The aim of this study was to evaluate whether noninsulin-dependent diabetes (NIDDM) and its metabolic control and duration predict coronary heart disease (CHD) events during a 3.5-year follow-up in a randomly selected Finnish population sample 65–74 years of age at baseline. Of 1,298 subjects participating in the baseline study, 1,069 were nondiabetic and 229 had NIDDM. During the follow-up, 3.4% of nondiabetic and 14.8% of NIDDM subjects died from CHD or had a nonfatal myocardial infarction (MI). The impact of NIDDM on CHD mortality and morbidity was more marked in women than in men. Odds ratios (ORs) and their 95% confidence intervals for CHD death and nonfatal MI in women with NIDDM compared with women with normal glucose tolerance were 11.7 (3.8–36.4) and 4.7 (3.6–6.1). In men, the corresponding ORs were 0.43 (0.1–1.9) and 1.4 (0.6–3.2). In multiple logistic regression analyses including all study subjects, NIDDM (P < 0.01), male sex (P < 0.05), and previous MI (P < 0.01) predicted CHD death (n = 45). NIDDM (P < 0.01), male sex (P < 0.05), previous MI (P < 0.05), current smoking (P < 0.001), systolic blood pressure (P < 0.001), and low high-density lipoprotein cholesterol (P < 0.01) predicted all CHD events (CHD death or nonfatal MI) (n = 107). In NIDDM subjects, only glycated hemoglobin A1c (GHbsA1c) at baseline (P < 0.01) and duration of diabetes (P < 0.05) predicted CHD death (n = 15) and all CHD events (n = 33). There was a significant increase in the risk of CHD death and all CHD events in NIDDM subjects with GHbA1c levels higher than 7.0% compared with diabetic subjects with lower GHbA1c (ORs 4.3 [1.1–16.7] and 2.2 [1.0–5.1]). In conclusion, NIDDM and its metabolic control and the duration of diabetes are important predictors of CHD in elderly subjects, particularly in women.
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Original Articles|
August 01 1994
NIDDM and Its Metabolic Control Predict Coronary Heart Disease in Elderly Subjects
Johanna Kuusisto;
Johanna Kuusisto
Department of Medicine, Kuopio University Hospital
Finland
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Leena Mykkänen;
Leena Mykkänen
Department of Medicine, Kuopio University Hospital
Finland
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Kalevi Pyörälä;
Kalevi Pyörälä
Department of Medicine, Kuopio University Hospital
Finland
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Markku Laakso
Markku Laakso
Department of Medicine, Kuopio University Hospital
Finland
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Address correspondence and reprint requests to Dr. Markku Laakso, Department of Medicine, Kuopio University Hospital, 70210 Kuopio, Finland.
Diabetes 1994;43(8):960–967
Article history
Received:
December 28 1993
Revision Received:
March 24 1994
Accepted:
March 24 1994
PubMed:
8039603
Citation
Johanna Kuusisto, Leena Mykkänen, Kalevi Pyörälä, Markku Laakso; NIDDM and Its Metabolic Control Predict Coronary Heart Disease in Elderly Subjects. Diabetes 1 August 1994; 43 (8): 960–967. https://doi.org/10.2337/diab.43.8.960
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