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Diabetes Increases Heart Attack Risk
March 31, 2008 -- Adults being treated for diabetes are just as likely to have a heart attack or stroke or die from cardiovascular causes as people who have had a prior heart attack, new research shows.
They are also twice as likely as non-diabetics to die following a heart attack, the study revealed.
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Researchers say the population study confirms the importance of treating cardiovascular risk factors as aggressively as diabetes in adults with type 1 or type 2 disease.
"Adults who need glucose-lowering drugs are at very high risk for heart attacks and strokes, and they need to be monitored closely for this and treated with appropriate medications," study researcher Tina Ken Schramm, MD, tells WebMD.
Diabetes and Heart Risk
By examining Danish population registries, Schramm and colleagues from Denmark's Gentofte University Hospital followed 3.3 million adults over the age of 30 for five years between 1997 and 2002, including 71,801 people with diabetes and 79,575 who had had a previous heart attack.
Because of the comprehensive nature of the Danish registries, the researchers were able to identify and include all patients in the country with diabetes who were being treated with blood sugar-lowering drugs.
Patients being treated for diabetes had a cardiovascular risk comparable to patients without diabetes who had experienced a previous heart attack.
And compared with people without diabetes or a previous heart attack, the risk of having a heart attack was 11 times greater for women and seven times greater for men with both diabetes and a prior heart attack, Schramm tells WebMD.
"The increased risk was observed at all ages with either type 1 or type 2 diabetes who were receiving insulin or other drugs to reduce levels of sugar in the blood," Schramm notes. "When people with diabetes do have heart attacks, they are twice as likely to die as nondiabetics."
Drugs and Lifestyle Changes
Schramm says patients on insulin or those taking drugs to control their blood sugar should talk to their doctor about also taking low-dose aspirin for their heart, and their blood pressure and cholesterol should be monitored closely and treated aggressively.
In a joint statement issued last week by the American Diabetes Association and the American College of Cardiology, experts concluded that persons with diabetes might need even more aggressive cholesterol lowering than current guidelines suggest.
But many diabetic people remain unaware of their risk, and most are not being treated as aggressively as they should be, Northwestern University professor of preventive medicine Martha L. Daviglus, MD, PhD, tells WebMD.
"Little by little I think people are beginning to understand the dreadful consequences of diabetes, but we have to do more to make patients aware," she says. "It has been considered just another risk factor for heart attack and stroke. We now know that it is much more than this."
Daviglus, who is also a spokeswoman for the American Heart Association, says in addition to aggressive drug treatment, patients need to understand the importance of making lifestyle changes that can lower their cardiovascular risks.
Those lifestyle changes include losing weight, stopping smoking, and exercising regularly.
"We now know that diabetes is a totally reversible risk factor for cardiovascular disease," she says. "That is very important for patients to remember."
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