Declines in coronary heart disease incidence and mortality among middle-aged adults with and without diabetes.
Declines in coronary heart disease incidence and mortality among middle-aged adults with and without diabetes.
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DOI：
10.1016/j.annepidem.2014.05.007
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发表时间：
2014-08
影响因子：
5.6
通讯作者：
Muntner, Paul
中科院分区：
文献类型：
--
作者：
Carson, April P.;Tanner, Rikki M.;Yun, Huifeng;Glasser, Stephen P.;Woolley, J. Michael;Thacker, Evan L.;Levitan, Emily B.;Farkouh, Michael E.;Rosenson, Robert S.;Brown, Todd M.;Howard, George;Safford, Monika M.;Muntner, Paul
调查患有和不患有糖尿病的成年人中冠心病发病率和死亡率的长期变化，并确定增加降脂药物的使用和降低低密度脂蛋白胆固醇(LDL-C)水平对这些变化的影响。我们分析了1987年至1996年(早期)社区动脉粥样硬化风险研究的45-年龄参与者的数据，以及2003年至2009年(晚期)中风研究中地理和种族差异的原因。在调整了社会人口学、心血管危险因素、降脂药物使用和低密度脂蛋白-C后，获得了糖尿病和时间段与发生的冠心病和冠心病死亡率相关的危险比(HR)。经多因素调整后，糖尿病与早期(HR=1.99，95%CI=1.59，2.49)和晚期(HR=2.39，95%CI=1.69，3.35)的冠心病风险增加有关。糖尿病患者和非糖尿病患者的早期和晚期冠心病发病率和死亡率均呈下降趋势。糖尿病患者冠心病发病率和死亡率下降的33.6%和27.2%可由降脂药物的增加和低密度脂蛋白胆固醇的降低来解释。尽管发病率有所下降，但糖尿病仍然与冠心病发病率和死亡率的增加有关，这突显了继续预防糖尿病和管理心血管危险因素的必要性。
To investigate secular changes in CHD incidence and mortality among adults with and without diabetes and determine the effect of increased lipid-lowering medication use and reductions in low-density lipoprotein cholesterol (LDL-C) levels on these changes. We analyzed data on participants aged 45–64 years from the Atherosclerosis Risk in Communities Study in 1987–1996 (early time period) and the Reasons for Geographic and Racial Differences in Stroke Study in 2003–2009 (late time period). Hazard ratios (HR) for the association of diabetes and time period with incident CHD and CHD mortality were obtained after adjustment for socio-demographics, cardiovascular risk factors, lipid-lowering medication use, and LDL-C. After multivariable adjustment, diabetes was associated with an increased CHD risk during the early (HR=1.99,95% CI=1.59,2.49) and late (HR=2.39,95% CI=1.69,3.35) time periods. CHD incidence and mortality declined between the early and late time periods for individuals with and without diabetes. Increased use of lipid-lowering medication and lower LDL-C explained 33.6% and 27.2% of the decline in CHD incidence and CHD mortality, respectively, for those with diabetes. Although rates have declined, diabetes remains associated with an increased risk of CHD incidence and mortality, highlighting the need for continuing diabetes prevention and cardiovascular risk factor management.
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影响因子：
2.8
作者：
Lopez-de-Andres A;Hernández-Barrera V;Carrasco-Garrido P;Esteban-Hernandez J;Gil-de-Miguel A;Jiménez-García R
通讯作者：
Jiménez-García R
影响因子：
4.5
作者：
Olafsdottir, Elin;Aspelund, Thor;Gudnason, Vilmundur
通讯作者：
Gudnason, Vilmundur
影响因子：
2.9
作者：
Olafsdottir E;Aspelund T;Sigurdsson G;Thorsson B;Eiriksdottir G;Harris TB;Launer LJ;Benediktsson R;Gudnason V
通讯作者：
Gudnason V
影响因子：
120.7
作者：
Carroll, Margaret D.;Kit, Brian K.;Mussolino, Michael E.
通讯作者：
Mussolino, Michael E.
影响因子：
16.2
作者：
Brown, Todd M.;Tanner, Rikki M.;Muntner, Paul
通讯作者：
Muntner, Paul