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

  1. Caroline S. Fox, MD, MPH1,2,3,
  2. Michael J. Pencina, PHD1,4,
  3. Peter W.F. Wilson, MD5,
  4. Nina P. Paynter, PHD1,4,
  5. Ramachandran S. Vasan, MD1,6 and
  6. Ralph B. D’Agostino, Sr, PHD1,4
  1. 1National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Massachusetts
  2. 2National Heart, Lung, and Blood Institute, Bethesda, Maryland
  3. 3Division of Endocrinology, Metabolism, and Hypertension, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
  4. 4Boston University Department of Mathematics, Boston, Massachusetts
  5. 5Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
  6. 6Boston University School of Medicine, Boston, Massachusetts
  1. Corresponding author: Caroline S. Fox, foxca{at}


OBJECTIVE—We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes.

RESEARCH DESIGN AND METHODS—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.

RESULTS—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.

CONCLUSIONS—The lifetime risk of CVD among individuals with diabetes is high, and this relationship is further accentuated with increasing adiposity.


  • Published ahead of print at on 5 May 2008.

    C.F. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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    • Received January 11, 2008.
    • Accepted May 1, 2008.
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