Cardiovascular Disease Incidence and Risk Factor Patterns among Omanis with Type 2 Diabetes: A Retrospective Cohort Study

Rawahi, Abdul Hakeem Al; Lee, Patricia; Al-Anqoudi, Zahir M.; Busaidi, Ahmed Al; Rabaani, Muna Al; Mahrouqi, Faisal Al; Busaidi, Ahmed Mohammed Al

doi:10.5001/omj.2017.20

Cited by 17 publications

(16 citation statements)

References 26 publications

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“…Globally, the incidence rates of CVD vary among different high-risk populations. The findings from a recent 5-year study conducted in a neighboring Arab country showed that the incidence rate of CVD among patients with diabetes was 17.6 per 1000 person-years, which is higher than the incidence rate determined in this study [6]. A Chinese study’s findings showed a CVD incidence rate of 17.2 per 1000 person-years among high-risk patients over 5 years [21].…”

Section: Discussioncontrasting

confidence: 54%

“…The study’s sample size was calculated using a formula for a study designed to estimate incidence in a population [13]. A sample size of 923 was determined based on an anticipated 10% incidence of CVD [6] and utilizing 80% power at a 2-sided level of significance of 0.05.…”

Section: Methodsmentioning

confidence: 99%

“…Older age, obesity, hypertension (HTN), dyslipidemia, smoking, type 2 diabetes (DM), being male, and chronic kidney disease (CKD) are well-known risk factors associated with CVD [6].…”

Section: Introductionmentioning

confidence: 99%

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Incidence of cardiovascular disease and its associated risk factors in at-risk men and women in the United Arab Emirates: a 9-year retrospective cohort study

Al-Shamsi

Regmi

Govender

2019

BMC Cardiovasc Disord

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Background Cardiovascular disease (CVD) is the leading cause of mortality worldwide; however, the epidemiology of CVD among nationals from the United Arab Emirates (UAE) remains unknown. This study aimed to estimate the 9-year incidence rate of CVD and determine the risk factors associated with CVD among UAE nationals at high cardiovascular risk. In addition, we investigated whether sex was an important modifier of the risk factors associated with incident CVD in this population. Methods A retrospective cohort study was conducted on 977 subjects, including 492 women, aged ≥18 years, who did not have histories of CVD, and who had ≥1 CVD risk factors. Multivariable Cox proportional hazards regression analyses stratified by sex were used to examine the predictors of major CVD events, namely, myocardial infarction (MI), stroke, and acute peripheral arterial occlusion. Results During a median follow-up period of 8.9 years, the incidence rate of major CVD was 12.7 per 1000 person-years (95% confidence interval [CI] 10.4–15.4), and among men and women were 16.8 (95% CI 12.9–21.4) and 9.0 (95% CI 6.4–12.4) per 1000 person-years, respectively. Major CVD and MI were significantly more frequent among men than women, and the stroke and acute peripheral arterial occlusion rates were similar for both sexes. Multivariable Cox analyses showed that the systolic blood pressure, estimated glomerular filtration rate, and serum glycosylated hemoglobin A1c level were strong predictors of major CVD in both sexes. Among women, the total cholesterol (TC)-to-high-density lipoprotein-cholesterol (HDL-C) ratio (hazard ratio [HR] 1.44, 95% CI 1.02–2.04) was an additional independent predictor of major CVD. Age (HR 1.50, 95% CI 1.19–1.89) and a history of smoking (HR 1.80, 95% CI 1.07–3.02) were significant risk factors associated with major CVD in men. Conclusions Among high-risk UAE nationals who did not have histories of CVD, the risk of major CVD was associated with high systolic blood pressure, a low estimated glomerular filtration rate, and poorly controlled diabetes. The high TC-to-HDL-C ratios, especially among women, and smoking among men, are modifiable risk factors that should be managed aggressively. Electronic supplementary material The online version of this article (10.1186/s12872-019-1131-2) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 54%

Section: Methodsmentioning

confidence: 99%

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Incidence of cardiovascular disease and its associated risk factors in at-risk men and women in the United Arab Emirates: a 9-year retrospective cohort study

Al-Shamsi

Regmi

Govender

2019

BMC Cardiovasc Disord

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“…The presence of cardiovascular events may worsen T2DM symptoms and result in a higher risk of T2DM-related complications [ 28 ]. We adjusted for country income level, sex, and age; however, it may have been beneficial to further adjust for other risk factors such as high blood pressure [ 30 , 31 ]. Since this study is based on global aggregate data, we were unable to control for these variables.…”

Section: Discussionmentioning

confidence: 99%

Sex differences and risk factors for diabetes mellitus - an international study from 193 countries

et al. 2018

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BackgroundIncreases in overweight and obesity among youths have resulted in the diagnosis of Type 2 diabetes mellitus (T2DM) at earlier ages. The impact of lifestyle-related factors has been implicated; however, its relation to morbidity and mortality and sex differences remain unclear. We aimed to document the changes in risk factors and sex differences associated with T2DM-related morbidity and mortality during 1995–2015.MethodWe used mortality rates and morbidity estimates from the Global Burden of Diseases Study 2016 using Disability-Adjusted Life Years (DALY). Multiple linear regression analyses were used to determine associations between T2DM-related mortality and related risk factors. DALYs were grouped by country income level, and were stratified by sex.ResultsIncreases in mortality were observed for both sexes, and females tended to have higher mortality rates per 100,000 persons. Body mass index (BMI) continued to be the leading risk factor for T2DM-related mortality, and increases in BMI were more common in low- and middle-income countries (LIC and MIC). Low physical activity was strongly associated with mortality rates, followed by dietary risks and smoking (2.4; 1.4; 0.8 per 100,000 persons, respectively). Similar patterns were observed after adjustments for income level, sex, and age. DALYs continued to show increasing trends across all income levels during 1995–2015 (high-income (HIC):16%; MIC: 36%; LIC: 12%). Stratification by sex showed similar results; males had fewer T2DM DALYs than females, though a greater increase was observed among males.ConclusionOverall, T2DM related mortality was higher among females. Compared to in HIC, there appeared to be a considerable increase in the burden of T2DM in MIC and LIC, where BMI is the leading risk factor for T2DM-related mortality. Prevention programs should emphasize related risk factors according to the existing standard of care.

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“…Our study revealed higher incidence of CVD among diabetic patients as compared with studies conducted in the world. Studies in China (29) and Oman (30) showed that 17.2 and 17.6 per 1000 PY of CVD among DM within median follow up periods of 5.3 and 5.6 years, respectively. This difference was probable because of the higher proportion of DM patients in our study had hypertension which contribute to the risk for developing CVD, compared to general population (6).…”

Section: Predictors Of Cvd Among Diabetic Patientsmentioning

confidence: 99%

WITHDRAWN: Incidence and Predictors of Cardiovascular Disease Among Type 1 and Type 2 Diabetes Mellitus in Tertiary Health Care Setting of Ethiopia: 8-Year Retrospective Follow Up Study.

Debele¹,

Kefeni²,

Kanfe³

et al. 2020

Preprint

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Background: Cardiovascular disease (CVD) is a major cause of death and disability among people with diabetes in the world and it is being a major barrier to sustainable human development. Despite, CVDs have continued to devastate human survival, few studies in Ethiopia have focused on its prevalence which alone are insufficient to assess the risk of incident cardiovascular events. Therefore, we determined the incidence and predictors of cardiovascular disease among diabetic patients.Methods: A retrospective cohort study was conducted on 399 randomly selected diabetes patients. Data were entered using Epi-Data and analyzed using Stata version 14. Multivariable Weibull proportional hazards regression analysis was used to identify the predictors of CVDs (namely, coronary heart disease (CHD), stroke, and peripheral arterial disease (PAD)) at 5% level of significance. Results: After a median follow-up of 5.9 years, the overall incidence rate of CVD per 100 person–years was 2.71 (95% CI: 16.9–17.6). The Multivariable survival analysis showed a significant association of CKD; (Adjusted Hazard Ratio (AHR) (95%CI) 2.53 [1.36, 4.72]), Systolic blood pressure (SBP) >/= 140; (AHR (95%CI) (4.30 [2.12, 8.73]) and triglyceride >/= 200 mg/dl; (AHR (95%CI) (5.10 [2.02, 12.89]) with risk of incident CVD.Conclusion: CVD is being a public health problem among diabetic patients in Ethiopia. SBP >/= 140, chronic kidney disease and high triglyceride were independent predictors of new CVD among diabetic patients. These findings emphasize the need of attention for CVD patients with CKD and HTN comorbidities and longer follow up period using prospective study design to determine the long-term effects of predictors of CVD among diabetic patients.

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Cardiovascular Disease Incidence and Risk Factor Patterns among Omanis with Type 2 Diabetes: A Retrospective Cohort Study

Cited by 17 publications

References 26 publications

Incidence of cardiovascular disease and its associated risk factors in at-risk men and women in the United Arab Emirates: a 9-year retrospective cohort study

Incidence of cardiovascular disease and its associated risk factors in at-risk men and women in the United Arab Emirates: a 9-year retrospective cohort study

Sex differences and risk factors for diabetes mellitus - an international study from 193 countries

WITHDRAWN: Incidence and Predictors of Cardiovascular Disease Among Type 1 and Type 2 Diabetes Mellitus in Tertiary Health Care Setting of Ethiopia: 8-Year Retrospective Follow Up Study.

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