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CVD risk assessment priority for adults with diabetes, metabolic syndrome
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Approximately one-quarter of adults with type 2 diabetes and metabolic syndrome face a cardiovascular disease risk of at least 20%, according to research published in The Diabetes Educator.
“Diabetes educators should be aware that individuals with diabetes and metabolic syndrome are one of the most vulnerable groups for cardiovascular disease and should have priority in primary prevention of cardiovascular disease,” the researchers wrote.
Chun-Ja Kim, PhD, RN, of the Ajou University College of Nursing, Korea, and colleagues from other institutions conducted a cross-sectional survey involving 110 Korean adults (62% men; mean age, 56.5) with type 2 diabetes (mean duration, 12 years) and metabolic syndrome (based on national adult criteria) at a large university hospital in South Korea.
The investigators compared the risk equations from the Framingham and United Kingdom Prospective Diabetes (UKPDS) studies to calculate 10-year CVD risk.
CVD risk profile based on the Framingham study comprised sex, age, HDL cholesterol, total cholesterol, systolic blood pressure, diabetes and smoking status. Risk levels were classified as low (< 10%), moderate (10%-20%) or high (> 20%).
With CVD defined in the UKPDS as myocardial infarction, sudden cardiac death and other incidents of ischemic heart disease, stroke or peripheral vascular disease death, the researchers used age at diabetes diagnosis, sex, race, smoking status, HbA1c, systolic BP, and total cholesterol:HDL cholesterol ratio as variables.
On average, patients demonstrated a moderate prevalence of metabolic syndrome factors (64.3%); abdominal obesity was seen most often (86.4%), followed by elevated BP (78.2%). Fewer women than men smoked and consumed alcohol. More men than women had their weight and stress under control.
The mean scores of 10-year CVD risk were 14.55% using the Framingham equation and 15.99% using the UKPDS equation; no significant differences were seen between the results of the two equations.
Based on both equations, the percentage of high CVD risk was approximately 24%. Further, the area under the receiver operating characteristic curves using both engines was similar (Framingham, 0.707; UKPDS, 0.696), indicating moderate accuracy.
“In practice, people with type 2 diabetes and metabolic syndrome could be managed earlier and more intensively based on their risk estimated by the Framingham or UKPDS equations,” the researchers wrote. “The high prevalence of CVD seen in our study participants with diabetes and metabolic syndrome indicates that diabetes educators should consider incorporating assessment of CVD risk in this target population based on the relevant optimal cutoff point during routine care of persons with diabetes and metabolic syndrome.” – by Allegra Tiver
Disclosure: The research reports no relevant financial disclosures.
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