Risk factors for coronary disease and stroke in previously hospitalized African-Americans with Type 1 diabetes: a 6-year follow-up

Aims To report the 6-year incidence of, and risk factors for, cardiovascular disease (CVD), either coronary disease or stroke, in previously hospitalized African-Americans with Type 1 diabetes mellitus. Methods African-Americans (n = 483) with Type 1 diabetes were re-examined as part of a 6-year follow-up. At both visits, patients underwent a structured clinical interview, which included history of either coronary disease or stroke, ocular examination and masked grading of seven stereoscopic fundus photographs, blood pressure measurements, and administration of the Beck Depression Inventory. Biological measurements included blood and urine assays. Results Of the 483 patients who had a 6-year follow-up, 449 had no evidence of CVD at the baseline examination. Of these 449 patients, 51 (11.4%) developed any CVD-42 (9.3%) coronary disease and 14 (3.1%) a stroke. Six-year incidence of any CVD was significantly associated with older age (P < 0.0001) and longer duration of diabetes (P < 0.0001) at baseline. Multiple logistic regression showed that baseline older age, higher body mass index, higher diastolic blood pressure, proteinuria, retinopathy severity and being depressed were significant and independent risk factors for incidence of any CVD. Conclusion Six-year incidence of CVD is high in previously hospitalized African-Americans with Type 1 diabetes. Risk factors appear to include older age, higher body mass index, higher diastolic blood pressure, proteinuria, retinopathy severity and depression.