Health of heart attack, diabetes patients compared

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Health of heart attack, diabetes patients compared

NEW YORK, Apr 19 (Reuters Health) - Although people with diabetes are

known to be at higher risk for heart problems, new study findings

suggest that diabetics in their 40s, 50s or 60s who are otherwise

healthy fare better than people without diabetes who have had a heart

attack in the past.

Previous research has identified diabetics as being at high risk of

developing heart disease. Indeed, some experts have gone so far as to

suggest that patients with type 2 diabetes should be treated as if they

already have heart disease--regardless of their medical history.

Now, reporting in the April 20th issue of the British Medical Journal,

Dr. Josie M. M. of Ninewells Hospital in Dundee, Scotland, and

colleagues are offering a different perspective.

In a head-to-head comparison of nearly 5,000 patients diagnosed with

type 2 diabetes and nearly 9,000 patients who had a previous heart

attack, the diabetes patients were found to be at lower risk of

cardiovascular complications and death than those who had had heart

attacks, the investigators found.

In the study, and colleagues monitored the health status of two

groups of patients. The first group contained 1,155 patients with type 2

diabetes and 1,347 patients who had had a heart attack. The health

status of these patients was monitored for 8 to 15 years.

In the second group, 3,477 patients with type 2 diabetes were compared

with 7,414 patients who had a previous heart attack. The health status

of this group was monitored for 8 years. All of the patients in the

study were between 45 and 64 years old.

During the follow-up period, patients in group 1 that had had a heart

attack were more than two times more likely to die from any cause

compared with the diabetics, the report indicates.

Heart attack patients in group 2 were 1.35 times more likely to die from

all causes, 2.93 times more likely to die of a heart attack and 3.10

times more likely to be hospitalized as a result of another heart attack

than the patients with diabetes, according to the report.

" Our results do not support the hypothesis that patients with diabetes

have as high a cardiovascular risk as patients with established coronary

heart disease, " and colleagues write.

The findings suggest that physicians should treat type 2 diabetes

patients on a case-by-case basis, based on their individual risk factors

for heart disease, and should not necessarily treat all such patients as

if they already have heart disease, the authors conclude.

SOURCE: British Medical Journal 2002;324:939-942.