Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, Norway

Abstract

Abstract. Claudi T, Midthjell K, Holmen J, Fougner K, Krüger Ø, Wiseth R (University of Tromsø/Rønvik Health Center, Bodø; National Institute of Public Health, Community Medicine Research Unit, Verdal; University Hospital of Trondheim; and Norwegian University of Science and Technology, Trondheim, Norway). Cardiovascular disease and risk factors in persons with type 2 diabetes diagnosed in a large population screening: The Nord-Trøndelag Diabetes Study, Norway. J Intern Med 2000; 248: 493–501. Objective. To study cardiovascular status and risk factors in persons with newly diagnosed type 2 diabetes and controls in a large population. Design. Case–control study. Setting. Population screening Subjects. The screening of 74 499 individuals (88.1%), aged 20 years and older, in Nord-Trøndelag County, Norway, during 1984–86 detected 428 persons with undiagnosed diabetes according to the 1980 WHO criteria, of whom 205 attended a clinical follow-up examination assessing cardiovascular status and risk factors. Methods. For each of 205 cases, one control person matched by age and sex underwent the same clinical examination. Lipids, body mass index, waist/hip ratio, blood pressure, pulse rate, blood pressure medication, kidney function, cardiovascular disease, family history and lifestyle were recorded. Results. At the screening prior to the diagnosis of diabetes, those with diabetes reported poorer general health, less physical activity, more siblings with diabetes and more frequent use of antihypertensive medication. They had higher body mass index, systolic and diastolic blood pressure and pulse rate compared with controls. At the clinical evaluation, diabetics had higher urine albumin levels, increased waist/hip ratio, and higher total cholesterol/HDL cholesterol ratios than the controls. They also reported a greater incidence of angina pectoris and had more ECG changes. Conclusions. Diabetics presented with more cardiovascular risk factors, angina pectoris and ECG changes than the controls, and they had an established metabolic syndrome more often than controls. These results suggest that prevention of cardiovascular disease in diabetics requires earlier diagnosis of the diabetes.