Importance of lipid levels in elderly diabetic individuals - Baseline characteristics and 1-year survey of cardiovascular events

Toshio Hayashi, Seinosuke Kawashima, Hideki Itoh, Nobuhiro Yamada, Hirohito Sone, Hiroshi Watanabe, Yoshiyuki Hattori, Takashi Ohrui, Masashi Yoshizumi, Koutaro Yokote, Kiyoshi Kubota, Hideki Nomura, Hiroyuki Umegaki, Akihisa Iguchi

    Research output: Contribution to journalArticlepeer-review

    11 Citations (Scopus)

    Abstract

    Background: The respective incidences of ischemic heart and cerebrovascular disease (IHD, CVD) are high in diabetic individuals. Complications of dyslipidemia increase the risk, but direct evidence is limited, so a cohort prospective study (Japan-CDM) was conducted. Methods and Results: The study group comprised 4,014 subjects with type 2 diabetes (1,936 women, 2,078 men; mean age 67.4±9.5 years) who were divided into dyslipidemic patients (79.1%) with or without medication (medicated, 50.9%; not medicated, 28.2%) and normo-lipidemic patients (20.9%). The incidence of IHD, CVD, arteriosclerosis obliterans (ASO), congestive heart failure (CHF) and death was assessed. IHD and CVD occurred in 0.82 and 0.67%, respectively, during the first year following registration. CHF, ASO and sudden death occurred in 0.27%, 0.12% and 0.12%, respectively. There was a significant statistical difference in the relation of elevated levels of high-density lipoprotein-cholesterol to lower rates of IHD and CVD. IHD and CVD in males were dependent on the level of low-density lipoprotein-cholesterol (LDL-C): 0.45%, 1.56%, 1.78%, 1.91% and 2.34% were observed in less than 2.11, 2.11-2.62, 2.63-3.15, 3.16-3.67, and more than 3.68 mol/L of LDL-C. In the lowest LDL-C group, death other than from vascular diseases was increased. Age, sex (male) and complicated hypertension increased the risk of events. Patients who were prescribed antihyperlipidemic agents suffered less events than patients who were not being treated, which suggests direct effects of therapy. Conclusion: Strict lipid control may be effective for reducing the incidence of vascular events in Japanese diabetic individuals.

    Original languageEnglish
    Pages (from-to)218-225
    Number of pages8
    JournalCirculation Journal
    Volume72
    Issue number2
    DOIs
    Publication statusPublished - 2008

    Keywords

    • Diabetes mellitus
    • Elderly
    • HDL-cholesterol
    • Ischemic heart disease
    • LDL-cholesterol

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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