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 Among people with diabetes but not heart disease, researchers linked
more than a third of cardiovascular “events” - such as heart attack
and stroke – and 7 percent of deaths to inadequate control of heart
risk factors.
That means those cardiac events and deaths might have been avoided
with better control of the known risk factors, the study team writes
in Diabetes Care.
“The take home message from this study is that adults with diabetes
can reduce their risk of cardiovascular events, and patients should
work together with their provider to set a care plan including goals
and strategies to reduce modifiable risk factors,” said lead author
Gabriela Vazquez-Benitez, a research investigator at HealthPartners
Institute for Education and Research in Minneapolis, Minnesota.
“This can include regular care visits, screening, laboratory,
weight, and blood pressure,” she told Reuter’s Health in an email.
The risk factors for cardiovascular problems in diabetes are well
known and include high blood pressure, smoking and poor control of
blood sugar. If more attention were paid to these risk factors, the
rate of cardiovascular problems and death could be substantially
reduced, the study team argues.
There are nearly 25 million Americans with diabetes and if current
trends continue, more than one in three adults are projected to
develop the disease.
Stroke and coronary heart disease are the major causes of
complications, deaths and healthcare costs in adults with diabetes,
they write.
The authors point out that medical advances have improved the health
of people with diabetes, especially when it comes to cardiovascular
problems. But for people with diabetes as a group, the burden of
cardiovascular problems remains very high.
In their study, Vaquez-Benitez and her team analyzed data on nearly
860,000 adults with diabetes.
They looked at rates of major cardiovascular complications such as
heart attacks and heart failure, as well as deaths from all causes,
plus four risk factors: blood pressure, levels of LDL cholesterol,
smoking and blood sugar levels over the months.
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The authors emphasize that overall rates of major cardiovascular
complications and deaths were “substantially higher” in people with
diabetes who already had heart disease, compared to those without
it.
But delaying diabetes complications is possible, Vazquez-Benitez
said, not only for cardiovascular events but for problems like nerve
damage and kidney disease.
“Although there is a genetic component of diabetes, there are
modifiable risk factors that can reduce risk of heart attack, stroke
and death,” said Deborah Greenwood, a registered nurse and president
of the American Association of Diabetes Educators. Lowering blood
sugar, LDL cholesterol and blood pressure, as well as quitting
smoking can greatly reduce risk, she said.
All adults over 45 should be screened for diabetes so it can be
diagnosed and treated early, said Greenwood, who was not involved in
the study. For most people with so-called pre-diabetes, she pointed
out, losing 5 to 7 percent of body weight and doing 150 minutes of
physical activity per week could avert progression to full-blown
diabetes.
She also emphasized the importance of participating in diabetes
self-management education and partnering with a credentialed
diabetes educator to change behaviors and improve modifiable risk
factors. “A diabetes educator will work with you to develop a plan
specifically tailored to your individual needs, preferences and
lifestyle to ensure success,” Greenwood said.
SOURCE: http://bit.ly/1zYWcys Diabetes Care, online February 20,
2015.
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