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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).
Diabet Med. 2009 Jan; 26(1):53-60.DM

Abstract

AIMS

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.

METHODS

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).

RESULTS

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 < or = 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) > or = 25 kg/m(2)], 86%/85%; obesity (BMI > or = 30 kg/m(2)), 41%/42%; smokers in age group < 65 years, 16-23%/18-19%; as well as waist circumference > or = 102 cm (men) or > or = 88 cm (women), 68% in 2005.

CONCLUSIONS

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.

Authors+Show Affiliations

Department of Medicine, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19125761

Citation

Gudbjörnsdottir, S, et al. "Risk Factor Control in Patients With Type 2 Diabetes and Coronary Heart Disease: Findings From the Swedish National Diabetes Register (NDR)." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 26, no. 1, 2009, pp. 53-60.
Gudbjörnsdottir S, Eeg-Olofsson K, Cederholm J, et al. Risk factor control in patients with Type 2 diabetes and coronary heart disease: findings from the Swedish National Diabetes Register (NDR). Diabet Med. 2009;26(1):53-60.
Gudbjörnsdottir, S., Eeg-Olofsson, K., Cederholm, J., Zethelius, B., Eliasson, B., & Nilsson, P. M. (2009). Risk factor control in patients with Type 2 diabetes and coronary heart disease: findings from the Swedish National Diabetes Register (NDR). Diabetic Medicine : a Journal of the British Diabetic Association, 26(1), 53-60. https://doi.org/10.1111/j.1464-5491.2008.02633.x
Gudbjörnsdottir S, et al. Risk Factor Control in Patients With Type 2 Diabetes and Coronary Heart Disease: Findings From the Swedish National Diabetes Register (NDR). Diabet Med. 2009;26(1):53-60. PubMed PMID: 19125761.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factor control in patients with Type 2 diabetes and coronary heart disease: findings from the Swedish National Diabetes Register (NDR). AU - Gudbjörnsdottir,S, AU - Eeg-Olofsson,K, AU - Cederholm,J, AU - Zethelius,B, AU - Eliasson,B, AU - Nilsson,P M, AU - ,, PY - 2009/1/8/entrez PY - 2009/1/8/pubmed PY - 2009/5/16/medline SP - 53 EP - 60 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 26 IS - 1 N2 - AIMS: 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. METHODS: 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). RESULTS: 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 < or = 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) > or = 25 kg/m(2)], 86%/85%; obesity (BMI > or = 30 kg/m(2)), 41%/42%; smokers in age group < 65 years, 16-23%/18-19%; as well as waist circumference > or = 102 cm (men) or > or = 88 cm (women), 68% in 2005. CONCLUSIONS: 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. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/19125761/Risk_factor_control_in_patients_with_Type_2_diabetes_and_coronary_heart_disease:_findings_from_the_Swedish_National_Diabetes_Register__NDR__ L2 - https://doi.org/10.1111/j.1464-5491.2008.02633.x DB - PRIME DP - Unbound Medicine ER -