12% higher for individuals with education level 1. Individuals with income in the 2nd quartile had a 4% higher risk of incurring SHC costs but a 17% lower risk of emergency department visits. Individuals with income in the 4th quartile had 9% lower risk of hospitalization. The risk of using SHC services for the population was not associated with distance to hospital. Patients living over 40 km from hospital and patients with higher SES had lower use of SHC services.ConclusionsIt was found that distance to hospital and SES influence SHC use after adjusting for comorbidity level, age, and gender. These results suggest that GPs and health care managers should pay a higher degree of attention to this when planning primary care services in order to minimize the potentially redundant use of SHC.

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Section: Methodsmentioning

confidence: 99%

Distance to hospital and socioeconomic status influence secondary health care use

Zieliński

Borgqúist

Halling

2013

Scandinavian Journal of Primary Health Care

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“…Thus, in numerous studies the occurrence of diseases, such as coronary heart disease and stroke in diabetics, has been investigated [16-18]. Much less is known about the clustering of other disease combinations, such as heart disease and cancer, in the general population.…”

Section: Introductionmentioning

confidence: 99%

Co-occurrence of diabetes, myocardial infarction, stroke, and cancer: quantifying age patterns in the Dutch population using health survey data

Baal

Engelfriet

Boshuizen

et al. 2011

Popul Health Metrics

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BackgroundThe high prevalence of chronic diseases in Western countries implies that the presence of multiple chronic diseases within one person is common. Especially at older ages, when the likelihood of having a chronic disease increases, the co-occurrence of distinct diseases will be encountered more frequently. The aim of this study was to estimate the age-specific prevalence of multimorbidity in the general population. In particular, we investigate to what extent specific pairs of diseases cluster within people and how this deviates from what is to be expected under the assumption of the independent occurrence of diseases (i.e., sheer coincidence).MethodsWe used data from a Dutch health survey to estimate the prevalence of pairs of chronic diseases specified by age. Diseases we focused on were diabetes, myocardial infarction, stroke, and cancer. Multinomial P-splines were fitted to the data to model the relation between age and disease status (single versus two diseases). To assess to what extent co-occurrence cannot be explained by independent occurrence, we estimated observed/expected co-occurrence ratios using predictions of the fitted regression models.ResultsPrevalence increased with age for all disease pairs. For all disease pairs, prevalence at most ages was much higher than is to be expected on the basis of coincidence. Observed/expected ratios of disease combinations decreased with age.ConclusionCommon chronic diseases co-occur in one individual more frequently than is due to chance. In monitoring the occurrence of diseases among the population at large, such multimorbidity is insufficiently taken into account.

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“…23 Women with type 2 diabetes aged 35-54 years were at almost five times the risk of MI compared with women of the same age without diabetes (hazard ratio 4.86, 95% CI 2.78-8.51). Population-based registry data 24 show that although the CAD risk associated with diabetes decreases with age in both men and women (trend P values <0.001), it is higher among women than men in each age group. In the 45-54-year age group, diabetes is associated with an increase in ischaemic heart disease prevalence equivalent to ageing about 20 years in women and 10 years in men.…”

Section: Duration Of Undiagnosed Diabetesmentioning

confidence: 90%

Should diabetes still be considered a coronary artery disease equivalent?

Magri

Fava²

2012

Journal of Cardiovascular Medicine

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Diabetes is well established as a cardiovascular risk factor and is currently regarded as a coronary artery disease equivalent. However, some recent data have contradicted the concept. We review the currently available data and usefulness or otherwise of this concept. While the concept of coronary artery disease equivalence has served to highlight the importance of diabetes as a risk factor, it has a number of problems. We propose that it would be more useful to consider diabetes as a myocardial infarction risk equivalent. This is not only more precise and in line with the literature but also conveys better the message that patients with diabetes and one or more previous myocardial infarction(s) are at even higher risk.

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Age and gender differences in the impact of diabetes on the prevalence of ischemic heart disease: a population-based register study

Cited by 17 publications

References 26 publications

Distance to hospital and socioeconomic status influence secondary health care use

Distance to hospital and socioeconomic status influence secondary health care use

Co-occurrence of diabetes, myocardial infarction, stroke, and cancer: quantifying age patterns in the Dutch population using health survey data

Should diabetes still be considered a coronary artery disease equivalent?

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