Trends in All-Cause and Cardiovascular Disease Mortality Among Women and Men With and Without Diabetes Mellitus in the Framingham Heart Study, 1950 to 2005

Preis, Sarah R.; Hwang, Shih‐Jen; Coady, Sean; Pencina, Michael J.; D’Agostino, Ralph B.; Savage, Peter J.; Levy, Daniel; Fox, Caroline S.

doi:10.1161/circulationaha.108.829176

Cited by 528 publications

(403 citation statements)

References 22 publications

(26 reference statements)

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“…Our findings are consistent with results from the Framingham Heart Study [5] demonstrating no reduction of mortality rates in diabetes patients over the last 50 years and a persistent twofold higher mortality rate.…”

Section: Discussionsupporting

confidence: 92%

“…A decline in all-cause and cardiovascular mortality rates has been observed over the last decades among diabetes patients and individuals without diabetes. However, the decline in mortality rates in diabetes patients appears to be markedly lower than in individuals without diabetes [5,6]. Thus, diabetes patients remain at high risk of allcause and cardiovascular mortality [5].…”

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confidence: 99%

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Changes in short- and long-term cardiovascular risk of incident diabetes and incident myocardial infarction—a nationwide study

et al. 2010

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Aims/hypothesis We assessed secular trends of cardiovascular outcomes following first diagnosis of myocardial infarction (MI) or diabetes in an unselected population. Methods All Danish residents aged ≥30 years without prior diabetes or MI were identified by individual-level linkage of nationwide registers. Individuals hospitalised with MI or claiming a first-time prescription for a glucose-lowering medication (GLM) during the period from 1997 to 2006 were included. Analyses were by Poisson regression models. Primary endpoints were death by all causes, cardiovascular death and MI. Results The study included 3,092,580 individuals, of whom 77,147 had incident MI and 118,247 new-onset diabetes. MI patients had an increased short-term risk of all endpoints compared with the general population. The rate ratio (RR) for cardiovascular death within the first year after MI was 11.1 (95% CI 10.8-11.5) in men and 14.8 (14.3-15.3) in women, respectively. The risk rapidly declined and 1 year after the index MI, RR was 2.11 (2.00-2.23) and 2.8 (2.64-2.97) in men and women, respectively. Patients with diabetes carried a constantly elevated risk of all endpoints compared with the general population. The cardiovascular death RR was 1.90 (1.77-2.04) and 1.92 (1.78-2.07) in men and women, respectively during the first year after GLM initiation. Conclusions/interpretation Incident MI is associated with high short-term risk, which decreases rapidly over time. Incident diabetes is associated with a persistent excessive cardiovascular risk after initiation of GLM therapy. This further strengthens the necessity of early multi-factorial intervention in diabetes patients for long-term benefit.

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Section: Discussionsupporting

confidence: 92%

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confidence: 99%

Changes in short- and long-term cardiovascular risk of incident diabetes and incident myocardial infarction—a nationwide study

et al. 2010

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“…Moreover, rates of diabetes‐related complications have declined in the past 2 decades 10, 11. Although mortality rates in patients with diabetes remain higher compared to those without diabetes, reductions in all‐cause mortality in individuals with diabetes have occurred over time throughout the world 12, 13, 14, 15, 16. Therefore, we aimed to examine whether there were improved outcomes over time in individuals with diabetes in the 1999 to 2010 US NHANES.…”

Section: Introductionmentioning

confidence: 99%

Favourable changes in mortality in people with diabetes: US NHANES 1999–2010

Tsujimoto

Kajio

Sugiyama

2017

Diabetes Obesity Metabolism

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AimsDiabetes‐related complications have declined during the past two decades. We aimed to examine whether mortality in people with diabetes improved over time in the 1999 to 2010 National Health and Nutrition Examination Survey (NHANES).MethodsWe conducted a prospective cohort study using 1999 to 2004 and 2005 to 2010 data from the NHANES. For primary analyses, we compared the unadjusted, age‐adjusted and multivariable‐adjusted hazard ratios (HR) for mortality outcomes (total, cardiovascular, cardiac and cancer deaths) of the participants with diabetes with those without diabetes using Cox proportional hazard models.ResultsFor each mortality outcome, HR (95% confidence interval) in diabetic participants during the period 2005 to 2010 was lower than that during the period 1999 to 2004 (all‐cause death, 2.76 [1.87‐4.08] vs 4.23 [2.57‐6.98]; cardiovascular death, 2.70 [1.20‐6.04] vs 8.82 [3.28‐23.70]; cardiac death, 2.45 [0.98‐6.09] vs 15.55 [7.01‐34.50]; cancer death, 2.33 [0.87‐6.23] vs 3.03 [1.20‐7.65]). Compared with mortality outcome during the period 1999 to 2004, greater declines in mortality during the period 2005 to 2010 were observed for cardiovascular (−54.0%) and cardiac deaths (−64.8%). In age‐adjusted and multivariable‐adjusted models, the cumulative event rates for total, cardiovascular and cardiac deaths were not significantly different between participants with and without diabetes during the period 2005–2010; this was not the case during the period 1999–2004. The leading cause of death was malignant neoplasm during the period 2005–2010.ConclusionConsiderably improved outcomes for total, cardiovascular and cardiac deaths were observed in people with diabetes during the 2005 to 2010 NHANES compared to the 1999 to 2004 NHANES.

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“…1, 2 The presence of increased adiposity is associated with elevated risk of development of cardiovascular and renal complications. [2][3][4] Evidence from several studies indicates that obesity and weight gain are associated with an increased risk of hypertension and diabetes. 1,2,5,6 Furthermore, several large cohort studies have demonstrated close associations between obesity, especially abdominal obesity and the onset of chronic kidney disease (CKD) [7][8][9][10][11] and faster CKD progression.…”

Section: Introductionmentioning

confidence: 99%

Effects of weight loss on renal function in overweight Japanese men

et al. 2011

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Obesity is known as an independent risk factor for renal injury. Sympathetic nerve activation may have an important role of the pathogenesis of obesity, and hypertension may underpin the development of cardiovascular events. In the present study, we evaluated the effects of weight loss (WL) on renal function, especially focusing on sympathetic nervous activity. In 154 overweight or obese Japanese men (89 normotensive and 65 untreated mild hypertensive subjects), body weight, body mass index (BMI), total body fat mass, blood pressure (BP), serum creatinine, blood urea nitrogen, creatinine clearance (CCr) (calculated with the Cockcroft-Gault equation) and plasma norepinephrine (NE) were measured before and after a 12-month period of WL with a mild caloric-restricted diet and exercise. A significant WL was defined as 10% or more WL compared with the entry period. In total, 97 (63.0%) subjects succeeded in significant (by 14.3%) WL at 12 months, and 57 subjects (37.0%) did not succeed in significant WL but they lost 7.7% weight. At entry, levels of plasma NE, serum creatinine and fat mass were significantly lower and CCr was greater in the group with a significant WL compared with those without WL. BMI, total body fat mass and plasma NE significantly decreased, and CCr increased with WL. At both baseline and at the 12-month period, fat mass and plasma NE negatively correlated with CCr and positively correlated with creatinine at each time point. Changes in fat mass and plasma NE over 12 months correlated with changes in creatinine, and only changes in fat mass negatively correlated with changes in CCr. Basal fat mass and plasma NE correlated positively with serum creatinine at 12 months and negatively with CCr at the same time point. In multiple regression analyses, basal plasma NE and fat mass were significant determinants of serum creatinine levels and CCr at 12 months.In conclusion, WL improved renal function (as evident from measures of creatinine and CCr) in overweight individuals. Basal plasma NE levels and total body fat mass could be predictors for improvement in renal function associated with WL. Suppression of sympathetic nervous activation associated with WL may have a role in the ameliorative effects on renal function.

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Trends in All-Cause and Cardiovascular Disease Mortality Among Women and Men With and Without Diabetes Mellitus in the Framingham Heart Study, 1950 to 2005

Abstract: Background-Despite population declines in all-cause mortality, women with diabetes mellitus may have experienced an increase in mortality rates compared with men.

Cited by 528 publications

References 22 publications

Changes in short- and long-term cardiovascular risk of incident diabetes and incident myocardial infarction—a nationwide study

Changes in short- and long-term cardiovascular risk of incident diabetes and incident myocardial infarction—a nationwide study

Favourable changes in mortality in people with diabetes: US NHANES 1999–2010

Effects of weight loss on renal function in overweight Japanese men

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