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Age, sex, metabolic control associated with CV complications in diabetes
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Among Puerto Rican adults with type 2 diabetes, cardiovascular complications are more likely to occur in men, those aged at least 50 years and those with poor disease control, according to a retrospective analysis.
Efrain Rodriguez-Vigil, MD, FACP, of the Center for Diabetes Control in Carolina, Puerto Rico, and colleagues analyzed medical data from 2,075 patients with type 1 and type 2 diabetes visiting a local endocrinologist for at least two appointments (average number of visits, 7.8) between 2001 and 2009 (54% women; 82% aged at least 50 years; 14% had CVD). At each visit, patients underwent a physical exam including measurements for blood pressure, BMI and reviews of any diagnostic tests. Prevalence of chronic diabetes complications was estimated with data from encounters at which the health complication was first detected, according to researchers; multiple logistic regression analyses were used to determine which factors were associated with self-reported CV complications.
After adjusting for BMI, pulse pressure and HDL cholesterol, researchers found men were 1.5 times more likely to develop CV complications vs. women (OR = 1.72; 95% CI, 1.21-2.45). Odds were also higher for patients who had diabetes for 5 to 15 years vs. those who had the disease for 5 years or less (OR = 1.55; 95% CI, 0.99-2.45), with the greatest risk among patients with diabetes for at least 15 years (OR = 2.52; 95% CI, 1.55-4.11).
Researchers also observed a “strong relationship” between a higher HbA1c and CV complications in diabetes.
“We cannot set a cutoff point, but for a 1-unit increase in HbA1c over 7%, we expect a 21% increase in the odds of having a CV event,” the researchers wrote.
In a second model adjusting for sex, diabetes duration, BMI, pulse pressure, HDL cholesterol and HbA1c, patients with microalbuminuria were 2.5 times more likely to develop CV complications vs. patients with normal microalbumin renal excretion (OR = 2.46; 95% CI, 1.24-4.88).
“In this analysis, we found that the time living with diabetes is a strong risk factor for the development of macrovascular complications as well as HbA1c, with a cutoff value of 130 mm Hg for systolic [BP] and 7% for HbA1c, the researchers wrote. “This means that long-term diabetes control, as measured by HbA1c level, is a strong predictor of CV complications accompanying diabetes mellitus.” – by Regina Schaffer
D isclosure: The researchers report no relevant financial disclosures.
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