Predicted risk of coronary heart disease among persons with type 2 diabetes

Background Diabetes is an independent risk factor for the development of coronary heart disease (CHD). We evaluated whether there are racial/ethnic differences in predicted probability of CHID among persons with type 2 diabetes from the 1999-2002 National Health and Nutrition Examination Survey. Methods Adults with type 2 diabetes without cardiovascular disease (n=585) were evaluated; the United Kingdom Prospective Diabetes Study (UKPDS) Risk Engine was used to develop estimates of CHID and Framingham Risk Score (FRS) was used to assess the 10-year CH D risk. Chi-square tests and analysis of variance were used to assess differences between racial/ethnic groups in risk factors and predicted probability for CHD. Results Risk factors for CHD differed significantly amongst the three racial/ethnic groups. Whites had lower mean All C concentrations (73% +/- 0.2) than blacks (8.1% +/- 0.2, P < 0.05) or Mexican Americans (8.1% +/- 0.2, P < 0.05). Systolic blood pressure was higher in blacks compared with whites (P < 0.05) and in Mexican American men compared with white men (P < 0.05). Total cholesterol differed insignificantly by race/ethnicity whereas high-density lipoprotein cholesterol was higher in blacks compared with whites and Mexican Americans. Blacks had the greatest 5, 10, 15, and 20-year predicted risks of CHD among men, whereas whites had the greatest predicted risks among women. When evaluated by the FIRS, the 10-year predicted risk of CH D was estimated to be 22.5% by UKPDS and 17% using FRS. Conclusions UKPDS estimates of probability of CHD were similar across race/ethnicities, indicating that the risk factors tended to balance out. Despite differences in individual risk factors, the estimated risk for CHD was similar for all persons with diabetes. Coron Artery Dis 18:595-600 (c) 2007 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.