Abstract
BackgroundStudies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments. Furthermore, studies showed that the relative risk of CVD mortality associated with diabetes compared with non-diabetes is stronger in women than in men. Hence, we aimed to examine trends in CVD risk factors and intervention measures by sex and diabetic status.MethodsAnalysis of 5 distinct cross-sectional National Health and Nutrition Examination Surveys, 1988–1994, 1999–2002, 2003–2006, 2007–2010, and 2010–2014. Since detailed information on nontraditional risk factors such as sleep apnea was not available in each NHANES survey, traditional CVD risk factors including obesity, hypertension, and dyslipidemia were assessed in the study. To assess whether changes throughout the 27-year period differed by diabetes status, a logistic regression analysis was utilized to examine potential interaction effects between survey and diabetes. The similar process was repeated for sex.ResultsMeans of all risk factors except body mass index and waist circumference decreased and the prevalence of antihypertensive and lipid-lowering medication use increased over time among diabetic and non-diabetic men and women. For both men and women, survey × diabetes status interaction terms for changes in HDL-cholesterol and triglyceride levels were not statistically significant, while the prevalence of antihypertensive and lipid-lowering medication use increased more in diabetic than in non-diabetic persons (all P < 0.001). For women, survey × diabetes status interaction terms indicated that compared with the first survey, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol fallen more in diabetic than in non-diabetic persons (all P < 0.001). In the diabetic state, men experienced similar changes in means of all CVD risk factors and the prevalence of antihypertensive and lipid-lowering medication use as women (all P for interactions between survey and sex were >0.01).ConclusionsThe major traditional CVD risk factors in diabetic men decreased to the same extent that they did for non-diabetic men. The magnitude of changes in the favorable trends in diabetic women was of similar or greater compared with those among non-diabetic women. Diabetic women had as good an improvement in CVD risk factors as diabetic men.
Highlights
Studies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments
CVD is the leading cause of mortality associated with diabetes, diabetic patients experienced the decline in CVD mortality [2]
Previous studies have shown that the largest portion of the reduction in CVD mortality can be attributed to improvements in major CVD risk factors and evidence-based treatments [4]
Summary
Studies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments. Studies showed that the relative risk of CVD mortality associated with diabetes compared with non-diabetes is stronger in women than in men. National studies examined mortality trends between 1997 and 2006 showed that CVD death rates among both U.S men and women with diabetes declined substantially [2]. Previous studies have shown that the largest portion of the reduction in CVD mortality can be attributed to improvements in major CVD risk factors and evidence-based treatments [4]. Studies have shown that the relative risk of CVD mortality associated with diabetes compared with non-diabetes is stronger in women than in men [5]. We used data from consecutive nationally representative health surveys spanning 1988 to 2014 to examine the trends in certain major CVD risk factors and intervention measures among diabetic and non-diabetic men and women
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