Cardiovascular risk factors and diseases precede oral hypoglycaemic therapy in patients with type 2 diabetes mellitus

被引:4
作者
Erkens, JA
Herings, RMC
Stolk, RP
Spoelstra, JA
Grobbee, DE
Leufkens, HGM
机构
[1] Univ Utrecht, Utrecht Inst Pharmaceut Sci, Dept Pharmacoepidemiol & Pharmacotherapy, NL-3508 TB Utrecht, Netherlands
[2] Univ Utrecht, Med Ctr, Julius Ctr Patient Oriented Res, Utrecht, Netherlands
关键词
diabetes mellitus; cardiovascular drugs; case-control study; epidemiology; prevalence;
D O I
10.1016/S0895-4356(01)00482-6
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Although patients with type 2 diabetes mellitus and cardiovascular disease share common risk factors, the link between these diseases remains largely unexplained. In this case-control study, the earlier use of cardiovascular drugs (before the diagnosis of diabetes) was investigated among cases with type 2 diabetes mellitus and controls without diabetes. Using the PHARMO database, we identified 4,864 patients who were prescribed oral hypoglycaemic agent (OHA) therapy between 1985-1998 in the Netherlands. For each case, two controls matched on age, sex and pharmacy were randomly selected. Controls had not received insulins or OHA therapy. There were 2,656 (55.0%) cases compared with 2,727 (28.1%) controls who used cardiovascular drugs at the start of OHA therapy. Cases had a 3.5-fold increased risk of cardiovascular drug use (OR95% CI = 3.5 [3.2-3.8]) compared to controls. Differences in cardiovascular drug use were noted as early as 7 years before the start of OHA therapy, distinguishing cases from controls. Our finding that patients with type 2 diabetes mellitus were more likely to receive treatment for cardiovascular disease several years before they start diabetes therapy supports the hypothesis of a common underlying mechanism of these two disorders and stresses the importance of the pre-diabetic state. (C) 2002 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:345 / 349
页数:5
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