Aggressively Treating Cardiac Risk Factors May Reverse Ischemia
People with diabetes who have asymptomatic heart disease may be able to vastly improve the flow of blood to their hearts without surgical intervention, according to a study being published in the November issue of Diabetes Care,.
Researchers found that patients with obstructed blood flow (known as ischemia) who aggressively treated their cardiac risk factors with medication were able to reverse the course of heart disease over a three-year period.
Patients were given stress tests to measure how well blood was flowing to the heart at the beginning of the study and again at the end. Though none of the patients exhibited symptoms of heart disease, 20 percent fared poorly on their stress tests, showing signs of obstructed blood flow. However, three years later, 79 percent of those whose initial stress tests were abnormal no longer showed any sign of obstruction.
The reversal came as a surprise to researchers, who had anticipated a worsening of ischemia, since type 2 diabetes is "an important aggravating risk factor" for the progression of cardiovascular disease. People with diabetes are two to four times more likely to develop heart disease than those who don't have diabetes. While the study was not designed to measure the impact of heart medications on ischemia, researchers did note that those whose stress tests returned to normal had increased their use of aspirin, statins and ACE inhibitors, all prescribed to help control cardiovascular risk factors.
Typically, doctors treat obstructed blood flow to the heart with surgical interventions, such as angioplasty or bypass surgery. This study suggests that alternative treatments, such as medication, may also be effective. Further research is needed to confirm these findings.