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. 2017 Nov 22;17(1):893.
doi: 10.1186/s12889-017-4921-4.

Trends in cardiovascular risk factors among U.S. men and women with and without diabetes, 1988-2014

Xingxing Sun  1 , Tingting Du  2
Affiliations

Trends in cardiovascular risk factors among U.S. men and women with and without diabetes, 1988-2014

Xingxing Sun et al. BMC Public Health. .

Abstract

Background: Studies evidenced that reduction in cardiovascular disease (CVD) mortality in diabetic patients can be attributed to improvements in major CVD risk factors and evidence-based treatments. Furthermore, studies showed that the relative risk of CVD mortality associated with diabetes compared with non-diabetes is stronger in women than in men. Hence, we aimed to examine trends in CVD risk factors and intervention measures by sex and diabetic status.

Methods: Analysis of 5 distinct cross-sectional National Health and Nutrition Examination Surveys, 1988-1994, 1999-2002, 2003-2006, 2007-2010, and 2010-2014. Since detailed information on nontraditional risk factors such as sleep apnea was not available in each NHANES survey, traditional CVD risk factors including obesity, hypertension, and dyslipidemia were assessed in the study. To assess whether changes throughout the 27-year period differed by diabetes status, a logistic regression analysis was utilized to examine potential interaction effects between survey and diabetes. The similar process was repeated for sex.

Results: Means of all risk factors except body mass index and waist circumference decreased and the prevalence of antihypertensive and lipid-lowering medication use increased over time among diabetic and non-diabetic men and women. For both men and women, survey × diabetes status interaction terms for changes in HDL-cholesterol and triglyceride levels were not statistically significant, while the prevalence of antihypertensive and lipid-lowering medication use increased more in diabetic than in non-diabetic persons (all P < 0.001). For women, survey × diabetes status interaction terms indicated that compared with the first survey, total cholesterol, LDL-cholesterol, and non-HDL-cholesterol fallen more in diabetic than in non-diabetic persons (all P < 0.001). In the diabetic state, men experienced similar changes in means of all CVD risk factors and the prevalence of antihypertensive and lipid-lowering medication use as women (all P for interactions between survey and sex were >0.01).

Conclusions: The major traditional CVD risk factors in diabetic men decreased to the same extent that they did for non-diabetic men. The magnitude of changes in the favorable trends in diabetic women was of similar or greater compared with those among non-diabetic women. Diabetic women had as good an improvement in CVD risk factors as diabetic men.

Keywords: Cardiovascular risk factors; Diabetes; Trends.

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Conflict of interest statement

Ethics approval and consent to participate

Each adult participant provided a written informed consent and the NHANES was approved by the National Center for Health Statistics ethics review board. All procedures followed were performed in accordance with the ethical standards of the responsible committee on human experimentation and with the 1975 Helsinki Declaration and its later amendments.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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