Abstract 1191: Trends in Cardiovascular Disease Risk Factors among Middle-Aged Individuals with and without Diabetes in the Framingham Heart Study
BACKGROUND: Despite decline in cardiovascular (CVD) among individuals with and without type 2 diabetes (DM), individuals with DM remain at ~2-fold increased risk for CVD relative to those without DM. The role of changes in CVD risk factors over time in individuals with and without DM has not been fully explored. The objective of this study is to examine the temporal trends in body mass index (BMI), systolic blood pressure (SBP), and total cholesterol, among individuals with and without DM.
METHODS: Participants from the Framingham Heart Study Offspring cohort, who attended any one of the 7 serial examinations occurring during the period of 1971 to 2001 were included in this analysis (n=165 DM; 3172 non-DM). DM was defined as having a fasting plasma glucose ≥126 mg/dL or DM treatment. CVD risk factor levels were measured at the exam closest (within 2 years) to when the participant was 50 years old. Linear regression models were used to assess the interaction between DM status and calendar year on CVD risk factor levels.
RESULTS: Overall, from 1971 to 2001, mean BMI increased from 26.5 to 27.4 kg/m2 (p<0.0001), mean SBP decreased from 131 to 118 mmHg (p<0.0001) and mean total cholesterol decreased from 218 to 201 mg/dL (p<0.0001) among 50 year olds. Among non-DM, there was an increase in BMI of 0.04 kg/m2 per calendar year whereas for DM there was an increase of 0.29 kg/m2 (p-value for the DM by calendar year interaction [P-INTERACTION] = 0.0001). For SBP, the mean decrease was −0.43 mmHg per calendar year for non-DM and −0.28 mmHg for DM (P-INTERACTION = 0.35). For total cholesterol, the mean decrease was −0.76 mg/dL per calendar year for non-DM and −1.31 mg/dL for DM (P-INTERACTION = 0.15).
CONCLUSION: Overall, mean BMI increased and mean SBP and total cholesterol have decreased among 50 year olds with and without DM over the time period 1971–2001. However, individuals with DM experienced a greater increase in BMI than those with DM, and a similar magnitude of decline in SBP and total cholesterol as compared to those without DM. Individuals with DM have not experienced the necessary declines in CVD risk factors to overcome their increased risk of CVD as compared to those without DM. Further efforts are needed to aggressively control CVD risk factors among individuals with DM.