Contrasting Associations Between Diabetes and Cardiovascular Mortality Rates in Low-, Middle-, and High-Income Countries: Cohort Study Data From 143,567 Individuals in 21 Countries in the PURE Study.

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Fältnamn	Indikatorer	Metadata
000		04370naa a2200685 4500
001		oai:gup.ub.gu.se/298579
003		SwePub
008		240528s2020 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
024	7	a https://gup.ub.gu.se/publication/2985792 URI
024	7	a https://doi.org/10.2337/dc20-08862 DOI
040		a (SwePub)gu
041		a eng
042		9 SwePub
072	7	a ref2 swepub-contenttype
072	7	a art2 swepub-publicationtype
100	1	a Anjana, Ranjit Mohan4 aut
245	1 0	a Contrasting Associations Between Diabetes and Cardiovascular Mortality Rates in Low-, Middle-, and High-Income Countries: Cohort Study Data From 143,567 Individuals in 21 Countries in the PURE Study.
264		c 2020-10-15
264	1	b American Diabetes Association,c 2020
520		a We aimed to compare cardiovascular (CV) events, all-cause mortality, and CV mortality rates among adults with and without diabetes in countries with differing levels of income.The Prospective Urban Rural Epidemiology (PURE) study enrolled 143,567 adults aged 35-70 years from 4 high-income countries (HIC), 12 middle-income countries (MIC), and 5 low-income countries (LIC). The mean follow-up was 9.0 ± 3.0 years.Among those with diabetes, CVD rates (LIC 10.3, MIC 9.2, HIC 8.3 per 1,000 person-years, P < 0.001), all-cause mortality (LIC 13.8, MIC 7.2, HIC 4.2 per 1,000 person-years, P < 0.001), and CV mortality (LIC 5.7, MIC 2.2, HIC 1.0 per 1,000 person-years, P < 0.001) were considerably higher in LIC compared with MIC and HIC. Within LIC, mortality was higher in those in the lowest tertile of wealth index (low 14.7%, middle 10.8%, and high 6.5%). In contrast to HIC and MIC, the increased CV mortality in those with diabetes in LIC remained unchanged even after adjustment for behavioral risk factors and treatments (hazard ratio [95% CI] 1.89 [1.58-2.27] to 1.78 [1.36-2.34]).CVD rates, all-cause mortality, and CV mortality were markedly higher among those with diabetes in LIC compared with MIC and HIC with mortality risk remaining unchanged even after adjustment for risk factors and treatments. There is an urgent need to improve access to care to those with diabetes in LIC to reduce the excess mortality rates, particularly among those in the poorer strata of society.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
700	1	a Mohan, Viswanathan4 aut
700	1	a Rangarajan, Sumathy4 aut
700	1	a Gerstein, Hertzel C4 aut
700	1	a Venkatesan, Ulagamadesan4 aut
700	1	a Sheridan, Patrick4 aut
700	1	a Dagenais, Gilles R4 aut
700	1	a Lear, Scott A4 aut
700	1	a Teo, Koon4 aut
700	1	a Karsidag, Kubilay4 aut
700	1	a Alhabib, Khalid F4 aut
700	1	a Yusoff, Khalid4 aut
700	1	a Ismail, Noorhassim4 aut
700	1	a Mony, Prem K4 aut
700	1	a Lopez-Jaramillo, Patricio4 aut
700	1	a Chifamba, Jephat4 aut
700	1	a Palileo-Villanueva, Lia M4 aut
700	1	a Iqbal, Romaina4 aut
700	1	a Yusufali, Afzalhussein4 aut
700	1	a Kruger, Iolanthe M4 aut
700	1	a Rosengren, Annika,d 1951u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine4 aut0 (Swepub:gu)xrosan
700	1	a Bahonar, Ahmad4 aut
700	1	a Zatonska, Katarzyna4 aut
700	1	a Yeates, Karen4 aut
700	1	a Gupta, Rajeev4 aut
700	1	a Li, Wei4 aut
700	1	a Hu, Lihua4 aut
700	1	a Rahman, M Omar4 aut
700	1	a Lakshmi, P V M4 aut
700	1	a Iype, Thomas4 aut
700	1	a Avezum, Alvaro4 aut
700	1	a Diaz, Rafael4 aut
700	1	a Lanas, Fernando4 aut
700	1	a Yusuf, Salim4 aut
710	2	a Göteborgs universitetb Institutionen för medicin, avdelningen för molekylär och klinisk medicin4 org
773	0	t Diabetes cared : American Diabetes Associationg 43:12, s. 3094-3101q 43:12<3094-3101x 1935-5548x 0149-5992
856	4	u https://care.diabetesjournals.org/content/diacare/43/12/3094.full.pdf
856	4 8	u https://gup.ub.gu.se/publication/298579
856	4 8	u https://doi.org/10.2337/dc20-0886

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