Clustering of Heart Disease Risk Factors in Diabetic Compared to Nondiabetic Adults

In a population-based study conducted by the Lipid Research Clinic between 1972 and 1974, the authors investigated the frequency and clustering of five heart disease risk factors--cholesterol, triglycerides, systolic blood pressure, obesity, and cigarette smoking--in 347 diabetic and 2285 euglycemic nondiabetic adults aged 35 to 79 years. Diabetics were more likely than nondiabetics to have high risk factor levels, although excesses for cholesterol and cigarette smoking were not statistically significant. Subjects at or above the 70th or 90th percentiles for one risk factor were more likely to be at or above these percentiles for other risk factors, and this clustering of heart disease risk factors was more common among diabetics than nondiabetics. Excess clustering in diabetics persisted after controlling for obesity and when only cholesterol, blood pressure, and cigarette smoking were analyzed. Clustering was more marked in women than in men. This may explain some of the excess risk of heart disease in female compared to male diabetics, which has been reported by others.