Subclinical Cardiovascular Disease in US Adults With and Without Diabetes

Figures

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  Figure 1. Crude prevalence of subclinical cardiovascular disease in asymptomatic US adults by diabetes status (National Health and Nutrition Examination Survey 1999–2004). Diabetes was defined as a prior diagnosis or glycated hemoglobin ≥6.5%. Elevated hs‐cTnT was defined as hs‐cTnT ≥14 ng/L. Elevated NT‐proBNP was defined as NT‐proBNP ≥125 pg/mL. hs‐cTnT indicates high‐sensitivity cardiac troponin T; and NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.

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  Figure 2. Age‐standardized prevalence of elevated hs‐cTnT (≥14 ng/L) in asymptomatic US adults by diabetes status, demographic characteristics, and weight status (National Health and Nutrition Examination Survey 1999–2004). Diabetes was defined as a prior diagnosis or glycated hemoglobin ≥6.5%. With the exception of age‐specific estimates, all estimates were age‐standardized to the 2000 US Census standard population using the direct method. BMI indicates body mass index; and NH, non‐Hispanic.

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  Figure 3. Age‐standardized prevalence of NT‐proBNP (≥125 pg/mL) in asymptomatic US adults, by diabetes status, demographic characteristics, and weight status (National Health and Nutrition Examination Survey 1999–2004). Diabetes was defined as a prior diagnosis or glycated hemoglobin ≥6.5%. With the exception of age‐specific estimates, all estimates were age‐standardized to the 2000 US Census standard population using the direct method. BMI indicates body‐mass index; and NH, non‐Hispanic.

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  Figure 4. Age‐adjusted associations between duration of diabetes and glycemic control with subclinical cardiovascular disease (elevated hs‐cTnT [A and B] or NT‐proBNP [C and D]) in asymptomatic US adults (National Health and Nutrition Examination Survey 1999–2004). Elevated hs‐cTnT was defined as hs‐cTnT ≥14 ng/L. Elevated NT‐proBNP was defined as NT‐proBNP ≥125 pg/mL. Duration of diabetes was modeled as a cubic spline with knots 0.5, 5, 10, and 28 years. HbA1c was modeled as a cubic spline with knots at 5.6%, 6.7%, 7.8%, and 11.6%. HbA1c indicates glycated hemoglobin; hs‐cTnT, high‐sensitivity cardiac troponin T; and NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.

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  Figure 5. Kaplan‐Meier curves for mortality (all‐cause [A and B] and CVD [C and D]) in asymptomatic US adults with diabetes, by subclinical CVD status (National Health and Nutrition Examination Survey 1999–2004). Elevated hs‐cTnT was defined as hs‐cTnT ≥14 ng/L. Elevated NT‐proBNP was defined as NT‐proBNP ≥125 pg/mL. CVD indicates cardiovascular disease; hs‐cTnT, high‐sensitivity cardiac troponin T; and NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.

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  Figure 6. Association between elevated hs‐cTnT (≥14 ng/L) or NT‐proBNP (≥125 pg/mL) and all‐cause mortality among asymptomatic US adults with diabetes (National Health and Nutrition Examination Survey 1999–2004). All hazard ratios were adjusted for age, sex, race and ethnicity, smoking status, weight status, hypertension, hyperlipidemia, and chronic kidney disease. Estimates for adults aged 20 to 45 years were not reported due to the small number of events. BMI indicates body mass index; HR, hazard ratio; hs‐cTnT,high‐sensitivity cardiac troponin T; and NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.

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  Figure 7. Association between elevated hs‐cTnT (≥14 ng/L) or NT‐proBNP (≥125 pg/mL) and cardiovascular disease mortality among asymptomatic US adults with diabetes (National Health and Nutrition Examination Survey 1999–2004). All hazard ratios adjusted for age, sex, race and ethnicity, smoking status, weight status, hypertension, hyperlipidemia, and chronic kidney disease. Estimates for adults aged 20 to 45 years were not reported due to the small number of events. BMI indicates body mass index; HR, hazard ratio; hs‐cTnT, high‐sensitivity cardiac troponin T; and NT‐proBNP, N‐terminal pro‐B‐type natriuretic peptide.