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Increasing Cardiovascular Disease Burden Due to Diabetes Mellitus: The Framingham Heart Study
Abstract
Background— Marked reductions in cardiovascular disease (CVD) morbidity and mortality have occurred in the United States over the last 50 years. We tested the hypothesis that the relative burden of CVD attributable to diabetes mellitus (DM) has increased over the past 5 decades. Methods and Results— Participants aged 45 to 64 years from the Framingham Heart Study, who attended examinations in an “early” time period (1952 to 1974), were compared with those who attended examinations in a later time period (1975 to 1998). The risk of CVD events (n=133 among those with and 1093 among those without DM) attributable to DM in the 2 time periods was assessed with Cox proportional hazards models; population attributable risk of DM as a CVD risk factor was calculated for each time period. The age- and sex-adjusted hazard ratio for DM as a CVD risk factor was 3.0 (95% CI, 2.3 to 3.9) in the earlier time period and 2.5 (95% CI, 1.9 to 3.2) in the later time period. The population attributable risk for DM as a CVD risk factor increased from 5.4% (95% CI, 3.8% to 6.9%) in the earlier time period to 8.7% (95% CI, 5.9% to 11.4%) in the later time period ( P for attributable risk ratio=0.04), although multivariable adjustment resulted in attenuation of these findings ( P =0.12); most of these observations were found among men. Conclusions— The proportion of CVD attributable to DM has increased over the past 50 years in Framingham. These findings emphasize the need for increased efforts to prevent DM and to aggressively treat and control CVD risk factors among those with DM.
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“diabetes-related morbidity and mortality is primarily due to cardiovascular complications [17,18,19].”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [19]
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Metadata
- Authors
- Fox, C. S., Coady, S., Sorlie, P. D., D’Agostino, R. B., Pencina, M. J., Vasan, R. S., Meigs, J. B., Levy, D., & Savage, P. J.
- Affiliations
- Boston University (US)
- ORCID
- Venue
- Circulation
- Published
- 2007-03-27
- Volume
- 115
- Issue
- 12
- Pages
- 1544-1550
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2055416829
- Cited by
- 656
- References
- 38
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 20 · 2023: 19 · 2022: 35 · 2021: 25 · 2020: 27 · 2019: 23 · 2018: 32 · 2017: 38 · 2016: 42 · 2015: 46 · 2014: 49 · 2013: 35 · 2012: 52
- FWCI
- 33.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01hc25195-41-0-1)
- U.S. Public Health Service (5K24H004334)
- National Heart, Lung, and Blood Institute (N01‐HC25195)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Epidemiology › Healthcare Systems and Public Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Keywords
- diabetes mellitus, cardiovascular disease, population attributable risk, cardiovascular risk factors, temporal trends, Framingham Heart Study, middle-aged adults, diabetes prevention, cardiovascular risk management
- MeSH terms
- Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Female, Humans, Hypertension, Male, Middle Aged, Obesity, Risk, Risk Factors, Smoking, United States, Cohort Studies, Incidence, Proportional Hazards Models, Diabetes Complications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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