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Diabetes and Cardiovascular Disease: The Framingham Study
Abstract
Based on 20 years of surveillance of the Framingham cohort relating subsequent cardiovascular events to prior evidence of diabetes, a twofold to threefold increased risk of clinical atherosclerotic disease was reported. The relative impact was greatest for intermittent claudication (IC) and congestive heart failure (CHF) and least for coronary heart disease (CHD), which was, nevertheless, on an absolute scale the chief sequela. The relative impact was substantially greater for women than for men. For each of the cardiovascular diseases (CVD), morbidity and mortality were higher for diabetic women than for nondiabetic men. After adjustment for other associated risk factors, the relative impact of diabetes on CHD, IC, or stroke incidence was the same for women as for men; for CVD death and CHF, it was greater for women. Cardiovascular mortality was actually about as great for diabetic women as for diabetic men. (JAMA241:2035-2038, 1979)
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In the citing paper
“Epidemiological evidence shows that diabetes is an independent risk factor for the development of CVD [7,11,12,13,14,15,16]”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [13]
In the citing paper
“Observational studies have consistently demonstrated a two-to four-fold increased risk of HF in individuals with diabetes compared with those without diabetes.[460][461][462][463]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [462]
In the citing paper
“Unrecognized HF is frequent in T2DM: a cross-sectional study in patients aged ≥60 years with T2DM without known HF using a standardized diagnostic work-up, including medical history, physical examination, ECG, and echocardiography, indicated that HF was present in 28% of patients (∼25% HFrEF and ∼75% HFpEF).[460][461][462][463][464]”
From 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes. (2023) · cites this paper as [462]
In the citing paper
“Since the report of the Framingham Heart study, type 2 diabetes (T2DM) has been known to increase the incidence of HF up to more than double with respect to non-affected individuals, with the growing awareness that this complication may develop independently of coronary artery disease (CAD) and associated risk factors [8,9,10,11].”
From Dysregulated epicardial adipose tissue as a risk factor and potential therapeutic target of heart failure with preserved ejection fraction in diabetes (2022) · cites this paper as [8]
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Metadata
- Authors
- Kannel, W. B.
- Corresponding author
- Kannel, William B.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1979-05-11
- Volume
- 241
- Issue
- 19
- Pages
- 2035
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4252437054
- Cited by
- 2,936
- References
- 0
- Citations by year
- 2026: 41 · 2025: 63 · 2024: 82 · 2023: 81 · 2022: 97 · 2021: 135 · 2020: 118 · 2019: 144 · 2018: 127 · 2017: 133 · 2016: 100 · 2015: 89 · 2014: 87 · 2013: 86 · 2012: 125
- FWCI
- 6.91
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- diabetes mellitus, cardiovascular disease, cardiovascular risk, atherosclerosis, intermittent claudication, congestive heart failure, coronary artery disease, stroke, cardiovascular mortality, sex differences, Framingham cohort, cardiovascular morbidity
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