Clinical Manifestations of Cardiovascular Disease in Diabetes
Clinical Manifestations of Cardiovascular Disease in Diabetes
Aims: Cardiovascular disease may manifest as CHD, PVD and CbVD. Our aim was to explore these interactions and associated risk factors.
Methods: Patients were identified who attended clinic in 1990-1991 and remained under follow-up in 2000-2001. The latter were categorised by the presence/absence of manifest CHD, PVD and CbVD. Baseline clinic measurements (1990-1991) were studied in relation to CVD manifestations.
Results: Seven hundred and ninety-eight (CVD:358) patients were identified with follow-up. Of those with CVD: 51% had CHD, 14% PVD, and 9% CbVD exclusively. A further 17% had CHD+PVD, 4% CHD+CbVD, 2% PVD+CbVD, while 3% of patients had all three manifestations together. Increasing age, LDL-cholesterol and glucose were associated with increased risk of CHD, PVD and CbVD.
Conclusions: The majority of diabetic patients with CVD have CHD (75%), and only 3% have a combination of CHD, PVD and CbVD.
CVD is the major cause of mortality in patients with diabetes, and hence the cost and clinical implications of the condition are significant. Several environmental and physiological factors are associated with the development of CVD. Patients with diabetes have a two-three-fold increased incidence of CVD and those who present in the fourth and fifth decade of life have a two-fold increase in mortality. The type 2 diabetic patient who is a non-smoker, normotensive and has normal serum cholesterol has the same mortality risk from CVD as a non-diabetic subject who has two of these three risk factors present.
There are few reports in the literature looking at the association between CHD, PVD and CbVD in patients with CVD. The most informative data come from the CAPRIE study. This study population comprised of 19,185 patients (3,837 with diabetes) with pre-existing CVD, with a mean age of 62.5 years. Of these 29.9% had CHD only, 19.2% PVD only and 25.6% CbVD only. Only 3.3% of the patients had all three manifestations. However, in a study 1,802 patients with a mean age of 80 years, 816 patients had clinically manifest CVD. Of these, 75% had CHD but only 9% had all three manifestations.
The aim of this study was to explore the concurrence of CHD, CbVD and PVD in a cohort of diabetic patients and the role risk factors play in determining these manifestations over a 10-year period.
Aims: Cardiovascular disease may manifest as CHD, PVD and CbVD. Our aim was to explore these interactions and associated risk factors.
Methods: Patients were identified who attended clinic in 1990-1991 and remained under follow-up in 2000-2001. The latter were categorised by the presence/absence of manifest CHD, PVD and CbVD. Baseline clinic measurements (1990-1991) were studied in relation to CVD manifestations.
Results: Seven hundred and ninety-eight (CVD:358) patients were identified with follow-up. Of those with CVD: 51% had CHD, 14% PVD, and 9% CbVD exclusively. A further 17% had CHD+PVD, 4% CHD+CbVD, 2% PVD+CbVD, while 3% of patients had all three manifestations together. Increasing age, LDL-cholesterol and glucose were associated with increased risk of CHD, PVD and CbVD.
Conclusions: The majority of diabetic patients with CVD have CHD (75%), and only 3% have a combination of CHD, PVD and CbVD.
CVD is the major cause of mortality in patients with diabetes, and hence the cost and clinical implications of the condition are significant. Several environmental and physiological factors are associated with the development of CVD. Patients with diabetes have a two-three-fold increased incidence of CVD and those who present in the fourth and fifth decade of life have a two-fold increase in mortality. The type 2 diabetic patient who is a non-smoker, normotensive and has normal serum cholesterol has the same mortality risk from CVD as a non-diabetic subject who has two of these three risk factors present.
There are few reports in the literature looking at the association between CHD, PVD and CbVD in patients with CVD. The most informative data come from the CAPRIE study. This study population comprised of 19,185 patients (3,837 with diabetes) with pre-existing CVD, with a mean age of 62.5 years. Of these 29.9% had CHD only, 19.2% PVD only and 25.6% CbVD only. Only 3.3% of the patients had all three manifestations. However, in a study 1,802 patients with a mean age of 80 years, 816 patients had clinically manifest CVD. Of these, 75% had CHD but only 9% had all three manifestations.
The aim of this study was to explore the concurrence of CHD, CbVD and PVD in a cohort of diabetic patients and the role risk factors play in determining these manifestations over a 10-year period.
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