According to background information in the article, deaths caused by cardiovascular disease (CVD) have decreased over the last 50 years. However, it is uncertain whether adults with diabetes, who are at a two- to four-fold increased risk of CVD events (heart attack, coronary heart disease death, and stroke), have experienced a decline in CVD risk.
Caroline S. Fox, M.D., M.P.H., from the National Heart, Lung, and Blood Institute, Framingham, Mass., and colleagues examined data from the Framingham Heart Study in order to determine whether adults with and without diabetes underwent similar declines in CVD. Two sets of study participants, aged 45 to 64 years, were examined: those who participated from 1950 to 1966, and those who participated from 1977 to 1995. Of the 4,118 individuals in the earlier time period, 113 had diabetes; of the 4,063 individuals in the later time period, 317 had diabetes.
The researchers found: "Adults with diabetes have experienced a 50 percent reduction in the rate of incident CVD, although persons with diabetes have remained at a consistent, approximate 2-fold excess for CVD events compared with those without diabetes. Adults without diabetes have had a smaller but statistically similar 35 percent reduction in CVD event rates. Patients with diabetes have benefited in a similar manner to those without diabetes during the decline in CVD rates in the U.S. population over the last several decades. Although gains have been made, substantial opportunity remains for additional progress to reduce the high absolute risk of CVD events in persons with diabetes."
(JAMA. 2004; 292: 2495-2499. Available post-embargo at jama.com)
Editor's Note: The work was supported by the National Heart, Lung, and Blood Institute's Framingham Heart Study. Dr. Meigs (co-author) is supported by an American Diabetes Association Career Development Award. Co-author Dr. Levy has previously consulted for GlaxoSmithKline on a diabetes clinical trial.