Diabetics Suffering Less From Heart Disease

Study finds big declines, but improvements needed

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By
HealthDay Reporter

TUESDAY, Nov. 23, 2004 (HealthDayNews) -- Adults with diabetes have experienced a drop in their incidence of problems related to cardiovascular disease over the last several decades.

However, the overall rate of cardiovascular disease among diabetics in the United States is still twice as high as of that people without diabetes, researchers report.

"Despite declines, people with diabetes are still at a twofold increased risk, so further research is necessary to understand the risk factors that are associated with that increased risk," said Dr. Caroline S. Fox, lead author of an article appearing in the Nov. 24 issue of the Journal of the American Medical Association and a medical officer with the National Heart, Lung and Blood Institute.

While overall deaths from heart attack, coronary heart disease, and stroke have decreased over the last half century, it has not been clear if the trend included people with diabetes.

In fact, Fox said, "prior work had shown that people with diabetes experienced much less of a decline than those without diabetes. Our study was to examine those findings."

Among other things, diabetics are at increased risk of developing heart disease and from dying of cardiovascular events, such as a heart attack or stroke. However, studies have shown that these complications can be minimized with proper treatment and lifestyle modifications.

"It's been known for many years that a person with diabetes has a higher risk for cardiovascular disease, including heart attacks, than a person who doesn't have diabetes," said Dr. Robert Rizza, president-elect of the American Diabetes Association and a professor of medicine at the Mayo Clinic. "There is excellent data showing us that if properly treated -- including drugs to lower cholesterol [and] blood pressure and keeping blood glucose normal -- you can dramatically reduce that risk."

The authors of this study looked at data for two sets of people, aged 45 to 64, who had participated in the Framingham Heart Study. The first set consisted of 4,118 people who participated from 1950 to 1966, while the second set included 4,063 individuals who took part from 1977 to 1995. In the earlier time period, 113 people had diabetes, while in the later period, 317 were diabetic, the researchers note.

Compared to people in the earlier period, adults in the later set had nearly a 50 percent reduction in the incidence of cardiovascular disease, meaning they benefited in a similar manner to people without diabetes over the last 50 years. In fact, the decline was slightly greater among people with diabetes than among those without, where the incidence decreased by just over 35 percent.

Given what previous studies had indicated, this finding was surprising, Fox said.

Even though the numbers are headed in the right direction, there is still a lot of room for improvement, according to the study authors.

Rizza agreed. "It's very encouraging, but there's a long way to go before making sure everyone is properly treated," he said. "It's very reassuring to show that it is increasing. This says that when the condition is treated, it makes a difference."

More information

For more on the link between diabetes and cardiovascular disease, visit the National Institutes of Health's National Diabetes Education Program.

SOURCES: Caroline S. Fox, M.D., medical officer, National Heart, Lung and Blood Institute, Framingham, Mass.; Robert Rizza, M.D., professor of medicine, Mayo Clinic and president-elect, American Diabetes Association, Rochester, Minn.; Nov. 24, 2004 Journal of the American Medical Association

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