HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Smith, N. L. Articles by Psaty, B. M. Search for Related Content PubMed PubMed Citation Articles by Smith, N. L. Articles by Psaty, B. M. Social Bookmarking                What's this?

New-Onset Diabetes and Risk of All-Cause and Cardiovascular Mortality

The Cardiovascular Health Study

¹ Department of Epidemiology, University of Washington, Seattle, Washington
² Department of Biostatistics, University of Washington, Seattle, Washington
³ Department of Medicine, University of Washington, Seattle, Washington
⁴ Department of Health Services, University of Washington, Seattle, Washington
⁵ Kaiser Permanente of Georgia, Tucker, Georgia

Address correspondence and reprint requests to Nicholas L. Smith, PhD, Cardiovascular Health Research Unit, 1730 Minor Ave., Suite 1360, Seattle, WA 98101. E-mail: nlsmith{at}u.washington.edu

OBJECTIVE—Cardiovascular risk associated with new-onset diabetes is not well characterized. We hypothesized that risk of all-cause and cardiovascular mortality would be similar among participants with and without new-onset diabetes in the first years of follow-up and rise over time for new-onset diabetes.

RESEARCH DESIGN AND METHODS—The Cardiovascular Health Study (CHS) is a longitudinal study of cardiovascular risk factors in adults aged 65 years. We used CHS participants to define a cohort (n = 282) with new-onset diabetes during 11 years of follow-up. New-onset diabetes was defined by initiation of antidiabetes medication or by fasting plasma glucose >125 mg/dl among CHS participants without diabetes at study entry. Three CHS participants without diabetes were matched for age, sex, and race to each participant with new-onset diabetes at the time of diabetes identification (n = 837). Survival analysis provided adjusted hazard ratios (HRs) for all-cause and cardiovascular mortality.

RESULTS—During a median of 5.9 years of follow-up, there were 352 deaths, of which 41% were cardiovascular. In adjusted analyses, new-onset diabetes was associated with an HR of 1.9 (95% CI 1.4–2.5) for all-cause and 2.2 (1.4–3.4) for cardiovascular mortality compared with no diabetes. Mortality risks were elevated within 2 years of onset, especially cardiovascular risk (4.3 [95% CI 1.7–10.8]), and did not increase over time.

CONCLUSIONS—Our findings indicate that there may be a mortality differential soon after diabetes onset in older adults and suggest that long-term macrovascular damage from atherosclerosis may not be primarily responsible for increased risk.

Abbreviations: CHS, Cardiovascular Health Study

CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				G. Hu, P. Jousilahti, and J. Tuomilehto Joint effects of history of hypertension at baseline and type 2 diabetes at baseline and during follow-up on the risk of coronary heart disease Eur. Heart J., December 2, 2007; 28(24): 3059 - 3066. [Abstract] [Full Text] [PDF]

				P. Verdecchia, F. Angeli, and G. Reboldi New-Onset Diabetes, Antihypertensive Treatment, and Outcome Hypertension, September 1, 2007; 50(3): 459 - 460. [Full Text] [PDF]

				New-Onset Diabetes Ups Cardiovascular Risk DOC News, November 1, 2006; 3(11): 20 - 20. [Full Text]