Preventable Coronary Heart Disease Events from Control of Cardiovascular Risk Factors in US Adults With Diabetes (Projections from Utilizing the UKPDS Risk Engine)
Preventable Coronary Heart Disease Events from Control of Cardiovascular Risk Factors in US Adults With Diabetes (Projections from Utilizing the UKPDS Risk Engine)
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DOI：
10.1016/j.amjcard.2013.12.042
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发表时间：
2014-04-15
影响因子：
2.8
通讯作者：
Iloeje, Uchenna
中科院分区：
文献类型：
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作者：
Wong, Nathan D.;Patao, Christopher;Iloeje, Uchenna
2型糖尿病（T2DM）具有显著的冠心病（CHD）风险。我们研究了单一和复合危险因素控制对美国人口的潜在影响。在2007年至2012年国家健康和营养检查调查中诊断为≥ 30岁T2DM的美国成年人中，我们使用英国前瞻性糖尿病研究CHD风险引擎评估了可预防的CHD事件。我们在所有未达到目标的受试者中检查了吸烟、糖化血红蛋白、收缩压、总胆固醇和高密度脂蛋白胆固醇的统计学控制的影响，根据预定义的标准，在不同的控制水平下设定风险因素，代表（1）“全部达到目标”，（2）“名义控制”，或（3）“积极控制”。“可预测的冠心病事件代表了控制这些风险因素与当前风险因素水平之间的事件数量差异。在606名男性（620万人）和603名女性（630万人）患有糖尿病且既往无CHD的患者中，130万男性和70万女性如果不加控制，将在10年内发生CHD事件。将所有危险因素控制在目标范围内，预计男性和女性分别可预防35%和45%的CHD事件。名义风险因素控制预计分别预防36%和38%的CHD事件，积极控制分别预防51%和61%的CHD事件。总之，T2DM成人中相当大比例的CHD事件可以通过对通常未达到目标的风险因素进行复合控制来预防。(C)2014爱思唯尔公司All rights reserved.
Type 2 diabetes mellitus (T2DM) carries significant risks for coronary heart disease (CHD). We examined the potential US population impact of single and composite risk factor control. Among US adults with diagnosed T2DM aged >= 30 years in the National Health and Nutrition Examination Survey 2007 to 2012, we assessed CHD events preventable using the United Kingdom Prospective Diabetes Study CHD risk engine. We examined in all those not at goal the impact of statistical control of smoking, glycated hemoglobin, systolic blood pressure, and total and high-density lipoprotein cholesterol, according to the predefined criteria setting risk factors at different levels of control representing (1) "All to Goal," (2) at "Nominal Control," or (3) at "Aggressive Control." Preventable CHD events represented the difference between the number of events estimated from the control of these risk factors versus current levels of the risk factors. Of 606 men (representing 6.2 million) and 603 women (6.3 million) with DM and no previous CHD, 1.3 million men and 0.7 million women would develop a CHD event within 10 years if left uncontrolled. Controlling all risk factors to goal was projected to prevent 35% and 45% of CHD events in men and women, respectively. Nominal risk factor control was projected to prevent 36% and 38% and aggressive control 51% and 61% of CHD events, respectively. In conclusion, a significant proportion of CHD events in adults with T2DM could be prevented from composite control of risk factors often not at goal. (C) 2014 Elsevier Inc. All rights reserved.