Drugs Alone Can't Curb Heart Disease in Diabetes

< Mar. 17, 2010 > -- Healthy diet and exercise remain important weapons against heart disease in people with diabetes. Results of a large federal study published this week found that aggressive drug treatment of cholesterol and blood pressure was not sufficient to lower their heart disease risk. 

Neither Therapy Lowered Risk for Heart Attack, Stroke

The findings come from a large government-sponsored trial of more than 10,000 patients with type 2 diabetes at risk for heart disease. The results were published this week in the New England Journal of Medicine.

For the cholesterol part of the trial, more than 5,500 people with type 2 diabetes and a high risk for heart disease took a cholesterol-lowering drug. Half were also given a pill to lower blood fats called triglycerides and boost HDL ("good") cholesterol. 

In the blood pressure part of the trial that included more than 4,700 people with type 2 diabetes, half took an intensive drug regimen intended to reduce systolic (the top number) blood pressure to less than 120 mm Hg. The other half received standard blood pressure therapy.

For both groups, the medications helped to control participants' cholesterol or blood pressure levels, respectively. However, neither treatment reduced the number of heart attacks or strokes among participants.

Plus, those who were on intensive blood pressure therapy experienced more serious adverse health events, as did women who received the triglyceride and HDL therapy. 

Lifestyle Measures Are the Best Bet for Heart Health

"These results could be disappointing to a lot of people -- that this intensive blood pressure control or intensive lipid control didn't reduce fatal or nonfatal events," says Stephen Kopecky, M.D., a cardiologist and professor of medicine at the Mayo Clinic in Rochester, MN.

However, the study did not look at lifestyle measures. Had they been factored in, researchers might have achieved the sought-after goals of fewer heart attacks, fewer strokes, and lower mortality, according to Dr. Kopecky. 

Previous research has shown dramatic reductions in heart problems in those with type 2 diabetes who took medication and added healthy lifestyle habits such as exercise and eating five fruits and vegetables a day, he notes. 

"I'm not saying medicines aren't helpful, just that they need to be done in combination with lifestyle measures," Dr. Kopecky explains. "It's reminding us how important our lifestyle is. You can't just overcome it with pills."

Make Good Diet and Exercise Choices for Heart Health

Eating a healthy diet and staying physically active has been shown to help keep cholesterol and blood pressure in check. The American Heart Association advises these steps:

• Aim for at least 30 minutes of physical activity most days of the week.
• Eat a variety of foods rich in nutrients, and avoid junk food.
• Include lots of fruits and vegetables in your diet.
• Eat fish at least twice a week.
• Opt for whole-grain, high fiber foods.
• Limit saturated fat and cholesterol.
• Avoid partially hydrogenated oils to limit trans fats.
• Cut back on salt and sugar.
• Choose fat-free or low-fat dairy products.
• Select lean meats and poultry and prepare them without adding fat.

It's also important to avoid smoking and drink moderately if you drink alcohol.

Always consult your physician for more information.