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90% of People with Type 2 Diabetes Had High Risk for Heart Attack, Study Finds

  • According to new research 90 percent of people with type 2 diabetes are at high risk of fatal heart disease or stroke within 10 years.
  • The average age of people studied was 70, and a little less than half were female.
  • Many had preexisting conditions including high blood pressure, high cholesterol, and obesity.

A new study finds that many people with type 2 diabetes may be at risk for a deadly heart attack.

According to new research in the European Journal of Preventive Cardiology, the official journal of the European Association of Preventive Cardiology, more than 90 percent of people with type 2 diabetes (T2D) are at high risk of fatal heart disease or stroke within 10 years.

“The most striking result of our study was that the vast majority of patients (93 percent) had a high or very high risk of fatal events within a decade. Half of patients in the very high-risk group had no history of heart disease, meaning they would not be receiving medications to prevent heart attacks and strokes,” said study author Dr. Manel Mata-Cases, a general practitioner for the Catalan Institute of Health in Sant Adria de Besos, Spain, said in a statement.

Over half of study participants at very high risk

The study used the Information System for Research in Primary Care (SIDIAP) database, used by all primary health providers in Catalonia, Spain. It includes almost 80 percent of the total population there.

According to researchers, the average age of people studied was 70, and a little less than half were female. Regarding preexisting conditions:

  • 72 percent had high blood pressure
  • 60 percent had high cholesterol
  • 45 percent had obesity
  • 14 percent were current smokers

“As far as we know, this study in nearly 375,000 people from a well-validated population-based database illustrates the situation in the Mediterranean for the first time,” said Mata-Cases in a statement. “Traditionally, cardiovascular risk in the region has been lower than in central and northern Europe or the U.S.; therefore, our results should generate concern and a call for action to prevent heart attacks and strokes in people with type 2 diabetes.”

Mata-Cases and team found more than half of participants were at very high risk of fatal cardiovascular disease (CVD) within 10 years, with only 7 percent having a moderate risk.

“Diabetes causes marked acceleration of atherosclerosis, causing an increase in artery blockages,” Dr. Mark Peterman, interventional cardiologist at Texas Health Presbyterian Hospital in Plano, Texas, told Healthline.

He added it can also cause inflammation that makes these blockages unstable in such a way that they can rupture and cause heart attacks or strokes.

What is type 2 diabetes?

According to the Centers for Disease Control and Prevention (CDC)Trusted Source, the hormone that allows sugar into your cells to be used for energy is insulin, and it’s made in your pancreas.

With type 2 diabetes, your cells don’t respond sufficiently to normal levels of insulin. This is a condition known as insulin resistance.

The pancreas begins secreting more insulin to get cells to respond, but eventually it can’t keep up, and blood sugar levels rises. This is the beginning of prediabetesTrusted Source, and type 2 diabetes.

CDC figures show 88 millionTrusted Source Americans have prediabetes, and about 34 millionTrusted Source Americans are living with diabetes. Type 2 diabetes is most common, with more than 90 percent of all people with diabetes having T2D.

This recent research is just one study and it focused mainly on older adults. It does not show all people with type 2 diabetes are at high risk for a fatal heart attack.

Growing number of treatment options

Injecting insulin was once the only treatment option available to treat the disease, but Peterman said this had drawbacks, and there are more refined treatment options available to help manage diabetes.

“In the past, more insulin was the main solution, but increasingly, it has been realized that this doesn’t solve the problem and leads to weight gain and more insulin resistance,” said Peterman. “Now, there are several classes of oral and injectable medications that decrease insulin resistance and improve the use of natural insulin.”

According to the American Diabetes Association (ADA), some of these drugs include:

  • metformin (Glucophage), which can reduce blood sugar levels
  • colesevelam (Welchol), which reduces cholesterol levels.
  • bromocriptine (Cycloset), used to reduce blood sugar after a meal.
Losing weight reduces risk

“Even a 5 percent body weight loss can lower glucose levels, lower cholesterol levels, lower blood pressure,” said Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York. And improving these conditions can reduce the risk of cardiovascular disease.

Sood emphasized using a two-pronged approach to reducing CVD risk for people living with T2D.

“There’s diabetes control, weight control, blood pressure control, as well as cholesterol control [that is] is very important,” she said. “That’s primarily done through diet and exercise.”

She recommended 150 to 300 minutes per week of moderate-intensity exercise.

According to Sood, there are many diets that have been studied, and no single one prevailed over the rest. However, she insisted that adopting a plant-based based with a reasonable (as opposed to high) intake of healthy starches, plant fiber, healthy fats, and low refined sugar is ideal.

While T2D can even be reversedTrusted Source by losing weight, she emphasized that loss would have to be significant.

“In most cases, however, weight loss can help control diabetes but the common scenario is that it’s still present in the background and that it can be progressive over time.”

Losing fat but keeping muscle key to reducing risk

Recent research from UT Southwestern (UTSW) Medical Center in Dallas suggests not all weight loss is good when it comes to reducing heart disease risk. While reducing body fat and waist size are associated with lower risk of heart failure in people with type 2 diabetes, the UT study found that it was most important that people with T2D lose fat rather than muscle.

“We have long counseled patients to lower their body mass index into the ‘healthy’ range. But that doesn’t tell us whether a patient has lost ‘fat mass’ or ‘lean mass,’ or where the weight came off,” Dr. Ambarish Pandey, senior author of the study and assistant professor of internal medicine at UTSW said in a statement. “We didn’t know how each of these factors might affect patients’ risk of heart disease.”

Pandey and team looked at data from more than 5,000 participants with diabetes to find even a 10 percent reduction in fat mass resulted in up to 24 percent lower risk of heart failure.

The bottom line

Researchers found over 90 percent of people with type 2 diabetes have a high risk of fatal heart disease or stroke within 10 years.

Experts say that diabetes is a condition that increases risk of both blocked arteries and inflammation that can make the blockages unstable, which in turn causes heart attack or stroke.

Experts also say that eating a plant-based diet, losing body fat, and reducing your waist measurement, while maintaining muscle mass, may also reduce the risk of heart disease from diabetes.

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