Thirty-year trends in cardiovascular risk factor levels among US adults with diabetes: National Health and Nutrition Examination Surveys, 1971-2000.
Among US adults with diabetes, using data from the National Health and Nutrition Examination Survey for 1971-1974, 1976-1980, 1988-1994, and 1999-2000, the authors describe 30-year trends in total cholesterol, blood pressure, and smoking levels. Using Bayesian models, the authors calculated mean changes per year and 95% credible intervals for age-adjusted mean total cholesterol and blood pressure levels and the prevalence of high total cholesterol (> or =5.17 mmol/liter), high blood pressure (systolic blood pressure: > or =140 mmHg and/or diastolic blood pressure: > or =90 mmHg), and smoking. Between 1971-1974 and 1999-2000, mean total cholesterol declined from 5.95 mmol/liter to 5.48 mmol/liter (-0.02 (95% credible interval: -0.03, -0.01) mmol/liter per year). The proportion with high cholesterol decreased from 72% to 55%. Mean blood pressure declined from 146/86 mmHg to 134/72 mmHg (systolic blood pressure: -0.5 (95% credible interval: -1.1, 0.5) mmHg per year; diastolic blood pressure: -0.6 (95% credible interval: -1.0, -0.03) mmHg per year). The proportion with high blood pressure decreased from 64% to 37%, and smoking prevalence decreased from 32% to 17%. Although these trends are encouraging, still one of two people with diabetes has high cholesterol, one of three has high blood pressure, and one of six is a smoker.
Imperatore
Giuseppina
G
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. gai5@cdc.gov
Cadwell
Betsy L
BL
Geiss
Linda
L
Saadinne
Jinan B
JB
Williams
Desmond E
DE
Ford
Earl S
ES
Thompson
Theodore J
TJ
Narayan
K M Venkat
KM
Gregg
Edward W
EW
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001499:Bayes Theorem; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D015897:Comorbidity / Q000639:trends*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D006973:Hypertension / Q000150:complications / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D015233:Models, Statistical; D009010:Monte Carlo Method; D009749:Nutrition Surveys; D011159:Population Surveillance; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000639:trends; D000074606:Smoking Prevention; D014481:United States / Q000453:epidemiology