Cardiovascular events in type 2 diabetes: comparison with nondiabetic individuals without and with prior cardiovascular disease. 10-year follow-up of the Hoorn Study

A. Becker, G. Bos, F. de Vegt, P.J. Kostense, J.M. Dekker, G. Nijpels, R.J. Heine, L.M. Bouter, C.D.A. Stehouwer

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    Abstract

    AIMS: We questioned whether prior cardiovascular disease has the same impact on risk of cardiovascular events as type 2 diabetes, and whether this differed between men and women.

    METHODS AND RESULTS: To address these issues we compared the 10-year risk of cardiovascular events among 208 Caucasian individuals with diabetes to that of 2253 Caucasian individuals without diabetes, in a population-based cohort study. Gender significantly modified the association between type 2 diabetes and cardiovascular events (p=0.01). The hazard ratio of cardiovascular events associated with the presence of diabetes was higher in women (adjusted hazard ratio, 1.8; 95% CI, 1.2 to 2.7) than in men (adjusted hazard ratio, 1.3; 0.9 to 2). As compared to men without diabetes but with prior cardiovascular disease, risk of cardiovascular events was significantly lower in men with diabetes but without prior cardiovascular disease (adjusted hazard ratio, 0.5; 0.3 to 0.9). In contrast, this risk was equal in women with diabetes but without prior cardiovascular disease and women without diabetes but with prior cardiovascular disease (adjusted hazard ratio, 1.0; 0.6 to 1.7; P for interaction between gender and diabetes=0.05).

    CONCLUSIONS: Women with diabetes but without prior cardiovascular disease have a risk of cardiovascular events that is similar to that of women without diabetes but with prior cardiovascular disease, whereas in men the presence of prior cardiovascular disease conferred a higher risk. These data emphasise the necessity of aggressive treatment of cardiovascular risk factors in women with type 2 diabetes.

    Original languageEnglish
    Pages (from-to)1406-1413
    Number of pages8
    JournalEuropean Heart Journal
    Volume24
    Issue number15
    DOIs
    Publication statusPublished - Aug 2003

    Keywords

    • Aged
    • Diabetes Mellitus, Type 2
    • Diabetic Angiopathies
    • Epidemiologic Factors
    • Female
    • Humans
    • Male
    • Middle Aged
    • Comparative Study
    • Journal Article
    • Research Support, Non-U.S. Gov't

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