heart attack and diabetics

Type 2 Diabetics Should Be Treated as Heart Patients : Researchers have known that having type 2 (non-insulin-dependent) diabetes increases the risk of developing coronary heart disease. But is the risk so great that diabetics who have not had a heart attack need to be treated as if they had?

To find out, Dr. Steven M. Haffner of the University of Texas Health Science Center at San Antonio and colleagues examined the rate of heart attacks in Finland over 7 years among 1,373 nondiabetic subjects and 1,059 diabetic individuals. Some of the participants were heart patients, having suffered at least one heart attack before the study began.

Over the 7 years, between 18 to 20 percent of both diabetic patients who had not had a heart attack before the study and nondiabetic heart patients suffered an attack, the team reports in the July 23 New England Journal of Medicine, heart attack and diabetics research .

Only 3.5 percent of the nondiabetics who were also not heart patients had a heart attack. But almost half -- 45 percent -- of diabetic heart patients had an attack.

Diabetics who have not had a heart attack and nondiabetic heart patients should receive similar treatment for cardiac risk factors, such as high blood pressure, the authors conclude.

Preliminary results from the Insulin Resistance Atherosclerosis Study, also coauthored by Dr. Haffner, found that type 2 diabetics without coronary artery disease and nondiabetic subjects with it had about equally clogged arteries. According to the team: "[c]arotid-artery intimal-wall thickness was very similar in diabetic subjects without clinical coronary artery disease and nondiabetic subjects with clinical coronary artery disease."

Since many diabetic patients did not have signs of heart disease at the outset of the study, but developed it during the course of the study, researchers suggest that diabetics' arteries may develop blockages faster than those of nondiabetics.

Studies are needed on the benefits of interventions such as lipid-lowering drugs and antihypertensives for diabetics with no history of heart disease, authors say, heart attack and diabetics research.

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