1. Considerably decreased risk of cardiovascular disease with combined reductions in HbA1c, blood pressure and blood lipids in type 2 diabetes: Report from the Swedish National Diabetes Register.
- Author
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Eeg-Olofsson K, Zethelius B, Gudbjörnsdottir S, Eliasson B, Svensson AM, and Cederholm J
- Subjects
- Adult, Aged, Biomarkers blood, Cardiovascular Diseases diagnosis, Cardiovascular Diseases mortality, Diabetes Mellitus, Type 2 blood, Diabetes Mellitus, Type 2 diagnosis, Diabetes Mellitus, Type 2 mortality, Dyslipidemias blood, Dyslipidemias diagnosis, Dyslipidemias mortality, Female, Humans, Hypertension diagnosis, Hypertension mortality, Hypertension physiopathology, Incidence, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Multivariate Analysis, Prognosis, Propensity Score, Prospective Studies, Registries, Risk Assessment, Risk Factors, Sweden epidemiology, Time Factors, Blood Pressure, Cardiovascular Diseases prevention & control, Diabetes Mellitus, Type 2 therapy, Dyslipidemias therapy, Glycated Hemoglobin metabolism, Hypertension therapy, Lipids blood
- Abstract
Objectives: Assess the effect of risk factors changes on risk for cardiovascular disease and mortality in patients with type 2 diabetes selected from the Swedish National Diabetes Register., Methods: Observational study of 13,477 females and males aged 30-75 years, with baseline HbA1c 41-67 mmol/mol, systolic blood pressure 122-154 mmHg and ratio non-HDL:HDL 1.7-4.1, followed for mean 6.5 years until 2012. Four groups were created: a reference group (n = 6757) with increasing final versus baseline HbA1c, systolic blood pressure and non-HDL:HDL cholesterol during the study period, and three groups with decreasing HbA1c (n = 1925), HbA1c and systolic blood pressure (n = 2050) or HbA1c and systolic blood pressure and non-HDL:HDL (n = 2745)., Results: Relative risk reduction for fatal/nonfatal cardiovascular disease was 35% with decrease in HbA1c only (mean 6 to final 49 mmol/mol), 56% with decrease in HbA1c and systolic blood pressure (mean 12 to final 128 mmHg) and 75% with combined decreases in HbA1c, systolic blood pressure and non-HDL:HDL (mean 0.8 to final 2.1), all p < 0.001 adjusting for clinical characteristics, other risk factors, treatments and previous cardiovascular disease. Similar risk reductions were found for fatal/nonfatal coronary heart disease, fatal cardiovascular disease, all-cause mortality and also in a subgroup of 3038 patients with albuminuria., Conclusion: Considerable risk reductions for cardiovascular disease and mortality were seen with combined long-term risk factor improvement., (© The Author(s) 2016.)
- Published
- 2016
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