Lifetime Risk of Cardiovascular Disease Among Individuals With and Without Diabetes Stratified by Obesity Status in the Framingham Heart Study

National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts, USA.
Diabetes care (Impact Factor: 8.57). 06/2008; 31(8):1582-4. DOI: 10.2337/dc08-0025
Source: PubMed

ABSTRACT We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes.
Participants were drawn from the original and offspring cohorts of the Framingham Heart Study. Lifetime (30-year) risk of CVD was assessed using a modified Kaplan-Meier approach adjusting for the competing risk of death, beginning from age 50 years.
Over 30 years, the lifetime risk of CVD among women with diabetes was 54.8% among normal-weight women and 78.8% among obese women. Among normal-weight men with diabetes, the lifetime risk of CVD was 78.6%, whereas it was 86.9% among obese men.
The lifetime risk of CVD among individuals with diabetes is high, and this relationship is further accentuated with increasing adiposity.

1 Follower
  • Source
    • "Cardiovascular disease (CVD) accounts for the majority of morbidity and mortality world-wide. Both are exacerbated by increases in associated risk factors such as obesity, diabetes and hypertension [1]. Causes of cardiac mortality can be divided into two categories: 1) cardiac, which includes both structural components such as heart failure and 2) functional components such as arrhythmogenic (neurologic) causes [2]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Heart rate is dependent on a cycle of depolarization and repolarization of the atria and ventricles that is regulated by intrinsic and extrinsic factors. Inhomogeneity in ventricular repolarization, measured as QT interval dispersion (QTd) is likely to lead to arrhythmia. The role of the autonomic nervous system in the development of this inhomogeneity is still uncertain. Autonomic regulation can be measured using the tone-entropy algorithm, which indicates inter-beat interval variation. When a sliding cut-off for QTd was used only the control group had a significant association between QTd and both tone and entropy. This finding suggests that for certain levels of ventricular inhomogeneity, autonomic control becomes more dissociated from intra-beat variation measured by QTd. This may be an early sign of potentially fatal arrhythmia.
    Computing in Cardiology, 2010; 10/2010
  • Source
    • "Furthermore, the risk of developing CVD dramatically increases when both diabetes and overweight/obesity are present. The coexistence of these 2 comorbidities results in a lifetime risk of between 80% and 90% of development of CVD in women and men, respectively [13]. Nearly 85% of patients with type 2 diabetes are overweight (body mass index [BMI] ≥ 25 kg/m2) and approximately 55% are considered obese (BMI ≥ 30 kg/m2) [14]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To summarize data supporting the effects of antidiabetes agents on glucose control and cardiovascular risk factors in patients with type 2 diabetes. Studies reporting on the effects of antidiabetes agents on glycemic control, body weight, lipid levels, and blood pressure parameters are reviewed and summarized for the purpose of selecting optimal therapeutic regimens for patients with type 2 diabetes. National guidelines recommend the aggressive management of cardiovascular risk factors in patients with type 2 diabetes, including weight loss and achieving lipid and blood pressure treatment goals. All antidiabetes pharmacotherapies lower glucose; however, effects on cardiovascular risk factors vary greatly among agents. While thiazolidinediones, sulfonylureas, and insulin are associated with weight gain, dipeptidyl peptidase-4 inhibitors are considered weight neutral and metformin can be weight neutral or associated with a small weight loss. Glucagon-like peptide-1 receptor agonists and amylinomimetics (e.g. pramlintide) result in weight loss. Additionally, metformin, thiazolidinediones, insulin, and glucagon-like peptide-1 receptor agonists have demonstrated beneficial effects on lipid and blood pressure parameters. Management of the cardiovascular risk factors experienced by patients with type 2 diabetes requires a multidisciplinary approach with implementation of treatment strategies to achieve not only glycemic goals but to improve and/or correct the underlying cardiovascular risk factors.
    Cardiovascular Diabetology 08/2010; 9:45. DOI:10.1186/1475-2840-9-45 · 3.71 Impact Factor
  • Source
    • "Additionally, studies demonstrate that, EMPs correlate in vivo with indices of EC dysfunction, the presence of coronary artery disease and with the complications of Diabetes Mellitus type 2 (DM) [5] [6]. DM is a major risk factor for cardiovascular morbidity and mortality, and the proportion of cardiovascular disease attributable to DM has increased over the past 50 years [7]. It is well established that endothelial dysfunction and inflammation are key features of DM and are independent of other cardiovascular risk factors [8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Endothelial Microparticles (EMPs) are small vesicles shed from activated or apoptotic endothelial cells and involved in cellular cross-talk. Whether EMP immunophenotypes vary according to stimulus in Diabetes Mellitus (DM) is not known. We studied the cellular adhesion molecule (CAM) profile of circulating EMPs in patients with and without Diabetes Mellitus type 2, who were undergoing elective cardiac catheterization. EMPs were analyzed by flow cytometry. The absolute median number of EMPs (EMPs/microL) specific for CD31, CD105, and CD106 was significantly increased in the DM population. The ratio of CD62E/CD31 EMP populations reflected an apoptotic process. Circulating CD31+, CD105+, and CD106+ EMPs were significantly elevated in patients with DM. EMPs were the only independent predictors of DM in our study cohort. In addition, the EMP immunophenotype reflected an apoptotic process. Circulating EMPs may provide new options for risk assessment.
    Mediators of Inflammation 06/2010; 2010(0962-9351):250476. DOI:10.1155/2010/250476 · 3.24 Impact Factor
Show more


Available from