Sex differences in cardiovascular and total mortality among diabetic and non-diabetic individuals with or without history of myocardial infarction

Hu, Gang; Jousilahti, Pekka; Qiao, Qing; Katoh, Shūichi; Tuomilehto, Jaakko

doi:10.1007/s00125-005-1730-6

Cited by 140 publications

(121 citation statements)

References 27 publications

(29 reference statements)

Supporting

Mentioning

110

Contrasting

Unclassified

Order By: Relevance

“…Our results were supported by the results of a recent meta-analysis by Bogers et al [9] comprising more than 300,000 participants. Table 4 Adjusted hazard ratios for change in BMI during the study period and first-incident fatal or non-fatal CHD, stroke and CVD and total mortality using Cox regression analysis in 4,916 overweight or obese (BMI 25-40 kg/m 2 ) type 2 diabetic patients followed-up for 6 BMI was shown to be an independent risk factor for CHD in that study, as the authors found the risk of CHD increased by 29% per 5 unit increase in BMI when adjusting for age, sex, physical activity and smoking, and by 16% when additionally adjusting for blood pressure and cholesterol.…”

Section: Discussionmentioning

confidence: 99%

“…It is well established that patients with diabetes are at high risk of cardiovascular disease (CVD) and that risk-factor control is of great importance in reducing this risk [4][5][6][7]. The association between overweight/obesity and the increased risk of cardiovascular disease is well established in the general population, in both men and women [8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

et al. 2008

View full text Add to dashboard Cite

Aims/hypothesis The aim of this study of type 2 diabetic patients in the Swedish National Diabetes Register was to study the associations of BMI, overweight (BMI 25-29.9 kg/m 2 ) and obesity (BMI≥30 kg/m 2 ) with cardiovascular disease in type 2 diabetes, as these associations have not previously been clarified. Methods Patients aged 30-74 years with no previous CHD or stroke (N=13,087) were followed for a mean of 5.6 years until 2003 for fatal or non-fatal CHD, stroke, cardiovascular disease (CHD or stroke) and total mortality. In total, 1,922 cardiovascular-disease events occurred, based on 64,864 person-years.Results The relative risks of CHD, stroke, cardiovascular disease and total mortality for a 5 unit increase in BMI at baseline were 15%, 11%, 13% and 27%, respectively, using Cox regression analysis, after adjusting for age, sex, diabetes duration, hypoglycaemic treatment and smoking (model 1), and were 9%, 4% (not significant), 7% and 20%, respectively, when adjusting also for HbA 1c , blood pressure, antihypertensive drugs, lipid-reducing drugs and microalbuminuria (model 2). Adjusted hazard ratios (model 1) for CHD, cardiovascular disease and total mortality with overweight were 1.27 (95% CI 1.09-1.48), 1.24 (1.09-1.41) and 1.16 (0.94-1.45), respectively, and 1.49 (1.27-1.76), 1.44 (1.26-1.64) and 1.71 (1.36-2.14) with obesity, as compared with normal weight. Significant hazard ratios were attenuated when adjusted according to model 2. For a 1 unit increase in BMI during follow-up, the relative risk of CHD (model 2) was 1.13 (1.04-1.23; p=0.005). Conclusions/interpretation Both overweight and obesity independently increased the risk of CHD and cardiovascular disease in patients with type 2 diabetes. The CHD risk was higher with increasing BMI than with stable or decreasing BMI during the study.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

et al. 2008

View full text Add to dashboard Cite

show abstract

“…Types 2 diabetes is a well-known risk factor for allcause, CVD and stroke mortality [23,[25][26][27][28]. A doseresponse relationship between level of hyperglycaemia and both CVD deaths and all-cause mortality has been observed [27].…”

Section: Discussionmentioning

confidence: 99%

Coffee consumption and risk of total and cardiovascular mortality among patients with type 2 diabetes

Bidel

Qiao

et al. 2006

Diabetologia

Self Cite

View full text Add to dashboard Cite

Aims/hypothesis Higher habitual coffee drinking has been associated with a lower risk of developing type 2 diabetes. The relation between coffee consumption and risk of cardiovascular disease (CVD) has been examined in many studies, but the issue remains controversial. This study was designed to assess the association between coffee consumption and CVD mortality among patients with type 2 diabetes. Methods We prospectively followed 3,837 randomly ascertained Finnish patients with type 2 diabetes aged 25 to 74 years. Coffee consumption and other study parameters were determined at baseline. The International Classification of Diseases was used to identify CHD, CVD and stroke cases using computerised record linkage to the national Death Registry. The associations between coffee consumption at baseline and risk of total, CVD, CHD, and stroke mortality were analysed by using Cox proportional hazards models. Results During the average follow-up of 20.8 years, 1,471 deaths were recorded, of which 909 were coded as CVD, 598 as CHD and 210 as stroke. The respective multivariateadjusted hazard ratios in participants who drank 0-2, 3-4, 5-6, and Q7 cups of coffee daily were 1.00, 0.77, 0.68 and 0.70 for total mortality (P<0.001 for trend), 1.00, 0.79, 0.70 and 0.71 for CVD mortality (P=0.006 for trend), 1.00, 0.78, 0.70 and 0.63 for CHD mortality (p=0.01 for trend), and 1.00, 0.77, 0.64 and 0.90 for stroke mortality (p=0.12 for trend). Conclusions/interpretation In this large prospective study we found that in type 2 diabetic patients coffee drinking is associated with reduced total, CVD and CHD mortality.

show abstract

“…Coronary heart disease has been identified as the leading cause of death among patients with type 2 diabetes [2]. In recent years, several studies have compared the magnitude of the risk of a history of type 2 diabetes and myocardial infarction on subsequent coronary mortality [6][7][8][9][10][11][12][13]. A Finnish prospective study found that the risk of coronary death among diabetic subjects without prior myocardial infarction was similar to that in non-diabetic subjects with prior myocardial infarction [6], but this finding has been challenged by several later studies [8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

“…Epidemiological studies have indicated that the risk of CVD mortality is two to four times higher in patients with type 2 diabetes than in those without diabetes [5]. Recent studies have investigated whether a history of myocardial infarction has the same risk on coronary death as a history of type 2 diabetes [6][7][8][9][10][11][12][13]. Our previous study reported that, among men, those who experienced myocardial infarction at baseline or during follow-up were at greater risk of coronary mortality than those with prior or incident diabetes; in women, prior myocardial infarction at baseline was associated with a lower risk of coronary mortality than prior diabetes, but incident myocardial infarction during follow-up was associated with a greater risk than incident diabetes [13].…”

mentioning

confidence: 99%

The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

Jousilahti

Sarti

et al. 2006

Diabetologia

Self Cite

View full text Add to dashboard Cite

Aims/hypothesis The aim of this study was to compare the magnitude of the effect of diabetes and stroke at baseline and during follow-up on risk of stroke mortality. Materials and methods Study cohorts included 25,155 Finnish men and 26,423 women aged 25-74 years. Data on diabetes and stroke history at baseline, their incidence during follow-up, and stroke death were obtained from national registers. Results During a mean follow-up of 18.9 years, 838 stroke deaths were recorded. In the baseline study, hazard ratios (HRs) for stroke mortality were 5.26 for men with prior diabetes only, 4.76 for men with prior stroke only, and 13.4 for men with both prior diabetes and stroke compared with men without diabetes and stroke at baseline and during follow-up. In women, the corresponding hazard ratios were 7.29, 5.27 and 5.52, respectively. When only diabetes and stroke status during the follow-up were considered, the hazard ratios for stroke mortality were 1.41 for men and 1.56 for women with incident diabetes only, 5.62 for men and 5.58 for women with incident stroke only, and 5.59 for men and 4.48 for women with both incident diabetes and stroke compared with men and women without diabetes and stroke at baseline and during follow-up. Conclusions/interpretation Diabetes and stroke, present either at baseline or during follow-up, markedly increase the risk of stroke death. Prior stroke at baseline carries a similar risk of stroke mortality as prior diabetes. There is a greater risk of stroke mortality associated with incident stroke during follow-up than with incident diabetes.

show abstract

Sex differences in cardiovascular and total mortality among diabetic and non-diabetic individuals with or without history of myocardial infarction

Abstract: Diabetes and MI markedly increase cardiovascular and all-cause mortality. In women, the association between diabetes and mortality was stronger than that between MI and mortality, whereas the converse was true among men.

Cited by 140 publications

References 27 publications

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

Risk of cardiovascular disease and mortality in overweight and obese patients with type 2 diabetes: an observational study in 13,087 patients

Coffee consumption and risk of total and cardiovascular mortality among patients with type 2 diabetes

The effect of diabetes and stroke at baseline and during follow-up on stroke mortality

Contact Info

Product

Resources

About