Context: Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have e xperienced similar declines in CVD risk. Objective: To det...Context: Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have e xperienced similar declines in CVD risk. Objective: To determine whether adults with and without diabetes experienced similar declines in incident CVD in 1950- 1995. Design, Setting, and Participants: Participants aged 4564 years from the F ramingham Heart Study original and offspring cohorts who attended examinations i n 19501966 ("earlier"time period; 4118 participants, 113 with diabetes) and 1977-1995 ("later"time period; 4063 participants, 317 with diabetes). Incid ence rates of CVD among those with and without diabetes were compared between th e earlier and later periods. Main Outcome Measures: Myocardial infarction, coron ary heart disease death, and stroke. Results: Among participants with diabetes, the age-and sex-adjusted CVD incidence rate was 286.4 per 10000 person-years in the earlier period and 146.9 per 10000 in the later period, a 49.3%(95%conf idence interval [Cl], 16.7%-69.4%) decline. Among participants without diabet es, the age-and sex-adjusted incidence rate was 84.6 per 10000 person-years i n the earlier period and 54.3 per 10000 person-yearsin the later period, a 35.4 %(95%Cl, 25.3%-45.4%) decline. Hazard ratios for diabetes as a predictor of incident CVD were not different in the earlier vs later periods. Conclusions: W e report a 50%reduction in the rate of incident CVD events among adults with di abetes, although the absolute risk of CVD is 2-fold greater than among persons without diabetes. Adults with and without diabetes have benefited similarly duri ng the decline in CVD rates over the last several decades. More aggressive treat ment of CVD risk factors and further research on diabetes-specific factors cont ributing to CVD risk are needed to further reduce the high absolute risk of CVD still experienced by persons with diabetes.展开更多
文摘Context: Despite reductions in cardiovascular disease (CVD) mortality over the past few decades, it is unclear whether adults with and without diabetes have e xperienced similar declines in CVD risk. Objective: To determine whether adults with and without diabetes experienced similar declines in incident CVD in 1950- 1995. Design, Setting, and Participants: Participants aged 4564 years from the F ramingham Heart Study original and offspring cohorts who attended examinations i n 19501966 ("earlier"time period; 4118 participants, 113 with diabetes) and 1977-1995 ("later"time period; 4063 participants, 317 with diabetes). Incid ence rates of CVD among those with and without diabetes were compared between th e earlier and later periods. Main Outcome Measures: Myocardial infarction, coron ary heart disease death, and stroke. Results: Among participants with diabetes, the age-and sex-adjusted CVD incidence rate was 286.4 per 10000 person-years in the earlier period and 146.9 per 10000 in the later period, a 49.3%(95%conf idence interval [Cl], 16.7%-69.4%) decline. Among participants without diabet es, the age-and sex-adjusted incidence rate was 84.6 per 10000 person-years i n the earlier period and 54.3 per 10000 person-yearsin the later period, a 35.4 %(95%Cl, 25.3%-45.4%) decline. Hazard ratios for diabetes as a predictor of incident CVD were not different in the earlier vs later periods. Conclusions: W e report a 50%reduction in the rate of incident CVD events among adults with di abetes, although the absolute risk of CVD is 2-fold greater than among persons without diabetes. Adults with and without diabetes have benefited similarly duri ng the decline in CVD rates over the last several decades. More aggressive treat ment of CVD risk factors and further research on diabetes-specific factors cont ributing to CVD risk are needed to further reduce the high absolute risk of CVD still experienced by persons with diabetes.
