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 Booth, G. L. Articles by Tu, J. V. Search for Related Content PubMed PubMed Citation Articles by Booth, G. L. Articles by Tu, J. V. Social Bookmarking                What's this?

Recent Trends in Cardiovascular Complications Among Men and Women With and Without Diabetes

¹ Department of Medicine, University of Toronto, Toronto, Ontario, Canada
² Division of Endocrinology and Metabolism, St. Michael’s Hospital, Toronto, Ontario, Canada
³ Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
⁴ Department of Medicine, University Health Network, Toronto, Ontario, Canada
⁵ University Health Network Women’s Health Program, Toronto, Ontario, Canada
⁶ Department of Medicine, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada

Address correspondence and reprint requests to Dr. Gillian L. Booth, Division of Endocrinology and Metabolism, St. Michael’s Hospital, 61 Queen St., East, 6-147, Toronto, Ontario, Canada M5C 2T2. E-mail: boothg{at}smh.toronto.on.ca

OBJECTIVE—To compare recent trends in cardiovascular disease (CVD) outcomes among men and women with diabetes with those in the nondiabetic population.

RESEARCH DESIGN AND METHODS—We conducted a retrospective cohort study using provincial health claims data to identify adults with (n = 670,602) and without (n = 9,190,721) diabetes living in Ontario, Canada, between 1 April 1992 and 31 March 2000. We compared changes in the annual age-/sex-adjusted rates and numbers of subjects admitted for acute myocardial infarction (AMI) and stroke and of deaths from AMI, stroke, and all causes between those with and without diabetes.

RESULTS—Over the 8-year period, the rate of patients admitted for AMI and stroke fell to a greater extent in the diabetic than the nondiabetic population (AMI: –15.1 vs. –9.1%, P < 0.0001; stroke: –24.2 vs. 19.4%, P < 0.0001). Diabetic patients experienced similar reductions in case-fatality rates related to AMI and stroke than those without diabetes (–44.1 vs. –33.2%, P = 0.1; –17.1 vs. –16.6%, P = 0.9, respectively). Declines in all-cause mortality were also comparable in the two populations. Over the same period, the number of diabetes cases increased from 405,471 to 670,602. Thus, while CVD rates fell, the number of events occurring in this population rose substantially (AMI: +44.6%, stroke: +26.1%, AMI deaths: +17.2%, and stroke deaths: +13.2%).

CONCLUSIONS—Our findings demonstrate a significant reduction in the rate of people affected by CVD within the diabetic population. However, as the number of people with diabetes rises, so may the absolute burden of CVD in our society.

Abbreviations: AMI, acute myocardial infarction • CVD, cardiovascular disease • ODD, Ontario Diabetes Database

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

This article has been cited by other articles:

				A. C. Dale, L. J Vatten, T. I. Nilsen, K. Midthjell, and R. Wiseth Secular decline in mortality from coronary heart disease in adults with diabetes mellitus: cohort study BMJ, July 1, 2008; 337(jul01_2): a236 - a236. [Abstract] [Full Text] [PDF]

				W. Rosamond, K. Flegal, K. Furie, A. Go, K. Greenlund, N. Haase, S. M. Hailpern, M. Ho, V. Howard, B. Kissela, et al. Heart Disease and Stroke Statistics--2008 Update: A Report From the American Heart Association Statistics Committee and Stroke Statistics Subcommittee Circulation, January 29, 2008; 117(4): e25 - e146. [Full Text] [PDF]

				M. Tonelli MD SM, B. Manns MD MSc, B. Culleton MD MSc, S. Klarenbach MD MSc, B. Hemmelgarn MD PhD, N. Wiebe MMath PSta, J. S. Gill MD MSc, and for the Alberta Kidney Disease Network Association between proximity to the attending nephrologist and mortality among patients receiving hemodialysis Can. Med. Assoc. J., October 23, 2007; 177(9): 1039 - 1044. [Abstract] [Full Text] [PDF]

				V. F. Panoulas, K. M. J. Douglas, H. J. Milionis, A. Stavropoulos-Kalinglou, P. Nightingale, M. D. Kita, A. L. Tselios, G. S. Metsios, M. S. Elisaf, and G. D. Kitas Prevalence and associations of hypertension and its control in patients with rheumatoid arthritis Rheumatology, September 1, 2007; 46(9): 1477 - 1482. [Abstract] [Full Text] [PDF]

				P. Secchiero, R. Candido, F. Corallini, S. Zacchigna, B. Toffoli, E. Rimondi, B. Fabris, M. Giacca, and G. Zauli Systemic Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Delivery Shows Antiatherosclerotic Activity in Apolipoprotein E-Null Diabetic Mice Circulation, October 3, 2006; 114(14): 1522 - 1530. [Abstract] [Full Text] [PDF]

				CVD Declining in Diabetic Patients DOC News, March 1, 2006; 3(3): 18 - 18. [Full Text]