Age-specific impact of diabetes mellitus on the risk of cardiovascular mortality: An overview from the evidence for Cardiovascular Prevention from Observational Cohorts in the Japan Research Group (EPOCH-JAPAN)

Hirakawa, Yoichiro; Ninomiya, Toshiharu; Kiyohara, Yutaka; Murakami, Yoshitaka; Saitoh, Shigeyuki; Nakagawa, Hideaki; Okayama, Akira; Tamakoshi, Akiko; Sakata, Kiyomi; Miura, Katsuyuki; Ueshima, Hirotsugu; Okamura, Tomonori

doi:10.1016/j.je.2016.04.001

Cited by 33 publications

(25 citation statements)

References 32 publications

(58 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, in accordance with previous observational evidence, an attenuation in the effect of diabetes with age on CVD risk was observed in both men and women (Supplemental Table 7) providing further reassurance of the robustness of this data. [33][34][35] Second, our cohort, constructed with individuals with newly-diagnosed type 2 diabetes between 2006 and 2013, may limit comparisons with prior work that included individuals with prevalent diabetes.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes Mellitus

et al. 2019

View full text Add to dashboard Cite

Background: With recent changes in UK clinical practice for diabetes care, contemporary estimates of sex disparities in cardiovascular risk and risk factor management are needed. Methods: In this retrospective cohort study, using the Clinical Practice Research Datalink linked to hospital and death records for people in England, we identified 79,985 patients with incident T2DM between 2006-2013 matched to 386,547 patients without diabetes. Sex-stratified Cox models were used to assess cardiovascular risk. Results: Compared to women without T2DM, women with T2DM had a higher cardiovascular event risk (adjusted HR 1.20 [95% CI 1.12-1.28]) with similar corresponding data in men (HR 1.12 [1.06-1.19]) leading to a non-significant higher relative risk in women (risk ratio 1.07 [0.98-1.17]). However, some important sex differences in the management of risk factors were observed. Compared to men with T2DM, women with T2DM were more likely to be obese, hypertensive and have hypercholesterolaemia but were less likely to be prescribed lipid-lowering medication and ACE inhibitors, especially if they had CVD. Conclusions: Compared to men developing T2DM, women with T2DM do not have a significantly higher relative increase in cardiovascular risk, but ongoing sex disparities in prescribing should prompt heightened efforts to improve the standard and equity of diabetes care in women and men. What is new?• In contrast to earlier studies, in this large contemporary cohort we showed no significant gender disparities in CVD risk associated with the development of T2DM.• Important sex differences in the management of risk factors remained: women with T2DM were more likely to be obese, have hypercholesterolemia and hypertension and were less likely to be prescribed statins and ACE inhibitors, especially if they had CVD.• In T2DM subgroups with CVD, women were less likely to receive antiplatelet agents than men. What are the clinical implications?• The observed gender biases in risk factor management highlight the need for closer adherence to prescribing guidance, continued routine surveillance for gender-related prescribing biases and possibly greater uptake of professional-based interventions in the community supporting the provision of high-quality equitable care.• Particular attention is required for women with abnormal cardiovascular risk factors, who may be receiving suboptimal preventative care.

show abstract

Section: Strengths and Limitationsmentioning

confidence: 99%

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes Mellitus

et al. 2019

View full text Add to dashboard Cite

show abstract

“…We found it interesting that only approximately 16 and 17% of patients had DM or HTN, respectively. We hypothesize that this is related to high cardiovascular mortality in patients with DM, which preclude the majority with this diagnosis from reaching their 80’s [ 22 , 23 ], especially given the comorbidities and frailty that come with age [ 24 , 25 ]. One issue to consider is the increased risk of injury due to falls in this age group.…”

Section: Main Textmentioning

confidence: 99%

Incidence and outcomes of acute kidney injury in octogenarians in Jordan

Oweis

Alshelleh

2018

BMC Res Notes

View full text Add to dashboard Cite

ObjectiveImprovements in the health care system, resulted in a greater number of geriatric patients diagnosed with acute kidney injury (AKI). We evaluated the incidence and outcome of AKI in octogenarians, as studies in the Middle-East region are few; moreover, treatment approaches, in addition to medical decisions, may require special consideration for advanced age to improve the outcomes.ResultsAt King Abdullah II teaching and referral hospital, we recruited patients aged 80–90 years who were admitted to the medical floor between January 2010 and December 2013. Patients were followed-up for at least 1 year after discharge.850 patients were admitted during the study period. Of these, 135 were excluded from our analysis. The most common admission diagnoses were uncontrolled diabetes mellitus and acute coronary syndrome. AKI occurred in 216 patients (30.2%). Using the acute kidney injury network classification; stage 1, stage 2, and stage 3 disease were present in 59, 17.5, and 23.5% of patients, respectively. Of the 115 patients who died before discharge (16.1%), 87 (75.6%) had developed AKI. Hypertension, the use of angiotensin receptor blockers and non-steroidal anti-inflammatory drugs, heart failure, and exposure to radiologic contrast media were significant risk factors for AKI.

show abstract

“…Individuals with T2DM had two-to-four fold increase in cardiovascular disease (CVD) risk [ 2 ]. Compared with healthy individuals, subjects with T2DM had an increased risk of cardiovascular mortality [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

The prevalence and risk factors of dyslipidemia in different diabetic progression stages among middle-aged and elderly populations in China

Zhao

et al. 2018

PLoS ONE

View full text Add to dashboard Cite

ObjectivesThis study aimed to examine the prevalence and risk factors of dyslipidemia in different diabetic progression stages among middle-aged and elderly Chinese populations.MethodsThe 2010–2012 China National Nutrition and Health Survey (CNNHS) is a nationally representative cross-sectional study. In the present study, a total of 69,974 participants aged ≥ 45 years were included. Dyslipidemia was defined based on the Chinese adult dyslipidemia prevention guide. A multivariable logistic regression model was performed to examine the associations between risk factors and dyslipidemia.ResultsThe prevalence of dyslipidemia was 39.9%, 46.8%, and 59.3% in participants with normal glucose, prediabetes, and type 2 diabetes mellitus (T2DM). Women had a lower dyslipidemia prevalence than men (38.7% vs. 43.3%). Dyslipidemia prevalence was positively associated with the education level and inversely correlated with the physical activity level, and negatively related to age only among prediabetes and T2DM groups (P for trend < 0.05). Obesity, abdominal obesity, and hypertension were associated with dyslipidemia.ConclusionsThe prevalence of dyslipidemia was relatively high among middle-aged and elderly T2DM person. There are different associations between multiple risk factors and dyslipidemia in different diabetic progression stages.

show abstract

Age-specific impact of diabetes mellitus on the risk of cardiovascular mortality: An overview from the evidence for Cardiovascular Prevention from Observational Cohorts in the Japan Research Group (EPOCH-JAPAN)

Cited by 33 publications

References 32 publications

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes Mellitus

Cardiovascular Risk and Risk Factor Management in Type 2 Diabetes Mellitus

Incidence and outcomes of acute kidney injury in octogenarians in Jordan

The prevalence and risk factors of dyslipidemia in different diabetic progression stages among middle-aged and elderly populations in China

Contact Info

Product

Resources

About