We examined associations between prediabetes and the incidence of CVD according to whether patients made regular clinic visits for hypertension (HT) and dyslipidemia (DL). Enrolled were 1,137,069 Japanese without a history of CVD or glucose abnormality. During a median follow-up of 5.4 y, 10,893 people developed CVD. Prescription of antihypertensive or cholesterol-lowering agents indicated instructions to make regular clinic visits for HT or DL. Of those without regular clinic visits, CVD risk increased stepwise with increasing HbA1c values from the cutoff between diabetes and prediabetes. Those with HbA1c 6.5-6.8 had a higher CVD risk than those with prediabetes (Table). Conversely, of those making regular clinic visits, the CVD risk was significantly higher in persons with HbA1c levels just below criteria for diabetes (6.2-6.4%) than with normal HbA1c (≤5.6%). However, CVD risk did not significantly increase in those with HbA1c only slightly above the criteria for diabetes (6.5-6.8%). By regular clinic visits for HT or DL, a diagnosis of incident diabetes is speculated to trigger a quick response by attending physicians resulting in a better cardiovascular outcome than in those not attending clinic. These results indicate the need for strategies directed toward patients with early diabetes who do not regularly attend clinics for other diseases.
K. Murai: None. K. Fujihara: None. M.H. Yamada: None. M. Yamamoto: None. Y. Matsubayashi: None. M. Kitazawa: None. T. Yamada: None. S. Kodama: None. H. Sone: Research Support; Novo Nordisk, Astellas Pharma Inc., Kowa Company, Ltd., Kyowa Kirin Co., Ltd., Eisai Inc., Sumitomo Dainippon Pharma Co., Ltd.
