The long-term effectiveness of metabolic control on cardiovascular disease in patients with diabetes in a real-world health care setting — A prospective diabetes management study
Document Type
Article
Publication Date
6-1-2020
Abstract
Aims: To determine the incidence rates of cardiovascular disease (CVD) and assess the effect of metabolic risk factor management on the development of CVD in patients with diabetes. Methods: We studied 733 patients with diabetes without prior CVD in the Shanghai Taopu community health service center. Success in managing CVD risk factors was evaluated as follows: (1) glucose control (haemoglobin A1c [HbA1c] <7.0% in patients aged <65 years and <8.0% in patients aged ≥65 years), (2) blood pressure control (<140/90 mmHg), and (3) lipid control (high-density lipoprotein cholesterol ≥1.0 mmol/L in men and ≥1.3 mmol/L in women, and triglycerides <1.7 mmol/L). Results: During a median 8.0-year follow-up, 206 CVD incident cases were identified. Each 1% increment in HbA1c, 10 mmHg increment in systolic blood pressure (SBP), and 1 mmol/L increment in triglycerides during follow-up significantly increased the risk of CVD by 17%, 37%, and 14%, respectively. Compared to those who did not, patients who met the blood pressure and glucose control goals during follow-up had a 64% and a 29% decreased risk of CVD, respectively. The multivariable-adjusted hazard ratios of CVD were 1.00, 1.78 (95% confidence interval [CI] 1.10–2.87), and 2.51 (95% CI 1.54–4.07) among patients who attained three, two, and one/none of the CVD factor control goals (HbA1c, blood pressure, and lipid) during follow-up, respectively. Conclusions: Average levels of HbA1c, SBP, and triglycerides during follow-up were positively associated with the risk of CVD, and treatment targeting multiple factors can significantly reduce CVD risk.
Recommended Citation
Chen, S., Hou, X., Zhou, X., Yu, J., Xue, H., Hu, G., Sun, Y., Chen, P., Wu, J., Liang, Y., Bao, Y., & Jia, W. (2020). The long-term effectiveness of metabolic control on cardiovascular disease in patients with diabetes in a real-world health care setting — A prospective diabetes management study. Retrieved from https://repository.lsu.edu/pop_public_health_pubs/91