Cardiometabolic Risk Factors in Canadian Primary Care Patients with Abdominal Obesity and Diabetes

Abstract

This cross-sectional study evaluated the prevalence and the management of cardiometabolic risk factors (CMRFs) in overweight/obese subjects, who were recruited by 468 primary care physicians across Canada. In addition to BMI >27 kg/m2 or high waist circumference, the following risk factors were also assessed: hypertension, dysglycemia (IGT or diabetes by CDA criteria), low HDL-C, triglycerides >1.7 mmol/L, LDL-C >3.5 mmol/L or >2 with cardiovascular event and smoking status. Of a total of 9985 subjects analyzed, 3398 (34%) had diabetes, with a higher mean age than nondiabetic subjects (60.5 years vs. 56.5 years). 77% of people with diabetes were taking oral agents and 18% were treated with insulin, with a mean A1C of 7.13%. More CMRFs were reported in the diabetes subjects, with an average of 4.6 vs. 2.6. People with diabetes were 10-fold more likely to have ≥5 additional CMRFs (59.6% vs. 5.6%, respectively), and fewer of them had ≤2 additional CMRFs (3.1% vs. 44.3%). Hypertriglyceridemia and hypertension were more common in the diabetes group (90% vs. 59% and 81% vs. 54% in nondiabetic subjects, respectively). Coronary artery disease, peripheral artery disease and severe renal impairment were more common in people with diabetes. A greater proportion of them were taking statins for dyslipidemia (76% vs. 35%) and antihypertensive drugs (78% vs. 50%) even though many were not treated to guidelines target values. In conclusion, CMRFs are much more common in overweight/obese people with diabetes in primary care, and require more intensive management to reduce their cardiovascular disease risk and mortality.