Almost 30% of patients with coronary artery disease have diabetes, according to the study. This compares to a prevalence of diabetes of around 9% in the general population. There was great geographic variation, with 60 percent of heart disease patients in the Gulf countries suffering from diabetes compared to 20 percent in Europe.
“Obesity and lack of exercise are common risk factors for diabetes and heart disease and our results highlight the urgent need to improve nutrition and increase activity levels around the world.” said study author Dr Emmanuelle Vidal-Petiot from Bichat-Claude Bernard Hospital, Paris France.
Vidal-Petiot added: “The countries most affected by diabetes are also at the epicenter of the obesity epidemic, which can be partly attributed to urbanization and the associated changes in physical activity and food intake. “
This was a review of the CLARIFY registry, which included 32,694 patients with chronic coronary syndromes from 45 countries in Europe, Asia, America, the Middle East, Australia and Africa. Patients were recruited from 2009 to 2010 and followed up annually for five years.
All of the adverse clinical outcomes measured in the study occurred more frequently in heart patients with diabetes than in those without diabetes. When the researchers compared the likelihood of poor outcomes in people with diabetes versus those without, they adjusted the scans for several factors that might influence the relationship, including age, gender, smoking, body mass index, blood pressure, medications and other conditions.
After these adjustments, they found that among patients with stable coronary artery disease, those with diabetes had a 38% higher death rate over the five-year follow-up.
They also had a 28% higher risk of a combined outcome of heart attack, stroke, or cardiovascular death. Patients with diabetes in the heart performed worse than those without diabetes, regardless of geographic region and ethnicity.
Dr Vidal-Petiot said: “Diabetes was associated with worse outcomes, even in areas with the lowest prevalence. In Europe, for example, diabetes was associated with a 29% higher risk of a combined outcome of heart attack, stroke, or cardiovascular death. This indicates that the management of these very high risk patients with heart disease and diabetes needs to be improved. Each country must identify these patients and offer appropriate educational and prevention programs. “
She concluded: “The importance of a healthy diet and lifestyle cannot be overstated. Anyone can reduce their chances of developing diabetes through weight control and exercise, and early detection is needed so blood sugar can be controlled. People with heart disease and diabetes also need an active lifestyle and good nutrition to protect their health. It is essential to avoid smoking, as is to control blood pressure and cholesterol levels. “
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