Patients with type 2 diabetes have a higher risk of heart disease even with controlled risk factors

New research suggests that cardiovascular disease (CVD) prevention among patients with type 2 diabetes (T2D) should continue to be a priority, even if risk factors associated with heart disease are optimally controlled.

“Previous studies have shown that people with type 2 diabetes had little or no risk of cardiovascular disease events or death when all risk factors are optimally controlled,” said first author Alison Wright, PhD, in a declaration. “Our team sought to determine how the degree of control of risk factors in people with type 2 diabetes affected CVD risk and mortality compared with people with type 2 diabetes who had all risk factors controlled. optimally and to people who do not have type 2 diabetes “.

In the study, the researchers analyzed data between 2006 and 2015 using the Clinical Practice Research Datalink (CPRD) and the Scottish Care Information-Diabetes (SCID) dataset. More than 101,000 people with type 2 diabetes were identified and matched with nearly 379,000 people without diabetes in the CPRD dataset and nearly 331,000 people with type 2 diabetes in the SCID dataset.

The team focused on 5 risk factors for heart disease, including blood pressure, smoking, cholesterol, triglycerides and blood glucose, and looked at the association with future cardiovascular events and death among these risk factors that were controlled in a way optimal. The researchers also examined whether the presence of cardiorenal disease had an impact on these connections.

According to a press release, the results revealed that only 6% of participants with T2D had all 5 risk factors within the target range. Even when all 5 factors were optimally controlled, T2D patients still had a 21% higher risk of CVD and a 31% higher risk of hospitalization for heart failure than patients without diabetes. Furthermore, the association between the number of elevated risk factors and the risk of cardiovascular events was stronger in T2D patients who did not also have cardiorenal disease.

“People with type 2 diabetes should be treated for cardiovascular risk factors as soon as possible, regardless of whether or not they have cardiovascular disease,” Wright said in the news release. “There is real potential here to reduce the overall impact of type 2 diabetes on future cardiovascular events, especially for patients with type 2 diabetes who have not yet been diagnosed with CVD.”

In the press release, the researchers said that while their findings demonstrate the importance of overall control of risk factors, future research will explore which individual actors have the greatest impact on cardiovascular risk and, therefore, are the most important to take. aim with interventions.

REFERENCE
Heart disease prevention should be a priority for people with type 2 diabetes [news release]. American Heart Association; November 16, 2020. https://newsroom.heart.org/news/preventing-heart-disease-should-be-a-priority-for-people-with-type-2-diabetes. Accessed November 30, 2020.