Diabetes ages your heart

When it comes to your heart and blood vessels, diabetes adds 15 years to your age.

That's the conclusion of Canadian researchers who looked at almost 400,000 people with diabetes and 9 million without it. They collected information on when heart attacks, strokes, other cardiovascular trouble, and deaths occurred in the two groups. From this mountain of numbers they calculated the average age at which men and women in the diabetes and nondiabetes groups crossed from low heart disease risk (under 10 cases per 1,000 people) to moderate risk (10-19 cases per 1,000) and then high risk (20 or more cases per 1,000). Accounting for small differences between men and women, people with diabetes crossed into the high-risk category an average of 15 years earlier than those without diabetes. The more broadly the researchers defined heart disease risk, the more diabetes advanced one's cardiovascular age.

The take-home message from this work is that it's a good idea for people with diabetes to start paying attention to their hearts and arteries years before their counterparts without the disease. Daily exercise and a diet that minimizes blood sugar swings are appropriate for everyone with diabetes. What about more aggressive strategies for protecting the heart and blood vessels, such as taking a cholesterol-lowering statin, low-dose aspirin, and other cardioprotective drugs?

Writing in the July 3, 2006, Lancet, the researchers call for individualizing prevention strategies, especially for younger people (under age 40) with diabetes, some of whom may still be at low risk for having a heart attack or stroke. Upon crossing into the moderate-risk category, though, it's time to pull out all the stops.

Julie K. Silver, M.D., is an assistant professor in the Department of Physical Medicine and Rehabilitation at Harvard Medical School. She is also the Chief Editor of Books for Harvard Health Publications.

Diabetes

Nearly 21 million Americans suffer from diabetes, and as anyone who has been affected by the disorder knows, it is about much more than a statistic: it means a new way of life. Diabetes: A plan for livingis a special report from Harvard Medical School that will help you learn how to better understand and manage your diabetes, including type 1 and type 2, as well as other variations of the disease. This report will show you that it's not just possible to live with diabetes; it's possible to live well.