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Objectives:  To assess sex and racial/ethnic differences in the relationship between multiple cardiovascular disease (CVD) risk factors and mortality among a nationally representative sample of adults with diabetes.   Methods:  Data were analyzed from 3,503 adults with diabetes from the National Health and Nutrition Examination Survey 2001–2010 and its linked mortality data through 31 December 2011. The outcome was mortality; the independent variables were sex and race/ethnicity. Covariates included demographics, comorbidity, and lifestyle variables. Cox proportional hazards regression was used to test associations between mortality and CVD risk factors.   Results:  In adjusted analyses, the association between diastolic blood pressure and mortality was significantly different by sex and race/ethnicity (unadjusted  p  = 0.009; adjusted  p  = 0.042). Kaplan-Meier survival curves showed Hispanic women had the highest survival compared to Hispanic men and Non-Hispanic Black (NHB) and Non-Hispanic White (NHW) men and women; NHW men had the lowest survival probability.   Conclusion:  In this nationally representative sample, stratified analyses showed women had higher survival rates compared to men within each race/ethnicity group, and Hispanic women had the highest survival compared to all other groups.

Association Between Cardiovascular Disease Risk Factors and Mortality in Adults With Diabetes: A Stratified Analysis by Sex, Race, and Ethnicity