Sixteen-year coronary mortality in black and white men with diabetes screened for the Multiple Risk Factor Intervention Trial (MRFIT)
Abstract
BACKGROUND: Risk of coronary heart disease (CHD) mortality associated with diabetes is high and it is unclear to what extent the high mortality is due to modifiable risk factors. To explore this, mortality and predictors of CHD death are compared in a large cohort of black and white men with diabetes. METHODS: In all, 610 black and 3997 white men who reported taking medication for diabetes and had no history of hospitalization for heart attack were screened by 22 centres for the Multiple Risk Factor Intervention Trial (MRFIT). At screening major risk factors for CHD were determined. Participants have been followed for an average of 16 years for vital status. Cause-specific mortality and predictors of CHD are compared for blacks and whites using proportional hazards regression. RESULTS: Serum cholesterol and systolic blood pressure levels were similar in blacks and whites with diabetes, while diastolic blood pressure and percentage of smokers were higher in blacks (89 versus 86 mmHg and 47% versus 34%) and median income was lower. Coronary heart disease was the leading cause of death, accounting for 31% (68/221) and 44% (564/1293) of deaths among blacks and whites, respectively. Adjusted relative risks of CHD death and all cause mortality for blacks compared to whites were 0.71 (95% CI: 0.53-0.95) and 0.94 (95% CI: 0.75-1.11). Differences in reporting cause of death probably account for some of the black/white difference in CHD. High serum cholesterol, high blood pressure, and smoking increased risk of CHD death similarly in blacks and whites. CONCLUSIONS: Serum cholesterol, blood pressure, and smoking are major influences on CHD mortality risk in both white and black men with diabetes. High prevalence of these factors indicates substantial potential for CHD prevention in both ethnic groups.
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Diabetes mellitus is an important risk factor for ASCVD.
“DM is an important risk factor for ASCVD125, 126).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [125]
Cites
Regression Models and Life-Tables
Cox, D. R. (1992) · Springer Series in Statistics · doi:10.1007/978-1-4612-4380-9_37 · Cited by 26,297 · see citing works
Stamler, J., Vaccaro, O., Neaton, J. D., Wentworth, D., & The Multiple Risk Factor Intervention Trial Research Group (1993) · Diabetes Care · doi:10.2337/diacare.16.2.434 · Cited by 4,063 · see citing works
Self-citationDiabetes and atherosclerosis: An epidemiologic view
Pyörälà, K., Laakso, M., & Uusitupa, M. I. J. (1987) · Diabetes/Metabolism Reviews · doi:10.1002/dmr.5610030206 · Cited by 917 · see citing works
Mortality and survival in Type 2 (non-insulin-dependent) diabetes mellitus
Panzram, G. (1987) · Diabetologia · doi:10.1007/bf00274216 · Cited by 541 · see citing works
MORTALITY AMONG DIABETICS IN A NATIONAL SAMPLE
Kleinman, J. C., Donahue, R. P., Harris, M. I., Finucane, F. F., Madans, J. H., & Brock, D. B. (1988) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a114979 · Cited by 297 · see citing works
Watkins, L. O., Neaton, J. D., & Kuller, L. H. (1986) · The American Journal of Cardiology · doi:10.1016/0002-9149(86)90831-3 · Cited by 112 · see citing works
Ethnic immunity to coronary heart disease?
Vermaak, W. J. H., Ubbink, J. B., Delport, R., Becker, P., Bissbort, S., & Ungerer, J. P. J. (1991) · Atherosclerosis · doi:10.1016/0021-9150(91)90056-9 · Cited by 43 · see citing works
Banerji, M. A., & Lebovitz, H. E. (1991) · The American Journal of Medicine · doi:10.1016/0002-9343(91)90073-7 · Cited by 43 · see citing works
Folsom, A. R., Gómez-Marı́n, O., Sprafka, J. M., et al. (1987) · American Heart Journal · doi:10.1016/0002-8703(87)90197-9 · Cited by 19 · see citing works
Cooper, R., Liu, K., Stamler, J., Schoenberger, J. A., Shekelle, R. B., Collette, P., & Shekelle, S. (1984) · American Heart Journal · doi:10.1016/0002-8703(84)90678-1 · Cited by 17 · see citing works
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Kinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Lanting, L. C., Joung, I. M. A., Mackenbach, J. P., Lamberts, S. W. J., & Bootsma, A. H. (2005) · Diabetes Care · doi:10.2337/diacare.28.9.2280 · Cited by 386 · see citing works
Risk Factors for Mortality Among Patients With Diabetes
McEwen, L. N., Kim, C., Karter, A. J., Haan, M. N., Ghosh, D., Lantz, P. M., Mangione, C. M., Thompson, T. J., & Herman, W. H. (2007) · Diabetes Care · doi:10.2337/dc07-0305 · Cited by 121 · see citing works
Ezzatvar, Y., Ramírez-Vélez, R., Izquierdo, M., & García-Hermoso, A. (2021) · Diabetologia · doi:10.1007/s00125-021-05554-9 · Cited by 42 · see citing works
- Authors
- Vaccaro, O.
- Affiliations
- Federico II University Hospital (IT)
- Corresponding author
- Vaccaro, O
- ORCID
- Vaccaro, O
- Venue
- International Journal of Epidemiology
- Publisher
- Oxford University Press (OUP)
- Published
- 1998-08-01
- Volume
- 27
- Issue
- 4
- Pages
- 636-641
- ISSN
- 0300-5771 (ISSN-L)
- 1464-3685
- OpenAlex
- W2137576445
- Cited by
- 69
- References
- 10
- Citations by year
- 2023: 1 · 2021: 1 · 2020: 2 · 2018: 1 · 2017: 1 · 2016: 3 · 2015: 1 · 2014: 2 · 2013: 2 · 2012: 4
- FWCI
- 2.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01hl028715-13)
- National Heart, Lung, and Blood Institute (1-R01-HL28715)
- NIH Clinical Center
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Keywords
- coronary heart disease mortality, diabetes mellitus, Multiple Risk Factor Intervention Trial, serum cholesterol, blood pressure, smoking, modifiable risk factors, cardiovascular risk factors, cause-specific mortality
- MeSH terms
- Adult, Black or African American, Blood Pressure, Cholesterol, Coronary Disease, Diabetes Mellitus, Humans, Male, Middle Aged, Risk Factors, Smoking, United States, White People, Diabetes Complications
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