Thirty-year Trends in Cardiovascular Risk Factor Levels among US Adults with Diabetes

Among US adults with diabetes, using data from the National Health and Nutrition Examination Survey for 1971–1974, 1976–1980, 1988–1994, and 1999–2000, the authors describe 30-year trends in total cholesterol, blood pressure, and smoking levels. Using Bayesian models, the authors calculated mean changes per year and 95% credible intervals for age-adjusted mean total cholesterol and blood pressure levels and the prevalence of high total cholesterol (≥5.17 mmol/liter), high blood pressure (systolic blood pressure: ≥140 mmHg and/or diastolic blood pressure: ≥90 mmHg), and smoking. Between 1971–1974 and 1999–2000, mean total cholesterol declined from 5.95 mmol/liter to 5.48 mmol/liter (–0.02 (95% credible interval: –0.03, –0.01) mmol/liter per year). The proportion with high cholesterol decreased from 72% to 55%. Mean blood pressure declined from 146/86 mmHg to 134/72 mmHg (systolic blood pressure: –0.5 (95% credible interval: –1.1, 0.5) mmHg per year; diastolic blood pressure: –0.6 (95% credible interval: –1.0, –0.03) mmHg per year). The proportion with high blood pressure decreased from 64% to 37%, and smoking prevalence decreased from 32% to 17%. Although these trends are encouraging, still one of two people with diabetes has high cholesterol, one of three has high blood pressure, and one of six is a smoker.