title: Trends in cardiovascular risk factors among people with diabetes in a population based study, Health Survey for England 1994-2009.
abstract: OBJECTIVE
  We evaluated trends in cardiovascular risk factors in a population-based sample of people with diabetes in England from 1994 to 2009.
  
  
  METHODS
  Data were obtained from Health Survey for England for 1994, 1998, 2003, 2006, 2008 and 2009. Participants were aged ≥30 years with self-reported diabetes.
  
  
  RESULTS
  The standerdised prevalence of diabetes increased from 2.8% in 1994 to 6.4% in 2009 and the prevalence among males was higher than females throughout. The trend in prevalence was more apparent in manual workers. From 1994 to 2009, mean systolic blood pressure declined from 148 mmHg to 137 mmHg; mean diastolic pressure declined from 80 mmHg to 70 mmHg; mean total cholesterol declined from 6.1 mmol/L to 4.5 mmol/L over the 15 years with linear trends. The proportion prescribed lipid lowering drugs increased from 2.2% to 47.4%. The percentage of current smokers declined from 17.5% to 13.4%. Mean body mass index increased from 27.7 kg/m(2) to 31.6 kg/m(2) with an overall increase of 0.24 kg/m(2) per year. Risk factor trends were generally similar between genders and social classes but the decline in smoking was not significant for men or for manual workers.
  
  
  CONCLUSIONS
  People with clinical diabetes have experienced substantial reductions in blood pressure, total cholesterol and smoking over 15 years. Increasing body mass index and persistence of smoking in lower socioeconomic groups, may compromise these improvements.
authors.affiliation: King's College London, Department of Primary Care and Public Health Sciences, Capital House, 42, Weston Street, London SE1 3QD, United Kingdom; Department of Family Medicine, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka. Electronic address: shyamalee.samaranayaka@kcl.ac.uk.
authors.forename: Shyamalee
authors.initials: S
authors.lastname: Samaranayaka
authors.forename: Martin C
authors.initials: MC
authors.lastname: Gulliford
mesh_terms: D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D004739:England / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence; D011314:Preventive Health Services; D012307:Risk Factors; D040242:Risk Reduction Behavior; D017678:Sex Distribution; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D016540:Smoking Cessation; D012959:Socioeconomic Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D000960:Hypolipidemic Agents; D008055:Lipids
keywords: Cardiovascular risk; Diabetes mellitus; England; Secular trends