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Risk factor control in patients with Type 2 diabetes and coronary heart disease: findings from the Swedish National Diabetes Register (NDR)

Gudbjoernsdottir, S.; Eeg-Olofsson, K.; Cederholm, J.; Zethelius, B.; Eliasson, B and Nilsson, Peter LU (2009) In Diabetic Medicine 26(1). p.53-60
Abstract
Patients with Type 2 diabetes and coronary heart disease (CHD) are infrequently treated to risk factor targets in current guidelines. We aimed to examine risk factor management and control levels in a large sample of patients with Type 2 diabetes with CHD. This was an observational study of 1612 patients with first incidence of CHD before 2002, and of 4570 patients with first incidence of CHD before 2005, from the Swedish National Diabetes Register (NDR). In patients with CHD 1-2 years before follow-up, the achievement of cardiovascular risk factor targets (follow-up 2002/follow-up 2005) was: HbA(1c) < 7%, 47%/54% (P < 0.01); blood pressure <= 130/80 mmHg, 31%/40% (P < 0.001); total cholesterol < 4.5 mmol/l, 47%/60% (P <... (More)
Patients with Type 2 diabetes and coronary heart disease (CHD) are infrequently treated to risk factor targets in current guidelines. We aimed to examine risk factor management and control levels in a large sample of patients with Type 2 diabetes with CHD. This was an observational study of 1612 patients with first incidence of CHD before 2002, and of 4570 patients with first incidence of CHD before 2005, from the Swedish National Diabetes Register (NDR). In patients with CHD 1-2 years before follow-up, the achievement of cardiovascular risk factor targets (follow-up 2002/follow-up 2005) was: HbA(1c) < 7%, 47%/54% (P < 0.01); blood pressure <= 130/80 mmHg, 31%/40% (P < 0.001); total cholesterol < 4.5 mmol/l, 47%/60% (P < 0.001); and low-density lipoprotein-cholesterol < 2.5 mmol/l, 49%/65% (P < 0.001). Use of medication: antihypertensives, 90%/94% (P < 0.01); lipid-lowering drugs, 75%/86% (P < 0.001); and aspirin, 85%/89% (P < 0.05). A high prevalence of adverse lifestyle characteristics prevailed (2002/2005): overweight [body mass index (BMI) >= 25 kg/m(2)], 86%/85%; obesity (BMI >= 30 kg/m(2)), 41%/42%; smokers in age group < 65 years, 16-23%/18-19%; as well as waist circumference >= 102 cm (men) or >= 88 cm (women), 68% in 2005. Patients with a combination of Type 2 diabetes and CHD showed an increased use of lipid-lowering drugs over time, corresponding to improving blood lipid levels. A discrepancy existed between the prevalent use of antihypertensive drugs and the low proportion reaching blood pressure targets. Regretfully, a high prevalence of adverse lifestyle characteristics prevailed. Evidence-based therapy with professional lifestyle intervention and drugs seems urgent for improved quality of secondary prevention in these patients. Diabet. Med. 26, 53-60 (2009). (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
hypertension, hyperlipidaemia, coronary heart disease, diabetes mellitus, secondary prevention
in
Diabetic Medicine
volume
26
issue
1
pages
53 - 60
publisher
Wiley-Blackwell
external identifiers
  • wos:000262223700009
  • scopus:58149291851
ISSN
1464-5491
DOI
10.1111/j.1464-5491.2008.02633.x
language
English
LU publication?
yes
id
383d43aa-4e23-4120-9ba0-d7ff36d3c2f2 (old id 1313440)
date added to LUP
2009-03-10 08:43:42
date last changed
2017-01-01 05:51:23
@article{383d43aa-4e23-4120-9ba0-d7ff36d3c2f2,
  abstract     = {Patients with Type 2 diabetes and coronary heart disease (CHD) are infrequently treated to risk factor targets in current guidelines. We aimed to examine risk factor management and control levels in a large sample of patients with Type 2 diabetes with CHD. This was an observational study of 1612 patients with first incidence of CHD before 2002, and of 4570 patients with first incidence of CHD before 2005, from the Swedish National Diabetes Register (NDR). In patients with CHD 1-2 years before follow-up, the achievement of cardiovascular risk factor targets (follow-up 2002/follow-up 2005) was: HbA(1c) &lt; 7%, 47%/54% (P &lt; 0.01); blood pressure &lt;= 130/80 mmHg, 31%/40% (P &lt; 0.001); total cholesterol &lt; 4.5 mmol/l, 47%/60% (P &lt; 0.001); and low-density lipoprotein-cholesterol &lt; 2.5 mmol/l, 49%/65% (P &lt; 0.001). Use of medication: antihypertensives, 90%/94% (P &lt; 0.01); lipid-lowering drugs, 75%/86% (P &lt; 0.001); and aspirin, 85%/89% (P &lt; 0.05). A high prevalence of adverse lifestyle characteristics prevailed (2002/2005): overweight [body mass index (BMI) &gt;= 25 kg/m(2)], 86%/85%; obesity (BMI &gt;= 30 kg/m(2)), 41%/42%; smokers in age group &lt; 65 years, 16-23%/18-19%; as well as waist circumference &gt;= 102 cm (men) or &gt;= 88 cm (women), 68% in 2005. Patients with a combination of Type 2 diabetes and CHD showed an increased use of lipid-lowering drugs over time, corresponding to improving blood lipid levels. A discrepancy existed between the prevalent use of antihypertensive drugs and the low proportion reaching blood pressure targets. Regretfully, a high prevalence of adverse lifestyle characteristics prevailed. Evidence-based therapy with professional lifestyle intervention and drugs seems urgent for improved quality of secondary prevention in these patients. Diabet. Med. 26, 53-60 (2009).},
  author       = {Gudbjoernsdottir, S. and Eeg-Olofsson, K. and Cederholm, J. and Zethelius, B. and Eliasson, B and Nilsson, Peter},
  issn         = {1464-5491},
  keyword      = {hypertension,hyperlipidaemia,coronary heart disease,diabetes mellitus,secondary prevention},
  language     = {eng},
  number       = {1},
  pages        = {53--60},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Risk factor control in patients with Type 2 diabetes and coronary heart disease: findings from the Swedish National Diabetes Register (NDR)},
  url          = {http://dx.doi.org/10.1111/j.1464-5491.2008.02633.x},
  volume       = {26},
  year         = {2009},
}