Comparative mapping and validation of multiple disease resistance QTL for simultaneously controlling common and dwarf bunt in bread wheat.

KEY MESSAGE: Resistance QTL on chromosomes 1AL and 7AL are effective against common and dwarf bunt, QTL on 1BS affects common bunt and QTL on 7DS affects dwarf bunt in bread wheat. Common bunt, caused by Tilletia caries and T. laevis, and dwarf bunt, caused by T. controversa, negatively affect grain yield and quality of wheat and are particularly destructive in low-input and organic production systems. Two recombinant inbred line (RIL) populations derived by crossing the highly and durably resistant cultivars 'Blizzard' and 'Bonneville' to the susceptible cultivar 'Rainer' were evaluated for their resistance to common and dwarf bunt in artificially inoculated field and greenhouse trials over two growing seasons and genotyped with a 15 K SNP array. Bunt resistance QTL were mapped to chromosomes 1AL, 1BS, 7AL and 7DS. Common bunt resistance was regulated by the major QTL QBt.ifa-1BS and QBt.ifa-1AL together with the moderate effect QTL QBt.ifa-7AL. Dwarf bunt resistance was on the other hand regulated by the QTL QBt.ifa-1AL, QBt.ifa-7AL and QBt.ifa-7DS. Common bunt resistance QTL exhibited pronounced epistatic effects, while epistatic effects were of smaller magnitude for dwarf bunt QTL. Kompetitive Allele-Specific PCR (KASP) markers were developed from SNPs associated with bunt resistance QTL and successfully used for QTL validation in an independent set of RILs. These KASP markers have the potential to support targeted introgression of QTL into elite wheat germplasm and accelerate breeding for enhanced bunt resistance. Durable protection against both common and dwarf bunt can be achieved by combining multiple resistance genes in the same genetic background.

Genetic characterization and genome-wide association mapping for dwarf bunt resistance in bread wheat accessions from the USDA National Small Grains Collection.

KEY MESSAGE: Dwarf bunt-resistant bread wheat accessions and SNP markers associated with DB resistance identified in this study are valuable resources for characterization and deployment of DB resistance in bread wheat. Dwarf bunt (DB), caused by Tilletia controversa J.G. Kühn, can significantly reduce grain yield and quality on autumn-sown wheat in regions with prolonged snow cover. DB can be managed with the use of resistant cultivars. The objectives of the present study were to characterize DB resistance in a large set of bread wheat accessions from the National Small Grains Collection and use a genome-wide association study approach to identify genetic loci associated with DB resistance. A total of 292 accessions were selected using historical DB resistance data recorded across many trials and years in the Germplasm Resources Information Network (GRIN) and re-tested for DB resistance in replicated field nurseries in Logan, UT, in 2017, 2018, and 2019. Ninety-eight accessions were resistant with DB normalized incidence ≤ 10%, and twenty-eight of these were highly resistant with DB normalized incidence ≤ 1% in both GRIN and the field nurseries. Based on the presence of marker haplotypes of the four published dwarf bunt QTL on 6DS, 6DL, 7AL, and 7DS, highly resistant accessions identified in this study may provide novel resistance and should be further evaluated. This study validated one previously identified QTL on 6DS and identified an additional locus on 6DS. These loci explained 9-15% of the observed phenotypic variation. The resistant accessions and molecular markers identified in the present study may provide valuable resources for characterization and deployment of DB resistance in bread wheat.

Global reforestation and biodiversity conservation.

The loss of forest is a leading cause of species extinction, and reforestation is 1 of 2 established interventions for reversing this loss. However, the role of reforestation for biodiversity conservation remains debated, and lacking is an assessment of the potential contribution that reforestation could make to biodiversity conservation globally. We conducted a spatial analysis of overlap between 1,550 forest-obligate threatened species' ranges and land that could be reforested after accounting for socioeconomic and ecological constraints. Reforestation on at least 43% (∼369 million ha) of reforestable area was predicted to potentially benefit threatened vertebrates. This is approximately 15% of the total area where threatened vertebrates occur. The greatest opportunities for conserving threatened vertebrate species are in the tropics, particularly Brazil and Indonesia. Although reforestation is not a substitute for forest conservation, and most of the area containing threatened vertebrates remains forested, our results highlight the need for global conservation strategies to recognize the potentially significant contribution that reforestation could make to biodiversity conservation. If implemented, reforestation of ∼369 million ha would also contribute substantially to climate-change mitigation, offering a way to achieve multiple sustainability commitments at once. Countries must now work to overcome key barriers (e.g., unclear revenue streams, high transaction costs) to investment in reforestation.

Reforestación Mundial y Conservación de la Biodiversidad Resumen La pérdida de los bosques es una de las causas principales de la extinción de especies y la reforestación es una de las dos intervenciones establecidas para revertir esta pérdida. Sin embargo, el papel de la reforestación en la conservación de la biodiversidad todavía se debate, además de que hay una falta de evaluación de la contribución potencial que podría dar la reforestación a la conservación mundial de la biodiversidad. Realizamos un análisis espacial del traslape de la distribución de 1,550 especies obligadas de bosque que se encuentran amenazadas y el suelo que podría utilizarse para reforestar después de considerar las restricciones socioeconómicas y ecológicas. El análisis predijo que la reforestación en al menos el 43% (∼ 369 millones de ha) del área que se puede reforestar beneficiará potencialmente a los vertebrados amenazados. Esto es aproximadamente el 15% del área total en donde están presentes los vertebrados amenazados. Las oportunidades más grandes para conservar a las especies amenazadas de vertebrados se encuentran en los trópicos, particularmente en Brasil y en Indonesia. Aunque la reforestación no es un sustituto para la conservación de los bosques, y aunque la mayoría del área que contiene vertebrados amenazados todavía tiene flora original, nuestros resultados resaltan la necesidad de tener estrategias mundiales de conservación para reconocer la contribución potencialmente significativa que podría dar la reforestación a la conservación de la biodiversidad. Si se implementa, la reforestación de ∼369 millones de ha también contribuiría significativamente a la mitigación del cambio climático, ofreciendo así una manera de cumplir varios compromisos de sustentabilidad a la vez. Los países ahora deben trabajar para sobreponerse a las barreras importantes (p. ej.: flujos inciertos de ingresos, costos elevados de las transacciones) que enfrentan las inversiones para la reforestación.

Identification and assessment of two major QTLs for dwarf bunt resistance in winter wheat line 'IDO835'.

KEY MESSAGE: Two major dwarf bunt resistance QTLs were mapped to a known Bt9 locus and a novel locus. The associated KASP markers were developed and validated in other two populations. Dwarf bunt (DB), caused by Tilletia controversa J.G. Kühn, and common bunt (CB), caused by T. caries and T. foetida, are two destructive diseases that reduce grain yield and quality in wheat. Breeding for bunt-resistant cultivars is important in many wheat production areas, especially where organic wheat is grown. However, few molecular markers have been used in selection of bunt resistance. In the present study, a doubled haploid (DH) population derived from the bunt-resistant line 'IDO835' and the susceptible cultivar 'Moreland' was evaluated for DB resistance in a field nursery in Logan, Utah, for four growing seasons. The population was genotyped with the Illumina 90 K SNP iSelect marker platform. Two major QTLs were consistently identified on chromosomes 6DL (Q.DB.ui-6DL) and 7AL (Q.DB.ui-7AL), explaining up to 53% and 38% of the phenotypic variation, respectively. Comparative study suggested that Q.DB.ui-6DL was located in the same region as the CB resistance gene Bt9, and Q.DB.ui-7AL was located at a novel locus for bunt resistance. Based on Chinese Spring reference sequence and annotations (IWGSC RefSeq v1.1), both resistance QTLs were mapped to disease resistance gene-rich (NBS-LRR and kinase genes) regions. To validate the identified QTL and design user-friendly markers for MAS, five SNPs were converted to Kompetitive Allele-Specific PCR (KASP) markers and used to genotype two validation panels, including a DH population and a diverse winter wheat population from USDA-ARS National Small Grain Collection, as well as a Bt gene investigation panel, consisting of 15 bunt differential lines and 11 resistant lines.

A novel QTL associated with dwarf bunt resistance in Idaho 444 winter wheat.

KEY MESSAGE: A novel QTL, Q.DB.ui-7DS, and the PCR-based markers identified in the current study will accelerate variety development for resistance to dwarf and common bunt of wheat. Dwarf bunt [Tilletia controversa J.G. Kühn [as 'contraversa'], in Rabenhorst, Hedwigia 13: 188 (1874)] is a destructive disease of wheat (Triticum aestivum L.) that reduces grain yield and quality. A number of distinct genes conferring resistance to dwarf bunt have been used by breeding programs for nearly 100 years. However, few markers were identified that can be used in selection of dwarf bunt resistance. A recombinant inbred line (RIL) population derived from the bunt-resistant germplasm, Idaho 444 (IDO444), and the susceptible cultivar, Rio Blanco, was evaluated for phenotypic reaction to dwarf bunt inoculation in four trials in two locations (USU and USDA) over 3 years. The population was genotyped with the Diversity Arrays Technology (DArT) and the Illumina Infinium 9K iSelect marker platforms. A total of three QTL were detected, and resistant alleles were from IDO444. QTL Q.DB.ui-7DS on 7DS was determined based on the location of a DArT marker wPt-2565 (X116197), which was consistently detected and explained 32 to 56 % of phenotypic variation among the four trials. QTL Q.DB.ui-1A on 1A was detected in three Utah State University (USU) trials and explained 11-15 % of phenotypic variation. QTL Q.DB.ui-2B on 2B was detected in two USU and one United States Department of Agriculture (USDA) trials and explained up to 6 % of phenotypic variation. Two PCR-based markers were developed based on the sequence of wPt-2565 and validated in the RIL population and used in genotyping of dwarf bunt differential lines, known resistance sources, and resistant cultivars.

Using changes in agricultural utility to quantify future climate-induced risk to conservation.

Much of the biodiversity-related climate change impacts research has focused on the direct effects to species and ecosystems. Far less attention has been paid to the potential ecological consequences of human efforts to address the effects of climate change, which may equal or exceed the direct effects of climate change on biodiversity. One of the most significant human responses is likely to be mediated through changes in the agricultural utility of land. As farmers adapt their practices to changing climates, they may increase pressure on some areas that are important to conserve (conservation lands) whereas lessening it on others. We quantified how the agricultural utility of South African conservation lands may be altered by climate change. We assumed that the probability of an area being farmed is linked to the economic benefits of doing so, using land productivity values to represent production benefit and topographic ruggedness as a proxy for costs associated with mechanical workability. We computed current and future values of maize and wheat production in key conservation lands using the DSSAT4.5 model and 36 crop-climate response scenarios. Most conservation lands had, and were predicted to continue to have, low agricultural utility because of their location in rugged terrain. However, several areas were predicted to maintain or gain high agricultural utility and may therefore be at risk of near-term or future conversion to cropland. Conversely, some areas were predicted to decrease in agricultural utility and may therefore prove easier to protect from conversion. Our study provides an approximate but readily transferable method for incorporating potential human responses to climate change into conservation planning.

Mapping the planet's critical areas for biodiversity and nature's contributions to people.

Meeting global commitments to conservation, climate, and sustainable development requires consideration of synergies and tradeoffs among targets. We evaluate the spatial congruence of ecosystems providing globally high levels of nature's contributions to people, biodiversity, and areas with high development potential across several sectors. We find that conserving approximately half of global land area through protection or sustainable management could provide 90% of the current levels of ten of nature's contributions to people and meet minimum representation targets for 26,709 terrestrial vertebrate species. This finding supports recent commitments by national governments under the Global Biodiversity Framework to conserve at least 30% of global lands and waters, and proposals to conserve half of the Earth. More than one-third of areas required for conserving nature's contributions to people and species are also highly suitable for agriculture, renewable energy, oil and gas, mining, or urban expansion. This indicates potential conflicts among conservation, climate and development goals.

Mapping the planet's critical natural assets.

Sustaining the organisms, ecosystems and processes that underpin human wellbeing is necessary to achieve sustainable development. Here we define critical natural assets as the natural and semi-natural ecosystems that provide 90% of the total current magnitude of 14 types of nature's contributions to people (NCP), and we map the global locations of these critical natural assets at 2 km resolution. Critical natural assets for maintaining local-scale NCP (12 of the 14 NCP) account for 30% of total global land area and 24% of national territorial waters, while 44% of land area is required to also maintain two global-scale NCP (carbon storage and moisture recycling). These areas overlap substantially with cultural diversity (areas containing 96% of global languages) and biodiversity (covering area requirements for 73% of birds and 66% of mammals). At least 87% of the world's population live in the areas benefitting from critical natural assets for local-scale NCP, while only 16% live on the lands containing these assets. Many of the NCP mapped here are left out of international agreements focused on conserving species or mitigating climate change, yet this analysis shows that explicitly prioritizing critical natural assets and the NCP they provide could simultaneously advance development, climate and conservation goals.

Expression and functional analysis of NUCLEAR FACTOR-Y, subunit B genes in barley.

NUCLEAR FACTOR-Y, subunit B (NF-YB) comprises a multigene family in plants and has been shown to play important roles in growth, development, and response to environmental stress. In this study, five NF-YBs containing the full-length coding region were obtained from barley (Hordeum vulgare) through database sequence analysis, cloning, and sequencing. Sequence alignment and phylogenetic analysis showed that HvNF-YB3 and HvNF-YB1 were clustered with NF-YB2 and NF-YB3 in Arabidopsis, suggesting these NF-YBs are evolutionary and functionally related. To test this hypothesis, HvNF-YB3 and HvNF-YB1 were overexpressed in Arabidopsis. Overexpression of HvNF-YB1 greatly promoted early flowering in Arabidopsis, supporting that HvNF-YB1may have conserved gene function in flowering time control as NF-YB2 and NF-YB3 in Arabidopsis. Overexpression of HvNF-YB3 in Arabidopsis had no effect on flowering time. An analysis of barley single-nucleotide polymorphism (SNP) data, however, revealed a significant association between an HvNF-YB3 SNP and heading date. While it is unknown whether HvNF-YB3 directly contributes to heading date regulation, the results implied that HvNF-YB3 may also have conserved function in flowering time (heading date in barley) control. Further studies are needed to directly verify these gene functions in barley. Barley NF-YBs showed different expression patterns associated with tissue types, developmental stages, and response to different stress treatments, suggesting that barley NF-YBs may be involved in other physiological processes.

Toward a management framework for networks of protected areas in the face of climate change.

Networks of sites of high importance for conservation of biological diversity are a cornerstone of current conservation strategies but are fixed in space and time. As climate change progresses, substantial shifts in species' ranges may transform the ecological community that can be supported at a given site. Thus, some species in an existing network may not be protected in the future or may be protected only if they can move to sites that in future provide suitable conditions. We developed an approach to determine appropriate climate-change adaptation strategies for individual sites within a network that was based on projections of future changes in the relative proportions of emigrants (species for which a site becomes climatically unsuitable), colonists (species for which a site becomes climatically suitable), and persistent species (species able to remain within a site despite the climatic change). Our approach also identifies key regions where additions to a network could enhance its future effectiveness. Using the sub-Saharan African Important Bird Area (IBA) network as a case study, we found that appropriate conservation strategies for individual sites varied widely across sub-Saharan Africa, and key regions where new sites could help increase network robustness varied in space and time. Although these results highlight the potential difficulties within any planning framework that seeks to address climate-change adaptation needs, they demonstrate that such planning frameworks are necessary, if current conservation strategies are to be adapted effectively, and feasible, if applied judiciously.

A metric for spatially explicit contributions to science-based species targets.

The Convention on Biological Diversity's post-2020 Global Biodiversity Framework will probably include a goal to stabilize and restore the status of species. Its delivery would be facilitated by making the actions required to halt and reverse species loss spatially explicit. Here, we develop a species threat abatement and restoration (STAR) metric that is scalable across species, threats and geographies. STAR quantifies the contributions that abating threats and restoring habitats in specific places offer towards reducing extinction risk. While every nation can contribute towards halting biodiversity loss, Indonesia, Colombia, Mexico, Madagascar and Brazil combined have stewardship over 31% of total STAR values for terrestrial amphibians, birds and mammals. Among actions, sustainable crop production and forestry dominate, contributing 41% of total STAR values for these taxonomic groups. Key Biodiversity Areas cover 9% of the terrestrial surface but capture 47% of STAR values. STAR could support governmental and non-state actors in quantifying their contributions to meeting science-based species targets within the framework.

Assessing the future threat from vivax malaria in the United Kingdom using two markedly different modelling approaches.

BACKGROUND: The world is facing an increased threat from new and emerging diseases, and there is concern that climate change will expand areas suitable for transmission of vector borne diseases. The likelihood of vivax malaria returning to the UK was explored using two markedly different modelling approaches. First, a simple temperature-dependent, process-based model of malaria growth transmitted by Anopheles atroparvus, the historical vector of malaria in the UK. Second, a statistical model using logistic-regression was used to predict historical malaria incidence between 1917 and 1918 in the UK, based on environmental and demographic data. Using findings from these models and saltmarsh distributions, future risk maps for malaria in the UK were produced based on UKCIP02 climate change scenarios. RESULTS: The process-based model of climate suitability showed good correspondence with historical records of malaria cases. An analysis of the statistical models showed that mean temperature of the warmest month of the year was the major factor explaining the distribution of malaria, further supporting the use of the temperature-driven processed-based model. The risk maps indicate that large areas of central and southern England could support malaria transmission today and could increase in extent in the future. Confidence in these predictions is increased by the concordance between the processed-based and statistical models. CONCLUSION: Although the future climate in the UK is favourable for the transmission of vivax malaria, the future risk of locally transmitted malaria is considered low because of low vector biting rates and the low probability of vectors feeding on a malaria-infected person.

Global hotspots for coastal ecosystem-based adaptation.

Helping the world's coastal communities adapt to climate change impacts requires evaluating the vulnerability of coastal communities and assessing adaptation options. This includes understanding the potential for 'natural' infrastructure (ecosystems and the biodiversity that underpins them) to reduce communities' vulnerability, alongside more traditional 'hard' infrastructure approaches. Here we present a spatially explicit global evaluation of the vulnerability of coastal-dwelling human populations to key climate change exposures and explore the potential for coastal ecosystems to help people adapt to climate change (ecosystem-based adaptation (EbA)). We find that mangroves and coral reefs are particularly well situated to help people cope with current weather extremes, a function that will only increase in importance as people adapt to climate change now and in coming decades. We find that around 30.9 million people living within 2km of the coast are highly vulnerable to tropical storms and sea-level rise (SLR). Mangroves and coral reefs overlap these threats to at least 5.3 and 3.4 million people, respectively, with substantial potential to dissipate storm surges and improve resilience against SLR effects. Significant co-benefits from mangroves also accrue, with 896 million metric tons of carbon stored in their soils and above- and below-ground biomass. Our framework offers a tool for prioritizing 'hotspots' of coastal EbA potential for further, national and local analyses to quantify risk reduction and, thereby, guide investment in coastal ecosystems to help people adapt to climate change. In doing so, it underscores the global role that conserving and restoring ecosystems can play in protecting human lives and livelihoods, as well as biodiversity, in the face of climate change.

Projected impacts of climate change on a continent-wide protected area network.

Despite widespread concern, the continuing effectiveness of networks of protected areas under projected 21st century climate change is uncertain. Shifts in species' distributions could mean these resources will cease to afford protection to those species for which they were originally established. Using modelled projected shifts in the distributions of sub-Saharan Africa's entire breeding avifauna, we show that species turnover across the continent's Important Bird Area (IBA) network is likely to vary regionally and will be substantial at many sites (> 50% at 42% of IBAs by 2085 for priority species). Persistence of suitable climate space across the network as a whole, however, is notably high, with 88-92% of priority species retaining suitable climate space in >or= 1 IBA(s) in which they are currently found. Only 7-8 priority species lose climatic representation from the network. Hence, despite the likelihood of significant community disruption, we demonstrate that rigorously defined networks of protected areas can play a key role in mitigating the worst impacts of climate change on biodiversity.

Evaluating natural infrastructure for flood management within the watersheds of selected global cities.

Cities are dependent on their upstream watersheds for storage and gradual release of water into river systems. These watersheds act as important flood mitigation infrastructure, providing an essential ecosystem service. In this paper we use metrics from the WaterWorld model to examine the flood management-relevant natural infrastructure of the upstream watersheds of selected global cities. These metrics enable the characterisation of different types, magnitudes and geographical distributions of potential natural flood storage. The storages are categorised as either green (forest canopy, wetland and soil) or blue (water body and floodplain) storages and the proportion of green to blue indicates how different city upstream basin contexts provide different types and levels of storage which may buffer flood risk. We apply the WaterWorld method for examining flood risk as the ratio of accumulated modelled annual runoff volume to accumulated available green and blue water storage capacity. The aim of these metrics is to highlight areas where there is more runoff than storage capacity and thus where the maintenance or restoration of further natural infrastructure (such as canopy cover, wetlands and soil) could aid in storing more water and thus better alleviate flood risks. Such information is needed by urban planners, city authorities and governments to help prepare cities for climate change impacts.

Modeling of crop wild relative species identifies areas globally for in situ conservation.

The impact of climate change is causing challenges for the agricultural production and food systems. More nutritious and climate resilient crop varieties are required, but lack of available and accessible trait diversity is limiting crop improvement. Crop wild relatives (CWR) are the wild cousins of cultivated crops and a vast resource of genetic diversity for breeding new, higher yielding, climate change tolerant crop varieties, but they are under-conserved (particularly in situ), largely unavailable and therefore underutilized. Here we apply species distribution modelling, climate change projections and geographic analyses to 1261 CWR species from 167 major crop genepools to explore key geographical areas for CWR in situ conservation worldwide. We identify 150 sites where 65.7% of the CWR species identified can be conserved for future use.

Engaging patients, clinicians and health funders in weight management: the Counterweight Programme.

BACKGROUND: The Counterweight Programme provides an evidence based and effective approach for weight management in routine primary care. Uptake of the programme has been variable for practices and patients. Aim. To explore key barriers and facilitators of practice and patient engagement in the Counterweight Programme and to describe key strategies used to address barriers in the wider implementation of this weight management programme in UK primary care. METHODS: All seven weight management advisers participated in a focus group. In-depth interviews were conducted with purposeful samples of GPs (n = 7) and practice nurses (n = 15) from 11 practices out of the 65 participating in the programme. A total of 37 patients participated through a mixture of in-depth interviews (n = 18) and three focus groups. Interviews and focus groups were analysed for key themes that emerged. RESULTS: Engagement of practice staff was influenced by clinicians' beliefs and attitudes, factors relating to the way the programme was initiated and implemented, the programme content and organizational/contextual factors. Patient engagement was influenced by practice endorsement of the programme, clear understanding of programme goals, structured proactive follow-up and perception of positive outcomes. CONCLUSIONS: Having a clear understanding of programme goals and expectations, enhancing self-efficacy in weight management and providing proactive follow-up is important for engaging both practices and patients. The widespread integration of weight management programmes into routine primary care is likely to require supportive public policy.

Effect of conjugal bereavement on mortality of the bereaved spouse in participants of the Renfrew/Paisley Study.

OBJECTIVES: To investigate how loss of a spouse affects mortality risk in the bereaved partner. DESIGN AND SETTING: Prospective cohort study in Renfrew and Paisley in Scotland. PARTICIPANTS: 4395 married couples aged 45-64 years when the study was carried out between 1972 and 1976. METHODS: The date of bereavement for the bereaved spouse was the date of death of his or her spouse. Bereavement could occur at any time during the follow-up period, so it was considered as a time-dependent exposure variable and the Cox proportional hazards model for time-dependent variables was used. The relative rate (RR) of mortality was calculated for bereaved versus non-bereaved spouses and adjusted for confounding variables. MAIN OUTCOME MEASURES: Causes of death to 31 March 2004. RESULTS: Bereaved participants were at higher risk than non-bereaved participants of dying from any cause (RR 1.27; 95% CI 1.2 to 1.35). These risks remained but were attenuated after adjustment for confounding variables. There were raised RRs for bereaved participants dying of cardiovascular disease, coronary heart disease, stroke, all cancer, lung cancer, smoking-related cancer, and accidents or violence. After adjustment for confounding variables, RRs remained higher for bereaved participants for all these causes except for mortality from lung cancer. There was no strong statistical evidence that the increased risks of death associated with bereavement changed with time after bereavement. CONCLUSIONS: Conjugal bereavement, in addition to existing risk factors, is related to mortality risk for major causes of death.

Should diabetes be considered a coronary heart disease risk equivalent?: results from 25 years of follow-up in the Renfrew and Paisley survey.

OBJECTIVE: The purpose of our study was to confirm or refute the view that diabetes be regarded as a coronary heart disease (CHD) risk equivalent and to test for sex differences in mortality. RESEARCH DESIGN AND METHODS: This was a prospective cohort study of 7,052 men and 8,354 women aged 45-64 years from Renfrew and Paisley, Scotland, who were first screened in 1972-1976 and followed for 25 years. All-cause mortality was calculated as death per 1,000 person-years. A Cox proportional hazards model was used to adjust survival for age, smoking habit, blood pressure, serum cholesterol, BMI, and social class. RESULTS: There were 192 deaths in 228 subjects with diabetes and 2,016 deaths in 3,076 subjects with CHD. The highest mortality was in the group with both diabetes and CHD (100.2 deaths/1,000 person-years in men, 93.6 in women) and the lowest in the group with neither (29.2 deaths/1,000 person-years in men, 19.4 in women). Men and women with diabetes only and CHD only formed an intermediate risk group. The adjusted hazard ratio (HR) for CHD mortality in men with diabetes only compared with men with CHD only was 1.17 (95% CI 0.78-1.74; P = 0.56). Corresponding HR for women was 1.97 (1.27-3.08; P = 0.003). CONCLUSIONS: Diabetes without previous CHD carries a lifetime risk of vascular death as high as that for CHD alone. Women may be at particular risk. Our data support the view that cardiovascular risk factors in diabetes should be treated as aggressively as in people with CHD.