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Diabetes and Glucose Tolerance as Risk Factors for Cardiovascular Disease: The Framingham Study
Abstract
This report examines prospectively, in the Framingham cohort, the relation of diabetes and impaired glucose tolerance to each of the cardiovascular sequelae, taking into account age, sex, and associated cardiovascular risk factors. The incidence of cardiovascular disease, as well as the levels of cardiovascular risk factors, were found to be higher in diabetic than in nondiabetic men and women. The relative impact of diabetes on coronary heart disease, peripheral vascular disease, or stroke incidence was the same in men and women, but for cardiovascular mortality and cardiac failure the impact is greater for women. Present evidence suggests that alleviation of associated cardiovascular risk factors is the most promising course in reducing cardiovascular sequelae in diabetic patients.
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“Diabetic patients are at high risk of cardiovascular events, particularly of coronary heart disease by about 3-fold [67,68].”
From Metformin: An Old But Still the Best Treatment for Type 2 Diabetes (2013) · cites this paper as [67]
In the citing paper
“T2DM is associated with a two-fold higher risk of CAD and ischaemic stroke”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [140]
In the citing paper
“and a two-to four-fold higher CAD-and stroke-related mortality.139 -141”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [140]
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“Serum glucose is regulated within a narrow range by multiple factors in physiological conditions, but the disorders involving hyperglycemia in diabetes mellitus cause serious complications, including systemic vascular disorder leading to ischemic heart disease, cerebrovascular disease and nephropathy, as well as sever…”
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“The Framingham cohort (8), and more recent data, have established the notion that diabetes is associated with a twoto fourfold increased risk of both CHD and stroke (9–11).”
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“Large population-based studies have suggested an association between elevated blood glucose and heart failure, especially in the context of type 2 diabetes (7, 27, 30, 62, 64).”
Comparative risk of new‐onset diabetes mellitus for antihypertensive drugs: A network meta‐analysis
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“The selection of articles was further narrowed down by defining the following inclusion criteria: (1) randomized controlled trail design; (2) diagnosis of NOD confirmed by American Diabetes Association criteria,13 diabetic symptoms, glucose levels on fasting or oral glucose tolerance testing; and (3) clearly described…”
BackgroundMethodInfluentialCoronary risk equivalence of diabetes assessed by SPECT-MPI
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“It is well-known that individuals with diabetes are at a much higher risk than are nondiabetic persons for developing CVD of all types, including coronary, cerebral, and peripheral arterial disease [ 15 ,16].”
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“The risk of cardiovascular disease in diabetic patients is 2-3 times higher than that in healthy people (2, 4, 6), which is related to the thrombogenic environment and the earlier and more severe vascular pathological change (7, 8).”
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Volpe, M., Battistoni, A., Savoia, C., & Tocci, G. (2015) · PubMed Central · doi:10.3978/j.issn.2223-3652.2015.06.02 · Cited by 19
“infarction, ischemic stroke and congestive heart failure, but also microvascular complications, such as retinopathy, nephropathy and peripheral artery disease (3).”
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BackgroundMethodDiabetes, colorectal cancer and cyclooxygenase 2 inhibition
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BackgroundA study on diabetic foot and its association with peripheral artery disease
Muthiah, A., Kandasamy, R., Nagulan, S., et al. (2017) · International Surgery Journal · doi:10.18203/2349-2902.isj20170937 · Cited by 16
“Framingham heart study revealed that 20% of symptomatic patients with PAD had diabetes but this probably underestimates the prevalence as most people with PAD are asymptomatic.2 Diabetes, smoking, hypertension, advanced age, hyperlipidemia, elevated Creactive protein, apolipoprotein, lipoprotein (a), fibrinogen and pl…”
BackgroundInfluentialFibrin Clot Strength in Patients with Diabetes Mellitus Measured by Thrombelastography
Maatman, B. T., Schmeisser, G., & Kreutz, R. P. (2018) · Journal of Diabetes Research · doi:10.1155/2018/4543065 · Cited by 15
The metabolic syndrome in type 2 diabetes: When does it matter?
Wong, J., Molyneaux, L. M., Constantino, M., Twigg, S. M., & Yue, D. K. (2006) · Diabetes Obesity and Metabolism · doi:10.1111/j.1463-1326.2005.00565.x · Cited by 15
Burdon, K. P., Langefeld, C. D., Wagenknecht, L. E., Carr, J. J., Freedman, B. I., Herrington, D. M., & Bowden, D. W. (2005) · Diabetic Medicine · doi:10.1111/j.1464-5491.2005.01777.x · Cited by 16
Risum, Ø., Abdelnoor, M., Svennevig, J. L., et al. (1996) · European Journal of Cardio-Thoracic Surgery · doi:10.1016/s1010-7940(96)80293-4 · Cited by 16
O’Neil, C. E., Nicklas, T. A., Suzuki, S., Myers, L., Johnson, C., & Berenson, G. S. (1997) · The American Journal of the Medical Sciences · doi:10.1097/00000441-199712000-00005 · Cited by 16
Vaur, L., Danchin, N., Hanania, G., Cambou, J., Lablanche, J. M., Blanchard, D., Clerson, P., & Guéret, P. (2003) · Diabetes & Metabolism · doi:10.1016/s1262-3636(07)70033-2 · Cited by 16
“D iabetes mellitus is associated with a two- to four- fold increase in the risk of coronary heart disease [1-4].”
BackgroundKoschinsky, T., B�nting, C. E., R�tter, R., & Gries, F. A. (1985) · Diabetologia · doi:10.1007/bf00282237 · Cited by 16
“A major role has been attributed to the abnormal metabolic environment in both Type 1 (insulin-dependent) and Type 2 diabetes [8-10], although the nature of any factor(s) with additional growth-stimulating effect in diabetic sera has remained uncertain.”
BackgroundAspirin therapy is still underutilized among patients with type 2 diabetes
Leitão, C. B., Krahe, A. L., Nabinger, G. B., et al. (2006) · Arquivos Brasileiros de Endocrinologia & Metabologia · doi:10.1590/s0004-27302006000600006 · Cited by 15
“Nevertheless, the specialists position statements need to guide the physicians based in the best available evidence and, at least until now, it indicates that the DM patient is in high risk of CHD and needs to be treated in the same way as that group of patients.”
BackgroundInfluentialKikuchi, C., Kajikuri, J., Hori, E., Nagami, C., Matsunaga, T., Kimura, K., & Itoh, T. (2014) · Biological and Pharmaceutical Bulletin · doi:10.1248/bpb.b13-00975 · Cited by 13
Relationship between Serum Cholesterol Efflux Capacity and Glucose Intolerance in Japanese-Americans
Kubota, M., Nakanishi, S., Hirano, M., Maeda, S., Yoneda, M., Awaya, T., Yamane, K., & Kohno, N. (2014) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.24315 · Cited by 15
Metadata
- Authors
- Kannel, W. B., & McGee, D. L.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 1979-03-01
- Volume
- 2
- Issue
- 2
- Pages
- 120-126
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W2059537042
- Cited by
- 1,203
- References
- 0
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 17 · 2023: 19 · 2022: 19 · 2021: 40 · 2020: 31 · 2019: 39 · 2018: 41 · 2017: 38 · 2016: 43 · 2015: 55 · 2014: 50 · 2013: 35 · 2012: 36
- FWCI
- 4.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Care (publishedVersion)
- PubMed (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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetes mellitus, impaired glucose tolerance, cardiovascular risk, coronary artery disease, peripheral vascular disease, stroke, cardiovascular mortality, heart failure, sex differences, cardiovascular risk factors, Framingham cohort
- MeSH terms
- Age Factors, Aged, Cardiovascular Diseases, Female, Glucose Tolerance Test, Humans, Male, Massachusetts, Middle Aged, Prospective Studies, Risk, Sex Factors, Diabetes Complications
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