title: Mortality associated with diabetes and cardiovascular disease in older women.
abstract: BACKGROUND
  Current guidelines for the prevention of cardiovascular disease (CVD) recommend diabetes as a CVD risk equivalent. However, reports that have examined the risk of diabetes in comparison to pre-existing CVD are lacking among older women. We aimed to assess whether diabetes was associated with a similar risk of total and cause-specific mortality as a history of CVD in older women.
  
  
  RESULTS
  We studied 9218 women aged 68 years or older enrolled in a prospective cohort study (Study of Osteoporotic Fracture) during a mean follow-up period of 11.7 years and compared all-cause, cardiovascular and coronary heart disease mortality among 4 groups: non-diabetic women with and without existing CVD, diabetic women with and without existing CVD. Mean (SD) age of the participants was 75.2 (5.3) years, 3.5% reported diabetes and 6.8% reported existing CVD. During follow-up, 5117 women died with 36% from CVD. The multivariate adjusted risk of cardiovascular mortality was increased among both non-diabetic women with CVD (hazard ratio (HR) 2.32, 95% CI: 1.97-2.74, P<0.001) and diabetic women without CVD (HR 2.06, CI: 1.62-2.64, P<0.001) compared to non-diabetic women without existing CVD. All-cause, cardiovascular and coronary mortality of non-diabetic women with CVD were not significantly different from diabetic women without CVD.
  
  
  CONCLUSIONS
  Older diabetic women without CVD have a similar risk of cardiovascular mortality compared to non-diabetic women with pre-existing CVD. The equivalence of diabetes and CVD seems to extend to older women, supporting current guidelines for cardiovascular prevention.
authors.affiliation: Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. david.nanchen@chuv.ch
authors.forename: David
authors.initials: D
authors.lastname: Nanchen
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.forename: Jacques
authors.initials: J
authors.lastname: Cornuz
authors.forename: Teresa
authors.initials: T
authors.lastname: Hillier
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Douglas C
authors.initials: DC
authors.lastname: Bauer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications / Q000453:epidemiology / Q000401:mortality*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D011446:Prospective Studies; D012307:Risk Factors