Cardiovascular disease risk in subjects with type 2 diabetes mellitus in a population in southern Spain

Abstract

To calculate overall 10-year cardiovascular disease (CVD) risk for patients with type 2 diabetes we applied the UKPDS and SCORE prediction models to data derived from clinical notes of 1846 patients (mean age 65.5 years; 55.8% women) with type 2 diabetes attending eight Primary-Care Centres serving a catchment population of 200,000 citizens in Andalusia. The results showed obesity and high blood pressure present in >50%, established CVD in 24%, retinopathy in 30%, and nephropathy in 17%. Mean HbAlc level was 7.3%. Compliance with therapeutic goals was 54% for systolic blood pressure <130 mmHg, 39% for HbA1c <7% and 9% for LDL cholesterol <2.58 mmol/L. Approximately 33% were receiving treatment with metformin, statins, renin-angiotensin system inhibitors and anti-aggregation agents. UKPDS risk for coronary heart disease (CHD) was 23% and 16% for stroke. The SCORE 10-year mortality risk was 5%. Correlation coefficient between the two models predicting CVD risk was 0.68 (p<0.001). We conclude that, despite the European consensus that CVD is low in Mediterranean countries, the CVD risk factors in the type 2 diabetes sub-population in southern Spain is relatively high. Specific measures of health-care intervention are needed if CVD-associated morbido-mortality rates in these diabetic patients are to be reduced.