Potentially modifiable metabolic factors and the risk of cardiovascular disease hospitalizations in urban African Americans with diabetes.
OBJECTIVE
Diabetes and cardiovascular disease (CVD) are frequent causes of hospitalization in African Americans but have rarely been studied as coexisting diagnoses. We analyzed data from an urban African American diabetes patient population to identify variables associated with CVD hospitalizations.


METHODS
Demographic, disease, and metabolic characteristics of patients seen from 1991 to 1997 were extracted from an electronic patient tracking system. Data were linked to a statewide hospital discharge dataset to establish who was hospitalized between 1998 and 2001. Patients with a CVD hospitalization were compared to patients without a CVD hospitalization.


RESULTS
3397 diabetes patients (average age, 56 years; 65% women; 92% African American) were included in the analysis; 24% had hospitalizations primarily due to CVD. Persons with CVD hospitalizations were older and had diabetes longer, and fewer were women. Mean systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol, triglyceride, and total cholesterol levels and urinary albumin/creatinine ratio were all higher among persons with CVD hospitalizations. In adjusted analyses, women had lower odds of experiencing a CVD hospitalization, but advancing age, diabetes duration, SBP, and LDL cholesterol were all associated with greater odds.


CONCLUSIONS
In this predominantly African American patient sample with diabetes, specific factors (age, sex, diabetes duration, LDL cholesterol, SBP) were associated with CVD hospitalizations. Additional studies are needed to determine whether management of metabolic risk factors in outpatient settings will translate into lower hospitalization rates due to CVD in this population.
Cook
Curtiss B
CB
Division of Endocrinology, Mayo Clinic, Scottsdale, AZ 85259, USA.
Hentz
Joseph G
JG
Tsui
Circe
C
Ziemer
David C
DC
Naylor
Dorothy B
DB
Miller
William J
WJ
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000419:Albuminuria / Q000652:urine; D015415:Biomarkers / Q000097:blood / Q000652:urine; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D003404:Creatinine / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology / Q000378:metabolism* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005845:Georgia / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000378:metabolism; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012107:Research Design; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014280:Triglycerides / Q000097:blood; D014505:Urban Population / Q000706:statistics & numerical data*
D015415:Biomarkers; D008078:Cholesterol, LDL; D003404:Creatinine; D006442:Glycated Hemoglobin; D014280:Triglycerides