Abstract
Based on long-term follow-up, the incidence of cardiovascular complications of diabetes, i. e. coronary heart disease (CHD) and cerebrovascular accident (CVA), and their risk factors were investigated. The subjects studied comprised 1, 850 diabetic patients who were traced until the end of 1981, with a mean observation period of 7.1 years
Among them, 68 patients had a previous history of heart disease, and 24 of cerebrovascular lisease, and were excluded from the study. In the patients with no previous evidence of CHD or CVA, the incidence rates of CHD (death due to heart disease or heart attack) were 7.4 ° for males and 4.3 ° for females, while those of CVA (death due to CVA or stroke) were 6.0 % and 4. 2 °for males and females, respectively. There was a distinct male preponderance as well as a; harp increase with aging in the incidence rates of both CHD and CVA.
The symptoms presented at entry to the study were also closely associated with the incidence of CHD and CVA. There was a higher incidence of CHD with chest pain, and shortness of breath by excercise; and a higher incidence of CVA with difficulty in walking or speech, and abnormality of the peripheral sensory nerves.
Multiple logistic analysis was undertaken to elucidate the relationship between the incidence and other risk factors. It was found that aging, male sex, ischemic changes in ECG and elevated serum cholesterol levels were risk factors for CHD, while aging, male sex, elevated systolic blood pressure and fasting glucose levels, and albnminuria were risk factors for CVA.
