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Diabetes ages the cardiovascular system
30 June 2006
Having diabetes is equivalent to being 15 years older in terms of the risk of cardiovascular disease (CVD), researchers have reported in The Lancet.
The Canadian study shows how important age is in predicting CVD among people with diabetes.
Nonetheless, the researchers add: "Our data suggest that the CVD risk in people with diabetes does not reach the threshold conventionally regarded as high until the early to late 40s, both for men and for women."
Gillian Booth (University of Toronto, Ontario) and colleagues examined the age at which people with diabetes develop a high risk of CVD by conducting a retrospective analysis of all 379,000 people with the condition and over 9 million people without the disease living in Ontario in 1994.
During 6 years of follow-up, 573,515 individuals had a CVD event, 18.3% of whom had diabetes.
Results showed that men and women with diabetes entered the high-risk category for CVD, defined as a 10-year risk of 20% or more, a mean of 14.6 years earlier than those without the condition.
For the outcome of acute myocardial infarction (AMI), stroke, or death, diabetic men entered this category at the age of 48 years, while for women this was 54 years. With a broader definition of CVD that also included coronary or carotid revascularization, the age at transition dropped to 41.3 years in men and 47.7 years in women with diabetes.
"We showed that in older men the presence of diabetes alone conferred a similar risk of death from any cause, as did a recent history of AMI, probably because of the effect of diabetes on fatal coronary heart disease (CHD)," Booth et al add.
"The same was not true for women and men younger than 50 years, in whom the risk of CHD was lower for people with diabetes alone than for those with a recent history of AMI (though still substantially higher than that for people without diabetes or recent AMI)."
The team concludes: "Middle-aged and older people with diabetes seem on average to be at high risk of CVD, thus aggressive risk-reduction strategies are warranted for them."
