Trends in the Risk for Coronary Heart Disease Among Adults With Diagnosed Diabetes in the U.S.: Findings from the National Health and Nutrition Examination Survey, 1999–2008

OBJECTIVE: Coronary heart disease (CHD) is a major cause of mortality among people with diabetes. The objective of this study was to examine the trend in an estimated 10-year risk for developing CHD among adults with diagnosed diabetes in the U.S. RESEARCH DESIGN AND METHODS: Data from 1,977 adults, aged 30–79 years, with diagnosed diabetes who participated in the National Health and Nutrition Examination Survey from 1999–2000 to 2007–2008 were used. Estimated risk was calculated using risk prediction algorithms from the UK Prospective Diabetes Study (UKPDS), the Atherosclerosis Risk in Communities study, and the Framingham Heart Study. RESULTS: Significant improvements in mean HbA(1c) concentrations, systolic blood pressure, and the ratio of total cholesterol to HDL cholesterol occurred. No significant linear trend for current smoking status was observed. The estimated UKPDS 10-year risk for CHD was 21.1% in 1999–2000 and 16.4% in 2007–2008 (P(linear trend) < 0.001). The risk decreased significantly among men, women, whites, African Americans, and Mexican Americans. CONCLUSIONS: The estimated 10-year risk for CHD among adults with diabetes has improved significantly from 1999–2000 to 2007–2008. Sustained efforts in improving risk factors should further benefit the cardiovascular health of people with diabetes.