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Diabetes May Double Risk of Heart Attack, Stroke
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The researchers implicate diabetes in one of every 10 deaths from cardiovascular disease, or about 325,000 deaths a year in industrialized countries.
"We have known for decades that people with diabetes are more likely to have heart attacks," said researcher Nadeem Sarwar, a lecturer in cardiovascular epidemiology at the University of Cambridge in England.
"But, in spite of decades of research, several questions have persisted as to how much higher this risk is, whether it's explained by things we already know of, and whether the risk is different in different people," he said.
These findings, Sarwar added, highlight the need to prevent and control diabetes, a disease in which blood sugar levels are too high.
The report is published in the June 26 issue of The Lancet, and Sarwar plans to present the findings at the American Diabetes Association's meeting, June 25 to 29 in Orlando, Fla.
For the study, Sarwar's team collected data on 698,782 people who participated in an international consortium. The participants were followed for 10 years through 102 surveys done in 25 countries.
The researchers found that having diabetes nearly doubled the risk of suffering from various diseases involving the heart and blood vessels. But this risk was only partially due to the usual culprits -- cholesterol, blood pressure and obesity, Sarwar said.
This suggests that diabetes may cause cardiovascular disease by a different mechanism, the study authors noted.
"This is a particularly exciting finding in terms of drug development and new therapeutic targets," Sarwar said.
In addition, the researchers found that higher-than-normal blood sugar in people without diabetes was not strongly related to having a heart attack or stroke.
In light of this finding, blood sugar levels are probably not a good indicator for identifying people at risk for heart attack or stroke, the researchers pointed out.
Cardiovascular disease, the leading cause of death around the world, accounts for some 17 million deaths every year, according to background information in the study.
Diabetes expert Dr. Hertzel C. Gerstein, professor of medicine at McMaster University in Canada and author of an accompanying journal editorial, said, "This study confirms that diabetes is a major problem that doubles the risk of heart attacks, stroke and death."
More than one in 10 adults in North America suffers from diabetes, and almost the same number of people have blood sugar levels that put them on the road to becoming diabetic, he noted.
"We are really in the midst of a major epidemic," Gerstein said.
Most of the problems result from the disease not being controlled, he explained. If people with diabetes work with their health care providers to learn about their condition and regulate it, their risks will be lower, he said.
"Make sure you understand about your diabetes and make sure you have a good health care team that can help you do the things you need to do to keep the disease under control and to prevent serious problems," Gerstein advised.
Dr. Gregg C. Fonarow, a professor of medicine and director of the Ahmanson-UCLA Cardiomyopathy Center at the University of California, Los Angeles, said more work is needed to prevent and treat diabetes.
"This study highlights the need for more aggressive individual efforts and public health measures to prevent diabetes," Fonarow said. "For patients with diabetes, statin therapy, ACE inhibitors and blood pressure control have all been demonstrated to substantially reduce the risk of vascular events."
Copyright © 2010 HealthDay. All rights reserved.
SOURCES: Nadeem Sarwar, Ph.D., lecturer in cardiovascular epidemiology, University of Cambridge, England; Hertzel C. Gerstein, M.D., professor of medicine, McMaster University, Hamilton Ontario, Canada; Gregg C. Fonarow, M.D., professor, medicine, and director, Ahmanson-UCLA Cardiomyopathy Center, University of California, Los Angeles; June 26, 2010, The Lancet