Canadian researchers found that people with diabetes fell into the high-risk category for cardiovascular disease ( CVD ) 15 years earlier than those without diabetes. People with diabetes are up to four times more likely to have cardiovascular disease as people without diabetes. In the past 5 years, increasing evidence has emerged that lends support to the use of cardioprotective agents, such as statins and Acetylsalicylic acid ( Aspirin ), in patients with diabetes. However, the age at which to start such treatment has been unclear.
To investigate, Gillian Booth from Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada, and colleagues assessed the age at which people with diabetes develop a high risk of cardiovascular disease.
They studied the majority of the population of Ontario, Canada, which consisted of 379 000 people with diabetes and over 9 million without the disease. The investigators recorded any cardiovascular events in this group between April 1994 and March 2000.
They found that diabetes led to earlier cardiovascular disease; diabetic men and women were about 15 years younger than those without diabetes in the same risk category. For those who had a myocardial infarction, stroke, or died from any cause, the transition from moderate to high risk of cardiovascular disease took place at about age 48 years for men with diabetes and 54 years for women with diabetes. When the researchers included cardiovascular procedures ( eg bypass surgery ) in the definition of cardiovascular disease, this transition took place at age 41 years for men with diabetes and 48 years for women with diabetes.
" Middle-aged and older people with diabetes seem on average to be at high risk of cardiovascular disease, thus aggressive risk-reduction strategies are warranted for them. Appropriate thresholds for younger people with diabetes are less clear. At least in the short term, many individuals with diabetes who are younger than 40 years seem to have a low to moderate absolute risk of cardiovascular disease", comments Booth. " Age should be taken into account in targeting of risk reduction in people with diabetes, " she concludes.
The Lancet, Dec. 2006
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