title: Glucose, blood pressure, and lipid control in older people with and without diabetes mellitus: the Cardiovascular Health Study.
abstract: 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.
authors.affiliation: Department of Medicine, Cardiovascular Health Research Unit, University of Washington, 1730 Minor Avenue, Seattle, WA 98101, USA. nlsmith@u.washington.edu
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Smith
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Savage
authors.forename: Susan R
authors.initials: SR
authors.lastname: Heckbert
authors.forename: Joshua I
authors.initials: JI
authors.lastname: Barzilay
authors.forename: Vera A
authors.initials: VA
authors.lastname: Bittner
authors.forename: Lewis H
authors.initials: LH
authors.lastname: Kuller
authors.forename: Bruce M
authors.initials: BM
authors.lastname: Psaty
mesh_terms: 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
chemical_list: D001786:Blood Glucose; D008078:Cholesterol, LDL