Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
In Reply: Undoubtedly, many factors influenced
the lower decline in mortality from ischemic heart disease among patients
with diabetes compared with nondiabetic patients during 1971 to 1993. The
well-known mortality decline in the general population has been attributed
to reduction in cardiovascular risk factors and better treatment of patients
with heart disease.1 Given the lower declines
in heart disease mortality for diabetic patients in our study, these changes
appear to have been less favorable or less effective for people with diabetes.
Obesity became much more prevalent during the period of our study and affected
both diabetic and nondiabetic adults.
Harris MI. Diabetes and Decline in Heart Disease Mortality—Reply. JAMA. 1999;282(12):1132. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-12-jbk0922