Blood pressure the key to protecting type 2 diabetes patients with irregular heart beat
A new analysis from the largest study of type 2 diabetes treatments has shown that while atrial fibrillation (irregular heart beat) is relatively common in patients with type 2 diabetes and substantially increases risk of death, these patients can be better protected against death by intensive blood pressure lowering treatment. The findings are published today in the European Heart Journal.
Atrial fibrillation (AF) is a common type of arrhythmia, or irregular heart beat. AF is commonly observed in diabetic patients, who are at least twice as likely to experience the condition. Researchers found that patients with type 2 diabetes with AF had up to 77% increased risk of dying, but this was significantly reduced when clinicians treated patients with a combination blood pressure lowering drugs, (perindopril and indapamide).
"Our new analysis confirms that among patients with type 2 diabetes, those with atrial fibrillation are at substantially higher risk of death. This study informs clinicians that AF, or an irregular heart beat is a marker of greater risk of cardiovascular events and death among diabetics. Such patients should have their cardiovascular risk factors, such as blood pressure and cholesterol, controlled more aggressively," said study leader, Professor Anushka Patel, from The George Institute for Global Health.
An estimated 250 million people are living with diabetes around the world, and this number is projected to increase to 380 million at 2025. Researchers anticipate that around 40 million of these will also have AF.
The Action in Diabetes and Vascular Disease (ADVANCE) study included 11,140 patients from 20 countries and was initiated and designed by Australia’s George Institute. This new analysis aimed to investigate serious clinical outcomes associated with AF and the effects of routine blood pressure lowering on such outcomes in the presence or absence of AF, among individuals with type 2 diabetes.
"We estimate that five years of active treatment would prevent one death among every 42 patients with AF and one death among every 120 patients without AF," added Professor Patel
Professor Patel pointed out that AF was frequently undetected in diabetic patients. "The current analysis highlights the importance of actively evaluating diabetic patients for the presence of AF, to identify those at particularly high risk of cardiovascular events. Routine administration of blood pressure-lowering treatment, as well as greater use of antiplatelet or anticoagulant agents and statins, may be expected to reduce the incidence of a broad range of adverse outcomes in these patients."
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