Cardiovascular Risk Factors in Type 2 Diabetes

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Epidemiological studies have shown that Type 2 diabetes is a potent independent risk factor for cardiovascular disease. The risk of coronary heart disease in Type 2 diabetes is two- to threefold higher than in the general population.

Professor Carl Johan Östgren is the principal investigator in CARDIPP (Cardiovascular Risk Factors in Patients with Diabetes - a Prospective study in Primary Care).

Baseline investigation

The baseline investigation was launched in 2005 and completed in 2008 with the aim of identifying risk markers for cardiovascular disease to facilitate early and individually adjusted interventions in middle-aged men and women with Type 2 diabetes. The participants were recruited consecutively from 22 different primary health care centres in the counties of Östergötland and Jönköping, Sweden and included 761 patients with type 2 diabetes aged 55-65 years.

The CARDIPP baseline investigation comprised:

  • Patient questionnaire
  • Blood and urine samples stored at -70° C
  • Anthropometric data
  • Office and ambulatory blood pressure recordings
  • Echocardiography
  • Tonometri (SphygmoCor®) for pulse wave analyses and pulse wave velocity
  • Carotid ultrasonography
  • Digital blood pressure recordings


Four years after the completion of the baseline examination, a re-investigation of the cohort was performed; all participants from the baseline study were invited to the re-investigation. The same study protocol as that in the baseline investigation was used in the re-investigation to measure blood pressure, echocardiography, carotid ultrasonography and tonometry.

Cardiovascular morbidity and mortality

The status of the cohort in terms of cardiovascular morbidity and mortality is currently ascertained from the index date by linkage to the Swedish national cause-of-death and inpatient registries.

Selected CARDIPP publications

  • Wijkman M, Länne T, Jan Engvall J, Lindström T, Östgren CJ, Nyström FH. Masked nocturnal hypertension – a novel marker of risk in type 2 diabetes. Diabetologia 2009;52:1258-64
  • Fredriksson I, Larsson M, Nyström FH, Länne T, Östgren CJ, Strömberg T. Reduced arterio-venous shunting capacity after local heating and redistribution of baseline skin blood flow in type 2 diabetes assessed with velocity-resolved quantitative laser Doppler flowmetry. Diabetes 2010;59:1578-84
  • Blomstrand P, Engvall M, Festin K, Lindström T, Länne T, Maret E, Nyström FH, Maret-Ouda J, Östgren CJ, Engvall J. Left ventricular diastolic function, assessed by echocardiography and tissue Doppler imaging, is a strong predictor of cardiovascular events, superior to global left ventricular longitudinal strain, in patients with type 2 diabetes. Eur Heart J Cardiovasc Imaging. 2015 Mar 6. pii: jev027. [Epub ahead of print]
  • Vavruch C, Länne T, Fredrikson M, Lindström T, Östgren CJ, Nystrom FH. Serum leptin levels are independently related to the incidence of ischemic heart disease in a prospective study of patients with type 2 diabetes Cardiovasc Diabetol. 2015 May 22;14(1):62. [Epub ahead of print]
  • Jennersjö P, Ludvigsson J, Länne T, Nystrom FH, Östgren CJ. Pedometer-determined physical activity level and change in arterial stiffness in Type 2 diabetes over 4 years. Diabet Med. 2015 Jul 30. doi: 10.1111/dme.12873. [Epub ahead of print]

Research Group