Blood pressure and cholesterol should be controlled more aggressively, study suggests
In people with diabetes, there’s a strong association between abnormal heart rhythm, or atrial fibrillation, and increased risk of other heart-related problems and death, according to a study that included 11,140 people.
Researchers found that participants who had atrial fibrillation (AF) at the start of the study were 61 percent more likely to die from any cause, 77 percent more likely to die from cardiovascular causes such as a heart attack or stroke, and 68 percent more likely to develop heart failure or other problems such as stroke.
But the study also found that the risk of developing complications or dying was lower if doctors gave more aggressive treatments to diabetic patients with AF. In this study, treatment involved a combination of the blood pressure lowering drugs perindopril and indapamide.
“Active treatment produced similar relative benefits to patients with and without AF. However, because of their higher risk at the start of the study, the absolute benefit associated with active treatment was greater in patients with AF than without. We estimate that five years of active treatment would prevent one death among every 42 patients with AF and one death among 120 patients without AF,” noted study leader Professor Anushka Patel, director of the Cardiovascular Division at The George Institute for International Health at the University of Sydney in Australia.
The researchers also found that the association between AF and deaths from cardiovascular disease was much stronger in women than in men. Women with AF were twice as likely to die as women without AF, while men with AF were 50 percent more likely to die than men without AF.
The findings were published March 12 in the European Heart Journal.
“This study informs clinicians that AF is a marker of greater risk of cardiovascular events and mortality among diabetics, both men and women. Such patients should have their cardiovascular risk factors, such as blood pressure and cholesterol, controlled more aggressively,” Patel advised.
“This is a separate issue from rate and rhythm control [or the use of anticoagulants to prevent thromboembolic events], which is the usual therapeutic focus in patients with AF. These issues are important, but we believe our data suggest that heightened awareness and management of overall cardiovascular risk is also important.”