The Incidence of Congestive Heart Failure in Type 2 Diabetes
Open Access
- 1 August 2004
- journal article
- research article
- Published by American Diabetes Association in Diabetes Care
- Vol. 27 (8), 1879-1884
- https://doi.org/10.2337/diacare.27.8.1879
Abstract
OBJECTIVE—The aims of this study were to update previous estimates of the congestive heart failure (CHF) incidence rate in patients with type 2 diabetes, compare it with an age- and sex-matched nondiabetic group, and describe risk factors for developing CHF in diabetic patients over 6 years of follow-up. RESEARCH DESIGN AND METHODS—We performed a retrospective cohort study of 8,231 patients with type 2 diabetes and 8,845 nondiabetic patients of similar age and sex who did not have CHF as of 1 January 1997, following them for up to 72 months to estimate the CHF incidence rate. In the diabetic cohort, we constructed a Cox regression model to identify risk factors for CHF development. RESULTS—Patients with diabetes were much more likely to develop CHF than patients without diabetes (incidence rate 30.9 vs. 12.4 cases per 1,000 person-years, rate ratio 2.5, 95% CI 2.3–2.7). The difference in CHF development rates between persons with and without diabetes was much greater in younger age-groups. In addition to age and ischemic heart disease, poorer glycemic control (hazard ratio 1.32 per percentage point of HbA1c) and greater BMI (1.12 per 2.5 units of BMI) were important predictors of CHF development. CONCLUSIONS—The CHF incidence rate in type 2 diabetes may be much greater than previously believed. Our multivariate results emphasize the importance of controlling modifiable risk factors for CHF, namely hyperglycemia, elevated blood pressure, and obesity. Younger patients may benefit most from risk factor modification.Keywords
This publication has 25 references indexed in Scilit:
- Lifetime Risk for Developing Congestive Heart FailureCirculation, 2002
- The Impact of Cardiovascular Disease on Medical Care Costs in Subjects With and Without Type 2 DiabetesDiabetes Care, 2002
- Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38BMJ, 1998
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)The Lancet, 1998
- Why can high insulin levels indicate a risk for coronary heart disease?Diabetologia, 1994
- Insulin resistance, compensatory hyperinsulinaemia, and coronary heart diseaseDiabetologia, 1994
- Why is insulin not a risk factor for coronary heart disease?Diabetologia, 1994
- Diabetes and Cardiovascular DiseaseJAMA, 1979
- Diabetes and cardiovascular disease. The Framingham studyJAMA, 1979
- Role of diabetes in congestive heart failure: The Framingham studyThe American Journal of Cardiology, 1974