title: Changes in all-cause and cardiovascular disease mortality in three different Finnish population cohorts with and without diabetes.
abstract: BACKGROUND
  We aimed to assess changes in cardiovascular (CVD) and all-cause mortality among diabetic and non-diabetic individuals between three large study cohorts with baseline assessments of 10 years apart and followed up for 10 years.
  
  
  METHODS
  Six population surveys were carried out in 1972, 1977, 1982, 1987, 1992 and 1997 in Finland. For the analyses we combined the 1972 and 1977 cohorts (cohort 1), the 1982 and 1987 cohorts (cohort 2) and similarly also the 1992 and 1997 cohorts (cohort 3).
  
  
  RESULTS
  Age-adjusted hazard ratio (HR) of all-cause mortality and CVD in men without diabetes showed that both had a statistically significant decreased risk of all-cause mortality compared to the first cohort. No statistically significant changes in all-cause mortality were observed in men and women with diabetes between the latter two cohorts compared with the first after controlling for several covariates. In both men and women without diabetes, cohort 2 (men, HR=0.65; 95% CI 0.51-0.82; women, HR=0.54; 95% CI 0.32-0.89) and cohort 3 (men, HR=0.32; 95% CI 0.22-0.47; women, HR=0.31; 95% CI 0.14-0.68) showed a statistically significant decreased risk of CVD mortality compared to cohort 1. Age-adjusted HRs in regard to CVD mortality in men (HR=0.22; 95% CI 0.07-0.69) and women (HR=0.22; 95% CI 0.05-0.99) with diabetes of cohort 3 were statistically significantly lower than in cohort 1.
  
  
  CONCLUSIONS
  There seems to be a decrease in CVD mortality in people with diabetes indicating that treatment of diabetes and cardiovascular risk factors in diabetes patients may have improved during the last decade.
authors: Institute of Clinical Medicine/Internal Medicine, University of Oulu, Oulu, Finland; Universidad del Tolima, Ibagué, Colombia. Electronic address: noel.barengo@gmail.com.
authors: Noël C
authors: NC
authors: Barengo
authors: Riitta
authors: R
authors: Antikainen
authors: Markku
authors: M
authors: Peltonen
authors: Jaakko
authors: J
authors: Tuomilehto
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D005544:Forecasting / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends
keywords: Cardiovascular disease; Diabetes; Mortality; Population