Risk factor control and cardiovascular events in patients with type 2 diabetes mellitus

PLoS One. 2024 Feb 29;19(2):e0299035. doi: 10.1371/journal.pone.0299035. eCollection 2024.

Abstract

Background: Since patients with type 2 diabetes mellitus (T2DM) have an increased risk of cardiovascular events, interventions addressing risk factors reduce the incidence of cardiovascular disease (CVD) events. This study aimed to evaluate the difference in the incidence of CVD events according to risk factor control in patients with diabetes with and without cardio-renal disease.

Methods: We analyzed 113,909 patients with diabetes and 290,339 without diabetes using data released by the National Health Insurance Service (NHIS).

Results: Among patients with diabetes with four or five poorly controlled risk factors, hazard ratio for CVD events was 1.19 (95% confidence interval [CI], 1.06-1.34) in patients with cardio-renal disease and 2.31 (95% CI, 1.95-2.74) in patients without cardio-renal disease compared to patients with diabetes without risk factors. In subjects with diabetes and cardio-renal disease, patients with four or five poorly controlled risk factors had a higher risk of CVD mortality compared to subjects without risk factors (hazard ratio, 1.64; 95% CI, 1.18-2.30).

Conclusion: Controlling cardiovascular risk factors reduced the incidence of CVD events in patients with diabetes, especially those without cardio-renal disease. The degree of risk control was strongly associated with CVD mortality in patients with diabetes with baseline cardio-renal disease.

MeSH terms

  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / epidemiology
  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / epidemiology
  • Heart Disease Risk Factors
  • Heart Diseases*
  • Humans
  • Hypertension, Renal*
  • Nephritis*
  • Risk Factors

Supplementary concepts

  • Hypertensive Nephropathy

Grants and funding

This work was supported by a grant (D.K.S., 2021F-9) from the Korean Diabetes Association. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.