Does early intensive multifactorial therapy reduce modelled cardiovascular risk in individuals with screen-detected diabetes? Results from the ADDITION-Europe cluster randomized trial.
Bottom Line: In the absence of long-term data on hard outcomes, we described change in 10-year modelled cardiovascular risk in the 5 years following diagnosis, and quantified the impact of intensive treatment on 10-year modelled cardiovascular risk at 5 years.Compared with routine care, 10-year modelled cardiovascular disease risk was lower in the intensive treatment group at 5 years.Our results suggest that patients benefit from intensive treatment early in the diabetes disease trajectory, where the rate of cardiovascular disease risk progression may be slowed.
Affiliation: MRC Epidemiology Unit, Cambridge University Biomedical Campus, Cambridge, UK.Show MeSH
Related in: MedlinePlus
Mentions: Ten-year modelled cardiovascular disease risk was 27.3% (sd 13.9) at baseline in the ADDITION-Europe trial cohort and 21.3% (sd 13.8) at 5 years (Table 2). Across all four centres there was a decline in modelled risk from baseline to follow-up in both the routine care (–5.0%; sd 12.2) and intensive care group (–6.9%; sd 9.0). Figure 1 shows the distribution of cardiovascular disease risk at baseline and follow-up separately by treatment group. For both groups, the distribution of modelled cardiovascular disease risk shifted to the left. Declines in modelled risk from diagnosis to 5 years were correlated with decreases in lipid, glucose and blood pressure values (see Supporting Information, Fig. S2).
Affiliation: MRC Epidemiology Unit, Cambridge University Biomedical Campus, Cambridge, UK.