US Pharm. 2008;33(2):12.
Adults with diabetes are at greater risk than those without for dying from heart disease. In 2005, cardiovascular disease (CVD) affected six million adults (age ?35 years) with diabetes and was a major cause of morbidity and mortality. Heart disease and stroke account for 65% of deaths among adults with diabetes. From 1997 to 2005, diabetes prevalence rose 43% while CVD prevalence among diabetic adults declined; in other words, the increase in the number of people with diabetes exceeded the increase in the number of people with both disorders.
The decline in CVD prevalence among adults with diabetes is consistent with the trend in the rate for CVD hospitalizations among diabetic adults; the aging of the population had little effect. From 1980 to 2003, the length of stay of hospital discharges with CVD as primary diagnosis and diabetes as secondary diagnosis dropped from 12.2 days to 4.4 days across all groups. The drop in CVD prevalence in diabetic adults might be a result of decreasing rates of some CVD risk factors (e.g., high total cholesterol, high blood pressure, smoking), use of statins, or increasing use of preventive treatments (e.g., aspirin therapy).
The prevalence of CVD among diabetic patients age 35 to 64 years fell from 31.1% in 1997 to 26.7% in 2005. Prevalence did not change in older patients, ranging from 45.7% to 50.9% for those age 65 to 74 years and 52.8% to 57.2% for those age ?75 years. Prevalence was higher in men than in women, higher in whites than in blacks, and higher in non-Hispanics than in Hispanics. Prevalence declined from 33.8% in 1997 to 30% in 2005 in women, and from 39.8% to 35.1% in men.
Rates of CVD as first-listed diagnosis per 1,000 diabetics increased for both whites and blacks in the 1980s, leveling off in the early 1990s. Until 2003, rates for blacks showed little change and rates for whites decreased. In 2003, the rate for whites was similar to the 1980 rate; the rate for blacks was 61% higher. Prevalence of CVD decreased by 25.3% among blacks; no significant decrease occurred among whites. Among non-Hispanics, the rate decreased from 37.9% in 1997 to 33.3% in 2005. No trends were detected for Hispanics, however.
Continued interventions (e.g., control of blood lipids, blood pressure, and blood glucose) are needed to reduce modifiable risk factors, better control diabetes, and decrease CVD prevalence in adults with diabetes. The Centers for Disease Control and Prevention provides resources for diabetes prevention and programs including diabetes education, improvements in and monitoring of diabetes care, and promotion of early detection of diabetes complications.
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