Glucose, blood pressure, and lipid control in older people with and without diabetes mellitus: the Cardiovascular Health Study.
OBJECTIVE
To determine the prevalence of cardiovascular risk-factor treatment and control in older adults with normal fasting glucose, impaired fasting glucose, and diabetes mellitus and whether those with diabetes mellitus had better risk factor control than older adults with normal fasting glucose.


METHODS
Secondary analysis of data from population-based, prospective cohort study of risk factors for cardio-vascular and cerebrovascular disease in older people (Cardiovascular Health Study).


METHODS
Community-based.


METHODS
Community-dwelling adults aged 65 and older.


METHODS
Fasting plasma glucose, serum cholesterol and its subfractions, systolic and diastolic blood pressures, and body mass index.


RESULTS
There were 579 (18%) cohort members with diabetes mellitus (77% receiving antidiabetic medication, 23% with fasting glucose > or =126 mg/dL and no treatment), 213 (6%) with impaired fasting glucose, and 2,582 (77%)with normal fasting glucose. Of diabetic participants, 12% had recommended fasting glucose levels of less than 110 mg/dL. Of participants with hypertension, a larger proportion of diabetic participants than nondiabetic participants (89% versus 75%, P < .01) was treated with antihypertensive agents, but a smaller proportion of diabetic participants had recommended blood pressure levels of 129/85 mmHg or lower than nondiabetic participants had recommended blood pressure levels of 139/89 mmHg or lower (27% vs 48%, P < .01). Diabetic dyslipidemic participants were treated less often with lipid-lowering therapy (26% versus 55%, P < .01) and achieved recommended low-density lipoprotein goals less often (8%versus 54%, P < .01) than nondiabetic dyslipidemic participants.


CONCLUSIONS
Overall, treatment and control of cardiovascular risk factors were suboptimal in this older population, especially among those with diabetes mellitus. Optimizing risk-factor control can improve health outcomes in older adults with and without diabetes mellitus.
Smith
Nicholas L
NL
Department of Medicine, Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Seattle, WA 98101, USA. nlsmith@u.washington.edu
Savage
Peter J
PJ
Heckbert
Susan R
SR
Barzilay
Joshua I
JI
Bittner
Vera A
VA
Kuller
Lewis H
LH
Psaty
Bruce M
BM
D000367:Age Factors; D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
D001786:Blood Glucose; D008078:Cholesterol, LDL