Prevalence of Cardiovascular and Renal Complications in Older Adults With Normal or Impaired Glucose Tolerance or NIDDM: A population-based study

Wingard, Deborah L.; Barrett‐Connor, Elizabeth; Scheidt‐Nave, Christa; McPhillips, Janice B.

doi:10.2337/diacare.16.7.1022

Cited by 99 publications

(54 citation statements)

References 4 publications

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“…[21][22][23] Moreover, myocardial ischemia due to coronary atherosclerosis commonly occurs without symptoms in patients with diabetes. 29 As a result, multivessel atherosclerosis often is present before ischemic symptoms occur and before treatment is instituted. A delayed recognition of various forms of CHD undoubtedly worsens the prognosis for survival for many diabetic patients.…”

Section: Diabetes and Specific Cvd Atherosclerotic Chdmentioning

confidence: 99%

“…Prospective studies [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40] indicate that all of the major cardiovascular risk factors-cigarette smoking, hypertension, and high serum cholesterol-continue to act as independent contributors to CVD in patients with diabetes. As already mentioned, clustering of metabolic risk factors, called the metabolic syndrome, occurs commonly in type 2 diabetes.…”

Section: Covariate Risk Factorsmentioning

confidence: 99%

See 1 more Smart Citation

Diabetes and Cardiovascular Disease

Grundy¹,

Benjamin²,

Burke³

et al. 1999

Circulation

1,850

531

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Section: Diabetes and Specific Cvd Atherosclerotic Chdmentioning

confidence: 99%

Section: Covariate Risk Factorsmentioning

confidence: 99%

Diabetes and Cardiovascular Disease

Grundy¹,

Benjamin²,

Burke³

et al. 1999

Circulation

1,850

531

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“…We aimed to include 38 patients in each group to have a 90% probability to detect a true mean difference in the change of LVM index of 15 g/m 2 (assumed s.d., 20 g/m 2 ) and in carotid DC of 2.5 Â 10 À3 /kPa (assumed s.d., 0.8 Â 10 3 /kPa) between the treatment groups at a ¼ 0.05. However, owing to laborious inclusion, we had to stop inclusion before reaching the planned number of patients.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…1,2 Hypertension control in these patients substantially reduces cardiovascular risk, 3 and current guidelines therefore recommend aggressive treatment of hypertension in type II diabetes.…”

Section: Introductionmentioning

confidence: 99%

Aggressive antihypertensive strategies based on hydrochlorothiazide, candesartan or lisinopril decrease left ventricular mass and improve arterial compliance in patients with type II diabetes mellitus and hypertension

et al. 2006

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We investigated the effects of aggressive antihypertensive therapy based on hydrochlorothiazide, candesartan or lisinopril on left ventricular mass (LVM) index and arterial stiffness in hypertensive type II diabetic individuals. Seventy hypertensive type II diabetic individuals were treated with three antihypertensive strategies in a randomized, double-blind, double-dummy design. Blood pressure was titrated to levels below 130/ 85 mm Hg or a decrease in systolic pressure of 10% with a diastolic pressure below 85 mm Hg. After titration, patients were treated for 12 months. Mean blood pressures were 157/93, 151/94 and 149/93 mm Hg at baseline in the hydrochlorothiazide (n ¼ 24), candesartan (n ¼ 24) and lisinopril (n ¼ 22) groups, and 135/80, 135/82 and 131/80 mm Hg after titration. About 70% reached target blood pressures, with the median use of three antihypertensive drugs. Left ventricular mass index and all estimates of arterial stiffness showed significant improvement after 12 months: that is, LVM index (À11 g/m 2 ; À8%); carotid distensibility coefficient (DC; þ 2.8 Â 10 À3 kPa À1 ; þ 27%), compliance coefficient (CC; þ 0.13 mm 2 /kPa; þ 21%) and elastic modulus (À0.19 kPa; À16%); femoral DC ( þ 1.6 Â 10 À3 kPa À1 ; þ 50%) and CC ( þ 0.08 mm 2 /kPa; þ 26%); brachial DC ( þ 2.1 Â 10 À3 kPa À1 ; þ 39%) and CC ( þ 0.03 mm 2 /kPa; þ 27%) and total systemic arterial compliance ( þ 0.29 ml/mm Hg; þ 16%). No differences in outcome variables between treatment groups were observed. Aggressive antihypertensive treatment, although difficult to achieve, resulted in substantial reductions of LVM index and arterial stiffness in relatively uncomplicated hypertensive type II diabetic individuals. Strategies based on renin-angiotensin system inhibitors were not clearly superior to conventional (i.e. diuretic-based) strategies.

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“…10,[13][14][15] Recently, prediabetic hyperglycemia has been recognized to confer an increased risk for CVD. 16 However, a few population studies 17 have reported a positive association between CVD and impaired fasting glucose (defined as blood glucose of 5.6-6.9 mmol l À1 according to the 2003 American Diabetes Association definition). 18 Evaluation of the combined impact of these two major borderline risk factors is essential in preventing CVD because elevated BP is the highest population attributable fraction (PAF) of CVD incidence, and the incidence of hyperglycemia is increasing in Asian and Western countries.…”

Section: Introductionmentioning

confidence: 99%

The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: the Suita Study

et al. 2010

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Few prospective studies have examined the combined impact of blood pressure (BP) categories and glucose abnormalities on the incidence of cardiovascular disease (CVD) in the general Asian population. This study aimed to examine the effect of the combined risks of these factors on the incidence of CVD in a general Japanese population. We studied 5321 Japanese individuals (aged 30-79 years), without CVD at baseline, who received follow-up for an average of 11.7 years. Serum fasting glucose categories were defined according to the 2003 American Diabetes Association recommendations. BP categories were defined by the 2009 Japanese Society of Hypertension Guidelines for the Management of Hypertension. The Cox proportional hazard ratios (HRs) for CVD according to the serum glucose and BP categories were calculated. In 62 036 person-years of follow-up, we documented 364 CVD events (198 stroke and 166 coronary heart disease (CHD)). Compared with normoglycemic subjects, the multivariable HRs (95% confidence intervals (CIs)) for CVD, CHD and stroke were 1.25 (1.00-1.58), 1.46 (1.04-2.04) and 1.11 (0.81-1.52), respectively, in individuals with impaired fasting glucose (IFG), whereas these values were 2.13 (1.50-3.03), 2.28 (1.34-3.88) and 2.08 (1.29-3.35), respectively, in individuals with diabetes mellitus (DM). Compared with normoglycemic and optimal blood pressure (BP) subjects, increased risks of CVD were observed in the normoglycemic subjects with high-normal BP or hypertension, the IFG subjects with normal or higher BP, and the DM subjects regardless of BP category (P-value for interaction¼0.046). In conclusion, the high-normal BP subjects in all glucose categories and the normal BP subjects with IFG showed increased risk of CVD in this Japanese population. Further investigation of larger cohorts of DM subjects should be conducted to better understand this phenomenon.

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Prevalence of Cardiovascular and Renal Complications in Older Adults With Normal or Impaired Glucose Tolerance or NIDDM: A population-based study

Cited by 99 publications

References 4 publications

Diabetes and Cardiovascular Disease

Diabetes and Cardiovascular Disease

Aggressive antihypertensive strategies based on hydrochlorothiazide, candesartan or lisinopril decrease left ventricular mass and improve arterial compliance in patients with type II diabetes mellitus and hypertension

The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: the Suita Study

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