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January 21, 2004

Novel Risk Factors for Atherosclerosis

JAMA. 2004;291(3):301. doi:10.1001/jama.291.3.301-b

To The Editor: I disagree with Drs Hackam and Anand1 that diabetes mellitus is a modifiable risk factor for atherosclerotic vascular disease. None of the 5 prospective studies that have evaluated the effect of lowering glycemia on cardiovascular disease, analyzed either singly2 or in a meta-analysis,3 have demonstrated a significant effect. This is probably not surprising, as the association between glycemia and increased cardiovascular disease extends into the mid normal range of glucose values.4,5

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