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Diabetics Face Doubled Risk of Heart Attack

MONDAY March 31, 2008 -- Diabetics are more than twice as likely to suffer a heart attack, stroke and death from cardiovascular disease, putting them at the same risk level as non-diabetics who had previously suffered a heart attack, Danish researchers report.

The findings, appearing in April 1 issue of Circulation, led one study author to suggest all diabetics talk to their doctors about possibly starting treatments to control cholesterol levels and blood-pressure levels.

"We've talked about 'the lower, the better' for cholesterol and blood pressure to reduce the risk of heart attack," lead author Dr. Tina Ken Schramm, a research fellow at the Gentofte Hospital in Hellerup, Denmark, said in a prepared statement. "Now I think we should be saying the sooner, the better for primary prevention of cardiovascular diseases in diabetics."

The study analyzes patient and national registries for people aged 30 and older living in Denmark in 1997. Researchers found 71,801 people with diabetes and 79,575 who had a previous heart attack, then identified deaths and causes of death over five years.

"The increased risk was observed in people 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 said. "When people with diabetes do have heart attacks, they are twice as likely to die as non-diabetics."

The relative risk, or hazard ratio, of dying from cardiovascular disease was found to be 2.45 times greater for female diabetics compared with 2.62 times greater for women with a prior heart attack. The relative risk of dying from cardiovascular causes was 2.42 times higher in male diabetics; for men who had a prior heart attack the hazard ratio was 2.44.

When looking at heart attack, stroke or death from cardiovascular disease combined, men with diabetes faced a 2.32 higher risk while the risk rate was 2.48 for men who had at least one heart attack. For female diabetics, the combined relative risk was 2.48 while those with a history of myocardial infarction had a hazard ratio of 2.71.

The study did not look at patients on diet-only treatment for diabetes. The researchers also couldn't differentiate between type 1 and type 2 diabetes patients or adjust for common risk factors, including high blood pressure, high cholesterol, obesity, smoking, physical activity and blood glucose levels.

Type 2 diabetes, the most common form of diabetes, develops when the body doesn't make enough insulin and fails to efficiently use what insulin it does produce. In type 1 diabetes, the pancreas makes little or no insulin, requiring the patient to need daily doses of insulin.

More information

The American Diabetes Association has more about diabetes prevention.

Posted: March 2008


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