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Logic would have it that if a person had a cardiovascular problem in the past, such as a heart attack, chances are they are at a higher risk for having another one compared to someone who never had cardiovascular problems. However, a new BWH study turns this logic on its head if a person has diabetes.
According to researchers, men with no history of cardiovascular disease who have type 2 diabetes treated with insulin are at higher risk for heart attack, stroke or death compared to men with a history of cardiovascular disease.
Men with diabetes taking insulin had a 16 percent rate of experiencing major cardiovascular problems over four years, compared to 13 percent for men who had prior heart disease but not diabetes.
The researchers concluded that men with diabetes taking insulin had a 70 percent increased risk for a first cardiovascular event, such as stroke or heart attack, compared to men with prior cardiovascular disease having another event.
Moreover, the risk of having major cardiovascular events over four years increased incrementally in patients with diabetes treated with diet only, oral diabetes medications or insulin.
“These findings suggest that men with diabetes who require insulin are at high risk for cardiovascular events, as high a risk as patients who already have established cardiovascular disease,” said lead study investigator Jacob Udell, MD, of the Cardiovascular Division. “Given that the number of patients with type 2 diabetes who require insulin continues to grow, these patients require diligent cardiovascular risk factor management from their health care team to potentially avoid a first heart attack or stroke.”