Hormonal
The duration of clinical diabetes is monotonically associated with increased risk of fatal CHD, with risk exceeding that of prior CHD alone after 15 years of diabetes duration.
If you have had diabetes for more than 15 years, your risk of fatal heart disease is extremely high, potentially triple that of someone with a prior heart attack if you also have prior CHD. You need aggressive cardiovascular risk management (lipids, BP, lifestyle) regardless of how well you feel. Do not let the passage of time normalize your risk.
The risk of CHD mortality increased monotonically with increased duration of clinical diabetes... The combination of CHD and a long duration of diabetes (ie, >15 years) identifies a particularly high-risk group for fatal CHD (RR, 30.0; 95% CI, 20.7-43.5).
Why this rating
Large cohort, long follow-up, clear trend analysis (P<.001).
Source
The Impact of Diabetes Mellitus on Mortality From All Causes and Coronary Heart Disease in Women
Frank B. Hu et al. · Archives of Internal Medicine · 2001
DOI 10.1001/archinte.161.14.1717
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