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Diabetics' heart attack risk can be reduced, research finds
May 22, 2009People with diabetes who maintain intensive, low blood sugar levels are significantly less likely to suffer heart attacks and coronary heart disease, new research published today in The Lancet has shown.
By undertaking a meta-analysis which pooled information from five large trials, researchers at the University of Cambridge were for the first time able to provide reliable evidence linking intensive blood sugar level (or glucose) control with fewer heart attacks.
The research, funded by the British Heart Foundation, pointed to a 17 % reduction in heart attacks and a 15 % reduction in coronary heart disease. However, the study found a more modest trend towards reduction in strokes with intensive control of glucose levels compared to standard care. Importantly, in contrast to smaller studies which had suggested possible harm from better blood sugar control, there were no adverse effects on deaths from any cause.
It is well documented that diabetics are at increased risk of heart disease. Even though patients can reduce their risk by maintaining healthy blood pressure levels and cholesterol reduction, the risk remains high.
Dr Kausik Ray of the University of Cambridge, lead author of the study, said: "Previous studies have been inconclusive, leaving diabetics and their doctors unsure as to whether maintaining lower blood sugar levels actually benefitted the patients. Although additional research needs to be conducted, our findings provide insight into the importance of improving glucose levels which should include lifestyle changes as well as medication."
The five trials involved more than 33,000 individuals, including 1497 heart attack cases, 2,318 cases of coronary heart disease, and 1227 strokes. In order to assess the possible risk of various heart conditions, Dr Ray and his team analyzed the data collected on the glucose levels in blood, specifically a long-term marker of glucose control called HbA1c. In healthy individuals, HbA1c levels average between 4-5%. However, diabetics often have levels above 6.5%.
In the present study, those taking a standard treatment maintained a HbA1c level of 7.5%. Individuals who underwent intensive treatment to lower their blood sugar level were 0.9% lower than those who underwent standard treatment (average 6.6%), thereby dramatically reducing their risk of disease in large blood vessels.
Professor Peter Weissberg, Medical Director at the British Heart Foundation said: "It is well established that carefully controlling blood sugar in people with diabetes can help prevent disease in small blood vessels that leads to kidney failure and blindness. This collective analysis of several large clinical trials suggests that careful blood sugar control also protects against heart attacks and strokes, the major causes of death in people with diabetes.
"These findings emphasise the importance of detecting and treating diabetes as early as possible, thus preventing the chances of developing heart and circulatory disease."
Dr Ray concluded: "The present findings reinforce the need for diabetic patients to achieve and maintain better control of blood sugars long-term, as a means to reduce risk of heart disease."
University of Cambridge
It is well documented that diabetics are at increased risk of heart disease. Even though patients can reduce their risk by maintaining healthy blood pressure levels and cholesterol reduction, the risk remains high.
Dr Kausik Ray of the University of Cambridge, lead author of the study, said: "Previous studies have been inconclusive, leaving diabetics and their doctors unsure as to whether maintaining lower blood sugar levels actually benefitted the patients. Although additional research needs to be conducted, our findings provide insight into the importance of improving glucose levels which should include lifestyle changes as well as medication."
The five trials involved more than 33,000 individuals, including 1497 heart attack cases, 2,318 cases of coronary heart disease, and 1227 strokes. In order to assess the possible risk of various heart conditions, Dr Ray and his team analyzed the data collected on the glucose levels in blood, specifically a long-term marker of glucose control called HbA1c. In healthy individuals, HbA1c levels average between 4-5%. However, diabetics often have levels above 6.5%.
In the present study, those taking a standard treatment maintained a HbA1c level of 7.5%. Individuals who underwent intensive treatment to lower their blood sugar level were 0.9% lower than those who underwent standard treatment (average 6.6%), thereby dramatically reducing their risk of disease in large blood vessels.
Professor Peter Weissberg, Medical Director at the British Heart Foundation said: "It is well established that carefully controlling blood sugar in people with diabetes can help prevent disease in small blood vessels that leads to kidney failure and blindness. This collective analysis of several large clinical trials suggests that careful blood sugar control also protects against heart attacks and strokes, the major causes of death in people with diabetes.
"These findings emphasise the importance of detecting and treating diabetes as early as possible, thus preventing the chances of developing heart and circulatory disease."
Dr Ray concluded: "The present findings reinforce the need for diabetic patients to achieve and maintain better control of blood sugars long-term, as a means to reduce risk of heart disease."
University of Cambridge
Heart Disease Current Events and Heart Disease News RSSMultiple health concerns surface as winter, vitamin D deficiences arrive
A string of recent discoveries about the multiple health benefits of vitamin D has renewed interest in this multi-purpose nutrient, increased awareness of the huge numbers of people who are deficient in it, spurred research and even led to an appreciation of it as "nature's antibiotic."
Carvedilol shown to have unique characteristics among beta blockers
In a new study, researchers report that a class of heart medications called beta-blockers can have a helpful, or harmful, effect on the heart, depending on their molecular activity.
ESC to give talks on Diabetes in three cities in China
As a result of successful events organised last year, a second Joint Scientific Forum, organised by the European Society of Cardiology (ESC) and the European Association for the Study of Diabetes (EASD), two of the most respected professional medical organisations in Europe, will be held from 27-29 November at three venues across China - Beijing, Shanghai and Guangzhou.
Saving the single cysteine: new antioxidant system found
We've all read studies about the health benefits of having a life partner. The same thing is true at the molecular level, where amino acids known as cysteines are much more vulnerable to damage when single than when paired up with other cysteines.
Drug for erectile dysfunction improves heart function in young heart-disease patients
Heart function significantly improved in children and young adults with single-ventricle congenital heart disease who have had the Fontan operation following treatment with sildenafil, a drug used to treat erectile dysfunction and pulmonary hypertension, say researchers from The Children's Hospital of Philadelphia.
Study raises concerns about outdoor second-hand smoke
Indoor smoking bans have forced smokers at bars and restaurants onto outdoor patios, but a new University of Georgia study in collaboration with the Centers for Disease Control and Prevention suggests that these outdoor smoking areas might be creating a new health hazard.
Night Beat, Overtime and a Disrupted Sleep Pattern Can Harm Officers' Health
A police officer who works the night shift, typically from 8 p.m. to 4 a.m., already is at a disadvantage when it comes to getting a good "night's" sleep.
Your Own Stem Cells Can Treat Heart Disease
The largest national stem cell study for heart disease showed the first evidence that transplanting a potent form of adult stem cells into the heart muscle of subjects with severe angina results in less pain and an improved ability to walk. The transplant subjects also experienced fewer deaths than those who didn't receive stem cells.
Vitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with CAD
The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows.
Heart and bone damage from low vitamin D tied to declines in sex hormones
Researchers at Johns Hopkins are reporting what is believed to be the first conclusive evidence in men that the long-term ill effects of vitamin D deficiency are amplified by lower levels of the key sex hormone estrogen, but not testosterone.
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