Diabetes mellitus, coronary heart disease incidence, and death from all causes in African American and European American women - The NHANES I Epidemiologic Follow-up Study

are available on risk for coronary heart disease in African American women with diabetes mellitus, a well-established coronary risk factor in European American women. This study tests the hypothesis that medical history of di abetes predicts coronary heart disease incidence in African American women in a national cohort. Participants in the NHANES I Epidemiologic Follow-up Study in this analysis were 1035 African American and 5732 European America n women aged 25-74 years without a history of coronary heart disease. Avera ge follow-up for survivors was 19 years (maximum 22 years). Risk of inciden t coronary heart disease by baseline diabetes status was estimated. Proport ional hazards analyses for African American women aged 25-74 revealed signi ficant associations of coronary heart disease risk with diabetics after adj usting for age (RR = 2.40; 95% CI, 1.58-3.64, P < 0.01). After adjusting fo r age, smoking, and low education, there was an elevated risk in diabetics age 25-74 (RR = 2.34; 95% CI, 1.54-3.56, P < 0.01); this association did no t differ significantly from that for European American women. Excess corona ry incidence in African American compared to European American women aged 2 5-64 was statistically Explained by controlling for diabetes history, age, education, and smoking hut only partly explained by age and diabetes histor y. In African American women aged 25-74, diabetes was also associated with increased coronary heart disease, cardiovascular, and all-cause mortality. The population attributable risk of coronary heart disease incidence associ ated with a medical history of diabetes was 8.7% in African American women and 6.1% in European American women. Medical history of diabetes was a sign ificant predictor of coronary heart disease incidence and mortality in Afri can American women and explained some of the excess coronary incidence in y ounger African American compared to European American women. (C) 2000 Elsev ier Science Inc. All rights reserved.