Risk Factors for Mortality from All Causes and from Coronary Heart Disease among Persons with Diabetes

Abstract

Coronary heart disease is the leading cause of mortality among persons with diabetes mellitus, but the factors that account for this high coronary heart disease mortality remain unclear. In the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study, conducted from 1982 to 1984, 92 deaths from coronary heart disease were found to have occurred among 602 diabetic participants and 558 deaths from coronary heart disease were found to have occurred among 12,562 nondiabetic participants during the follow-up period (1971-1984; average follow-up, 10 years). Using proportional hazards analysis, the authors found age, male sex, severe overweight, and non-leisure-time physical inactivity to be significantly associated with coronary heart disease mortality among persons with diabetes. Age, male sex, current smoking, hypertension, and non-leisure-time physical inactivity were associated with all-cause mortality. Cholesterol showed a more complex relation to all-cause mortality. The strength of the associations between risk factors and all-cause and coronary heart disease mortality did not differ significantly among persons with and without diabetes. These results reinforce the importance of controlling coronary heart disease risk factors among persons with diabetes.