Summary
The prevalence of coronary heart disease, left ventricular failure and hypertension was examined in a representative group of 133 newly diagnosed Type 2 (non-insulin-dependent) diabetic subjects (70 men, 63 women), aged 45 to 64 years, and in a group of 144 randomly selected non-diabetic control subjects (62 men, 82 women) of the same age group. The prevalence of previous myocardial infarction (major Q-QS abnormalities in resting ECG and/or myocardial infarction verified at hospital) was increased 1.7-fold in male (NS) and 4.4-fold in female (p = 0.007) diabetic patients compared with that found in non-diabetic subjects. Chest pain symptoms and ischaemic ECG abnormalities were about twice as common among diabetic than among non-diabetic subjects. The frequency of coronary heart disease defined by chest pain symptoms and ECG abnormalities was 3.5 times higher in male (p = 0.001) and 3.1 times higher in female (p = 0.001) diabetic patients than in the respective non-diabetic subjects. The frequency of current digitalis therapy was increased 3.3-fold in male (p = 0.006) and 3.9-fold in female (p = 0.001) diabetic patients suggesting an increased frequency of left ventricular failure among diabetic subjects. The prevalence of hypertension, based on the elevated blood pressure levels and/or current use of antihypertensive drugs, was increased 1.6–1.7-fold among the diabetic patients.
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Garcia MJ, McNamara PM, Gordon T, Kannel WB (1974) Morbidity and mortality in diabetics in the Framingham population. Sixteen year follow-up study. Diabetes 23: 105–111
Kannel WB, McGee DL (1979) Diabetes and carciovascular disease. The Framingham study. JAMA 241: 2035–2038
Herman JB, Medalie JG, Goldbourt U (1977) Differences in cardiovascular morbidity and mortality between previously known and newly diagnosed adult diabetics. Diabetologia 13: 229–234
Fuller JH, Shipley MJ, Rose G, Jarrett RJ, Keen H (1980) Coronary heart disease risk and impaired glucose tolerance. The Whitehall study. Lancet 1: 1373–1376
Heyden S, Heiss G, Bartel AG, Hames CG (1980) Sex differences in coronary mortality among diabetics in Evans county, Georgia. J Chron Dis 33: 265–273
Jarrett RJ, McCartney P, Keen H (1982) The Bedford survey: ten-year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risks indices for coronary heart disease in borderline diabetics. Diabetologia: 22: 79–84
Reunanen A, Laakso M, Pyörälä K (1983) Cardiovascular and coronary heart disease mortality of diabetics and non-diabetics; impact of risk factors. Am Coll Cardiol 2: 600 (Abstract)
Pyörälä K (1979) Relationship of glucose tolerance and plasma insulin to the incidence of coronary heart disease: results from two population studies in Finland. Diabetes Care 2: 131–141
Stamler R, Stamler J (eds) (1979) Asymptomatic hyperglycemia and coronary heart disease. A series of papers by the international collaborative group based on studies in fifteen populations. J Chron Dis 32: 638–837
Jarrett RJ, Keen H, Fuller JH, McCartney M (1979) Worsening to diabetes in men with impaired glucose tolerance (‘borderline diabetes’). Diabetologia 16: 25–30
Keen H, Rose G, Pyke DA, Boyns D, Chlouverakis C, Mistry S (1965) Blood sugar and arterial disease. Lancet 2: 505–508
Weaver JA, Bhalia SK, Boyle D, Haddan DR, Montgomery DAD (1970) Cardiovascular state of newly discovered diabetic women. Br Med J 1: 783–786
Kannel WB, Hjortland M, Castelli WP (1974) Role of diabetes in congestive heart failure. Am J Cardiol 34: 29–34
Pell S, D'Alonzo CA (1967) Some aspects of hypertension in diabetes mellitus. JAMA 202: 104–110
Dupree EA, Meyer MB (1980) Role of risk factors in complications of diabetes mellitus. Am J Epidemiol 112: 100–112
Aromaa A (1981) Epidemiology and public health impact of high blood pressure in Finland (Finnish, with English summary). Helsinki: Kansanterveystieteen julkaisuja AL: 17, Helsinki
Barrett-Connor E, Criqui MH, Klauber MR, Holdbrook M (1981) Diabetes and hypertension in a community of older adults. Am J Epidemiol 113: 276–284
Jarrett RJ, Keen H, McCartney M, Fuller JH, Hamilton PJS, Reid DD, Rose G (1978) Glucose tolerance and blood pressure in two population samples: their relation to diabetes mellitus and hypertension. Int J Epidemiol 7: 15–24
Jarrett RJ, Keen H, Chakrabarti R (1982) Diabetes, hyperglycaemia and arterial disease. In: Keen H, Jarrett RJ (ed) Complications of diabetes, 2nd edn. Edward Arnold, London, pp 179–203
WHO Expert Committee on Diabetes Mellitus (1980) Second report. Technical Report Series, No 646, Geneva
Laakso M, Honkonen E, Kauppinen U, Pyörälä K (1983) Diagnostic criteria used for the definition of diabetes in the district of University Central Hospital of Kuopio (Finnish). Suom Lääkäril 10: 862–865
Uusitupa M (1983) Coronary heart disease and left ventricular performance in newly-diagnosed non-insulin-dependent diabetics. M. D. academic thesis. University of Kuopio 1983
Rose GA (1962) The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull WHO 27: 645–658
Arterial hypertension, report of a WHO Expert Committee (1978) Technical Report Series 628, Geneva
Rose GA, Blackburn H (1968) Cardiovascular survey methods. WHO Monograph Series No 56, World Health Organization, Geneva
Jonsell S (1939) A method for the determination of the heart size by teleroentgenography (a heart volume index). Acta Radiologica 20: 325–340
Reid DD, Brett GZ, Hamilton PJS, Jarrett RJ, Keen H, Rose GA (1974) Cardiorespiratory disease among middle-aged civil servants. A study of screening and intervention. Lancet 1: 469–473
Armitage P (1980) Statistical methods in medical research. Blackwell, Oxford, pp 384–388
Pyörälä K, Punsar S, Reunanen A, Heinonen OP, Puro K, Aromaa A (1974) Social Insurance Institution's coronary heart disease study. Prevalence of chest pain symptoms and ECG findings in nine Finnish population groups (in Finnish with English summary). Kansaneläkelaitoksen julkaisuja AL 1/1975, Helsinki
Puska P, Tuomilehto J, Salonen J, Nissinen A, Virtamo J, Björkqvist S, Koskela K, Neittaanmäki L, Takalo T, Kottke T, Mäki J, Sipilä P, Varvikko P (1981) Community control of cardiovascular diseases. The North Karelia project: World Health Organization, Regional Office for Europe, Copenhagen
Reunanen A, Aromaa A, Pyörälä K, Punsar S, Maatela J, Knekt P (1983) The Social Insurance Institution's coronary heart disease study. Acta Med Scand Suppl 673
Murphy MB, Lewis PJ, Kohner E, Schumer B, Dollery CT (1982) Glucose intolerance in hypertensive patients treated with diuretics; a fourteen-year follow-up. Lancet 2: 1293–1295
Regan TJ, Weisse AB (1978) The question of cardiomyopathy in diabetes mellitus. Ann Int Med 89: 1000–1002
Ledet T, Neubauer B, Christensen, NJ, Lundbaek K (1979) Diabetic cardiopathy. Diabetologia 16: 207–209
Shapiro LM (1982) Specific heart disease in diabetes mellitus. Br Med J 1: 140–141
Shapiro LM, Leatherdale BA, Coyne ME, Fletcher RF, Mackinnon J (1980) Prospective study of heart disease in untreated maturity onset diabetics. Br Heart J 44: 342–348
Uusitupa M, Siitonen O, Aro A, Korhonen T, Pyörälä K (1983) Effect of correction of hyperglycemia on left ventricular function in non-insulin dependent (type 2) diabetics. Acta Med Scand 213: 363–368
Uusitupa M, Siitonen O, Aro A, Pyörälä K (1982) Echocardiographic evaluation of the left ventricular performance and hypertrophy in newly diagnosed non-insulin-dependent diabetic subjects. Diabetologia 25: 199–200 (Abstract)
DeFronzo RA (1981) The effect of insulin on renal sodium metabolism. Diabetologia 21: 165–171
Drury PL (1983) Diabetes and arterial hypertension. Diabetologia 24: 1–9
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Uusitupa, M., Siitonen, O., Aro, A. et al. Prevalence of coronary heart disease, left ventricular failure and hypertension in middle-aged, newly diagnosed Type 2 (non-insulin-dependent) diabetic subjects. Diabetologia 28, 22–27 (1985). https://doi.org/10.1007/BF00276995
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DOI: https://doi.org/10.1007/BF00276995