Abstract
Diabetes is an important risk factor for the development of coronary heart disease
(CHD). Recent studies have found that the rise in the mortality rate of diabetes mellitus type 2 patients was due to coronary heart disease. This study was conducted in June
through September 2007, with the intention to evaluate CHD risk in diabetes patients
attending Sangkhom Hospital, Nongkhai Province. Data were collected by interview, blood
sampling and retrieval from medical records. The participants were 309 patients with
type 2 diabetes, aged 33 to 75 years (mean 55 ± 22 years), and without cardiovascular
diseases. The 10-year probability was estimated by using the INTERHEART Study modified
from NCEP ATP III (National Educational Program and Adult Treatment Panel III).
Student t-test and chi-square test were used to determine the differences between men
and women patients regarding risk factors, and to predict the probability of CHD. Most
patients (92.2%) smoked; 46.9 percent were hypertensive or were taking antihypertensives;
37.2 percent had total blood cholesterol (CHOL) higher than 200 mg/dl and a high density
lipoprotein cholesterol (HDL-C) level of less than 40 mg/dl. Evaluation by the heart
risk score (based on a model using basic risk factors, i.e., age, smoking, CHOL, HDL-C,
systolic blood pressure), 6.8 percent of the patients (25.3% men and 1.6% women; p <
0.001) had a predicted 10-year probability of more than 20 percent at very high risk (I)
and 21.4 percent of the patients (58.2% men and 11.2% women; p < 0.001) had a predicted
10-year probability of 10-20 percent at high risk (II); whereas 71.8 percent of the patients
(16.4% men and 87.2% women; p < 0.001) had a predicted 10-year probability of less than
10 percent at moderate risk (III). The predicted 10-year probability of 10-20 percent and
over 20 percent of the diabetic men was significantly higher than that of diabetic women,
whereas the predicted 10-year probability of less than 10 percent of the diabetic women
was significantly higher than that of diabetic men. The prevalence of risk factors related
to high risk of CHD was different in diabetes patients. Thus, estimates of probability of
CHD are necessary for all persons with diabetes, indicating the risk factors to be corrected
in order to prevent mortality and morbidity. Despite differences in individual risk
factors and predicted probability between men and women, the estimated risk for CHD
should be calculated for all persons with diabetes mellitus.