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Member Research & Reports

Member Research & Reports

East Tennessee Publishes on Cardiovascular Disease Risk in Central Appalachia

Dr. Hadii Mamudu, associate professor in the department of health services management and policy in the East Tennessee State University College of Public Health, has published in the Journal of Diabetes and its Complications.  The article is titled, “The associated risk factors for coronary artery calcium in asymptomatic subjects with and without diabetes in rural Central Appalachia.”

Co-authors are from East Tennessee State University and additional co-authors include individuals from George Washington University, Ballad Health, and the Los Angeles Biomedical Research Institute.

In 2015, 30.3 million (9.4 percent) and 84.1 million individuals in the United States had diagnosed diabetes or pre-diabetes, respectively. It has been projected that the prevalence of diabetes in the U.S. will increase by 64 percent from 2010 to 2025.  Subjects with diabetes have increased risk of clinical and subclinical atherosclerosis, a marker of coronary artery disease that can be detected by coronary artery calcium scoring.

The goal of this study was to address this health disparity by examining the association between modifiable and non-modifiable risk factors of cardiovascular disease and coronary artery calcium in asymptomatic individuals with diabetes and those without diabetes in Central Appalachia. The results of this analysis should inform clinicians and public health practitioners in high-risk rural environments in the use of coronary artery calcium screening for the early detection of coronary artery disease in asymptomatic patients with diabetes as recommended by clinical guidelines with an ultimate goal to improve primary prevention interventions to reduce cardiovascular events.

The study population included 2479 asymptomatic participants from Central Appalachia who underwent coronary artery calcium screening between August 2012 and November 2016. Participants with diabetes were evaluated against two groups: age and gender matched individuals and randomly selected individuals without diabetes.  Participants with diabetes had a higher prevalence of all cardiovascular disease risk factors than controls.  Half of study participants had subclinical atherosclerosis, and diabetes was associated with increased coronary artery calcium score.

This study suggests that individuals with diabetes in Central Appalachia might benefit from screening for coronary artery calcium. Thus, as recommended, individuals with diabetes aged 40 years and above should consider coronary artery calcium screening for cardiovascular disease risk.