Preventing Cardiovascular Disease and Diabetes
A call to action from the American Diabetes Association and the American Heart Association
- Robert H. Eckel, MD1,
- Richard Kahn, PHD2,
- Rose Marie Robertson, MD3 and
- Robert A. Rizza, MD4
- 1Department of Physiology and Biophysics, University of Colorado Health Science Center, Aurora, Colorado
- 2American Diabetes Association, Alexandria, Virginia
- 3American Heart Association, Dallas, Texas
- 4Endocrine Research Department, Mayo Clinic, Rochester, Minnesota
- Address correspondence and reprint requests to Richard Kahn, PhD, American Diabetes Association, 1701 N. Beauregard St., Alexandria, VA 22311. E-mail: rkahn{at}diabetes.org
Excess body weight has become a major public health problem in the U.S., with nearly two-thirds of adults either overweight or obese (1). The steady gain in the prevalence of obesity over the last 25 years has affected our entire population—no racial or ethnic group, no region of the country, and no socioeconomic group has been spared (2). Perhaps most worrisome is the observation that the rise in the rate of obesity has been greatest in children and minorities, which suggests that future generations of Americans, and our fastest growing populations, may bear the ultimate burden of this condition (3).
Overweight or obesity results in a wide range of elevated risk factors and many fatal and nonfatal conditions (4). Paradoxically, although we have witnessed decades in which heart disease and stroke have steadily declined and cancer mortality has at worse remained stable (5), the prevalence of diabetes has soared (6). The increase in diabetes can largely be attributed to weight gain (7,8), and it threatens the enormous advances in disease prevention we have seen (3,9,10).
Among individuals with diabetes, cardiovascular disease (CVD) is the leading cause of morbidity and mortality (9,11); adults with diabetes have a two- to fourfold higher risk of CVD compared with those without diabetes (12,13). Diabetes is also accompanied by a significantly increased prevalence of hypertension and dyslipidemia (14).
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