{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T15:28:15Z","timestamp":1783697295035,"version":"3.55.0"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"\n Background<\/jats:title>\n \n The relative effect of hemoglobin A1c, blood pressure, and low\u2010density lipoprotein\u2010cholesterol (\n LDL<\/jats:styled-content>\n \u2010C) (\u201c\n ABC<\/jats:styled-content>\n \u201d factors) on the prevention of cardiovascular diseases (\n CVD<\/jats:styled-content>\n ) among patients with type 2 diabetes mellitus is poorly understood. This study aimed to evaluate the association of key clinical parameters on\n CVD<\/jats:styled-content>\n risk using a multifactorial optimal control approach in Chinese primary care patients with type 2 diabetes mellitus.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n A population\u2010based retrospective cohort study was conducted on 144\u00a0271 Chinese type 2 diabetes mellitus primary care patients, aged 18 to 79 and without prior clinical diagnosis of\n CVD<\/jats:styled-content>\n in 2008\u20132011. Cox regressions were conducted to examine the association between the combinations of\n ABC<\/jats:styled-content>\n targets (hemoglobin A1c <7%, blood pressure <130\/90\u00a0mm\u00a0Hg, and\n LDL<\/jats:styled-content>\n \u2010C <2.6\u00a0mmol\/L) and risks of\n CVD<\/jats:styled-content>\n (overall), coronary heart disease, stroke, and heart failure. Achieving more\n ABC<\/jats:styled-content>\n targets incrementally reduced the incidence of total\n CVD<\/jats:styled-content>\n and individual disease including coronary heart disease, stroke, and heart failure, irrespective of other patient characteristics. Compared with suboptimal control in all\n ABC<\/jats:styled-content>\n levels, achieving any 1, 2, and all 3\n ABC<\/jats:styled-content>\n targets reduced the relative risk of\n CVD<\/jats:styled-content>\n by 13% to 42%, 31% to 52%, and 55%, respectively. Among those achieving only 1\n ABC<\/jats:styled-content>\n target,\n LDL<\/jats:styled-content>\n \u2010C reduction was associated with the greatest\n CVD<\/jats:styled-content>\n risk reduction (42%), followed by blood pressure reduction (18%), and hemoglobin A1c reduction (13%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n To achieve the greatest risk reduction for the incidence of\n CVD<\/jats:styled-content>\n , the ultimate goal of treatment should be to achieve target control of hemoglobin A1c, blood pressure, and\n LDL<\/jats:styled-content>\n \u2010C. If it is not possible to achieve all 3 targets, efforts should be prioritized on treating the\n LDL<\/jats:styled-content>\n \u2010C to minimize\n CVD<\/jats:styled-content>\n risk.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006400","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":45,"title":["Effect of Multifactorial Treatment Targets and Relative Importance of Hemoglobin A1c, Blood Pressure, and Low\u2010Density Lipoprotein\u2010Cholesterol on Cardiovascular Diseases in Chinese Primary Care Patients With Type 2 Diabetes Mellitus: A Population\u2010Based Retrospective Cohort Study"],"prefix":"10.1161","volume":"6","author":[{"given":"Eric Yuk Fai","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colman Siu Cheung","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther Yee Tak","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weng Yee","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Yee Tak","family":"Fong","sequence":"additional","affiliation":[{"name":"School of Nursing, The University of Hong Kong, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca Ka Chun","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy Lo Kuen","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Ap Lei Chau, Hong Kong"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2015","unstructured":"International Diabetes Federation . 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Hospital authority clinical vocabulary table\u2013the past the present and the future. 2004 International Federation of Health Records Organization Congress Proceedings. 2004."}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.006400","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:52:06Z","timestamp":1715597526000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.006400"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,2]]},"references-count":39,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8,2]]}},"alternative-id":["10.1161\/JAHA.117.006400"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.006400","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,2]]},"assertion":[{"value":"2017-04-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-12","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006400"}}