Chest
Volume 115, Issue 3, March 1999, Pages 867-868
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Cardiology Practice Today
Incidence of Heart Failure in 2,737 Older Persons With and Without Diabetes Mellitus

https://doi.org/10.1378/chest.115.3.867Get rights and content

Study objectives

To investigate in older persons whether diabetes mellitus is an independent risk factor for congestive heart failure (CHF).

Design

A prospective study was performed in 2,737 older persons investigating the incidence of new CHF in persons with and without diabetes mellitus.

Setting

A long-term health-care facility.

Patients

Eight hundred sixty-five men and 1,872 women, with a mean age of 81 ± 9 years.

Measurements and results

At 43-month follow-up, new CHF developed in 272 of 690 persons (39%) with diabetes mellitus and in 467 of 2,047 persons (23%) without diabetes mellitus (p < 0.0001). Cox regression analysis showed that age (p = 0.0001, risk ratio = 1.048), hypertension (p = 0.0001, risk ratio = 2.524), coronary artery disease (p = 0.0001, risk ratio = 4.008), male gender (p = 0.0001, risk ratio = 1.399), and diabetes mellitus (p = 0.0003, risk ratio = 1.337) were significantly positively associated with the time to the development of CHF.

Conclusions

Older persons with diabetes mellitus had a 1.3 times higher chance of developing CHF than those without diabetes mellitus after controlling the confounding effects of other prognostic variables.

Section snippets

Materials and Methods

We investigated in a prospective study the association between diabetes mellitus and new CHF in 865 men and 1,872 women, with a mean age of 81 ± 9 years (range, 60 to 103 years), in a long-term health-care facility. Diabetes mellitus was present if the patient was receiving insulin (n = 360) or oral hypoglycemic drugs (n = 237) to control hyperglycemia or if the fasting venous plasma glucose levels were ≥140 mg/dL on two occasions (n = 93).9

Patients were considered at entry into the study to

Results

Follow-up was 43 ± 24 months (range, 1 to 160 months). CHF developed in 739 of 2,737 patients (27%). Table 1 shows the baseline characteristics and incidence of CHF in 690 patients with diabetes mellitus and in 2,047 patients without diabetes mellitus and levels of statistical significance. Table 2 shows the Cox regression analysis for the development of CHF.

Discussion

Diabetes mellitus is a risk factor for CHF independent of other risk factors.1,2,3,4,5,6,7,8 The data from this prospective study of 2,737 older patients show that age, hypertension, CAD, male gender, and diabetes mellitus were significantly positively associated with the time to the development of CHF. There was a 1.26 times higher chance of developing CHF for an increment of 5 years of age after controlling the confounding effects of other prognostic variables. Patients with CAD had a 4.0

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    Citation Excerpt :

    Moreover, the RR with type 1 diabetes in men was 3.47 (2.57, 4.69) and 5.15 in women (3.43, 7.74), with an RRR of 1.47 (1.90, 1.44) (Azoulay and Suissa, 2017). The risk of HF was found to be significantly higher in women than men with diabetes mellitus, which further complements the findings of Framingham Heart Study (Azoulay and Suissa, 2017; Aronow and Ahn, 1999). Moreover, an observational study conducted for 43 months suggested that the incidence of clinically confirmed HF was 39% in diabetic patients versus 23% in non-diabetics (Bertoni et al., 2006).

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Presented at CHEST 1998, the 64th Annual International Scientific Assembly of the American College of Chest Physicians, Toronto, ON, Canada, November 1998.

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