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Our Hearts

By David Mendosa

Last Update: October 31, 2002

Isn't having diabetes enough to be concerned about, without having to think about our hearts too? Actually, diabetes and heart trouble are a close couple.

Whatever the news [it is]…better than not knowing.

The statistics can be grim. I start with them to get your attention. But the heart of this column is about the American Diabetes Association's initiative in linking diabetes and heart disease, the American Heart Association's "Heart Profilers," and the many treatment options we have.

Diabetes and two of the biggest causes of heart disease are linked in an intimate embrace. The numbers are so big that I didn't believe them when I read them in a pharmaceutical company's ad recently.

The best data come from a national sample of 733 adults with type 2 diabetes in phase 2 of the Third National Health and Nutrition Examination Survey. Maureen Harris reported her findings in "Health Care and Health Status and Outcomes for Patients With Type 2 Diabetes" in the June 2000 issue of Diabetes Care.

Two-thirds—67 percent—of all adults with type 2 diabetes have one or more lipid abnormalities. This means total cholesterol or LDL cholesterol that is too high, HDL cholesterol that is too low, or a triglyceride level that is too high.

If that's not bad enough, almost as many of us have high blood pressure. The technical term is hypertension, and technically 63 percent of us have it, according to the Harris survey. The Centers for Disease Control and Prevention, however, says on its Web site that it is 73 percent.

Whatever the exact proportion, heart disease is the leading cause of premature death among people with diabetes. At least 65 percent of people with diabetes die from heart disease or stroke, according to the National Diabetes Education Program.

Furthermore, adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. We also have a stroke risk two to four time higher, according to the  National DiabetesStatistics.

Does this grim litany of statistics motivate you to do something about your high blood pressure or cholesterol? If so, you're on your way to the right place.

The American Diabetes Association is the major driver linking diabetes and heart disease. The ADA works with the American College of Cardiology to emphasize that management of diabetes is more than just control of blood glucose. "Make the Link! Diabetes, Heart Disease and Stroke" is the name of the joint initiative that stresses how important it is that we also manage our blood pressure and cholesterol and talk to our health providers about other ways to reduce our chance of heart attacks and stroke.

The Heart Profilers are a big recent addition to the Web site of the American Heart Association. This interactive tool will ask for personal medical data—everything from age, sex, and race to your triglyceride level and blood pressure. It's free. After spending 10 or 15 minutes answering all the questions, you will get back a personalized list of treatment options, questions to ask your doctor, and, if you like, even some clinical trials that you might be able to participate in.

The AHA licenses the Heart Profiler from NexCura Inc. in Seattle. NexCura makes its money by matching you with a clinical trail. To do that it may release your medical information and email address to pharmaceutical companies running those trials. However, you can specifically opt out.

To make the most of this interactive tool, you will need to be more aware than many people are about the status of their health. So just completing the questionnaire can be valuable for most of us.

In addition to high blood pressure and cholesterol, the American Heart Association has Heart Profilers for atrial fibrillation, coronary artery disease, and high blood pressure.

My main interest was in the cholesterol profiler. I have a triglyceride level that is borderline high, LDL cholesterol that is a bit too high for a person with diabetes, and HDL cholesterol that stubbornly remains a bit too low even after starting treatment with one of the statins. The section on treatment options tells me that these levels would improve with losing weight and exercising more and that the fish oils that I recently started might help.

The profiler also told me what I least wanted to hear but most needed to know. "You are at high risk with an estimated chance of greater than 20% of developing a heart attack or other serious coronary event within the next ten years," it reported after I diligently answer all the cholesterol questions.

You will, I hope, have better news. But whatever the news, I believe that it will be better than not knowing. 

The American Diabetes Association originally published this article on its Web site as one of my “About the Internet” columns.

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