BP key to diabetes heart risk
By Stephen Robinson, 31 January 2013
Controlling BP and cholesterol is more important than HbA1c in preventing heart disease in patients with diabetes, research suggests.
Findings from a US study indicate that BP and lipid targets should be the priority for clinicians attempting to lower the risk of cardiovascular disease in diabetes care.
But the researchers said HbA1c checks should not be neglected.
Their study found that patients with healthy BP and cholesterol had a lower risk of hospitalisation for stroke or MI. However, there was no risk reduction for patients who achieved HbA1c targets but missed those for BP and cholesterol.
Lead author Greg Nichols PhD of the Kaiser Permanente Center for Health Research in Portland, Oregon, said: 'People with diabetes are often focused on controlling their blood sugar, but our study found that controlling BP and cholesterol is even more important in preventing heart disease.'
Despite a large body of evidence connecting well-controlled HbA1c to a lower risk of heart disease, the relative importance of this and other risk factors had remained unclear.
In the study, researchers examined the records of 26,636 adults with diabetes between 2002 and 2010. They looked at whether patients met clinical targets of BP less than 130/80mmHg, LDL cholesterol under 100mg/dL and HbA1c of less than 53mmol/mol. During this time, about 7% of patients were hospitalised with a cardiovascular event.
Researchers found that only 13% - one in eight - of all patients met target levels for all three measures. These patients were 2.5 times less likely to be hospitalised with MI or stroke than those who met none of the targets.
But while patients who met BP and cholesterol targets saw their risk fall, a similar reduction was not seen in those who had only well-controlled blood sugar levels. Patients with all three risk factors well controlled faced the lowest risk.
Researchers said the findings did not mean patients should forget about their blood sugar levels, but that it was also important to pay attention to other risk factors for heart disease.
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