WCM-Q study links diabetes with heart failure
02 Apr 2017 - 22:25
Patients with both Type 2 diabetes and acute heart failure face a significantly lower risk of death, a recent study has revealed. However, they have a higher risk of heart failure-related hospitalisations if they had high systolic blood pressure on discharge from the hospital compared to those with normal blood pressure, according to the study led by a researcher from Weill Cornell Medicine - Qatar (WCM-Q).
Previous research has linked high blood pressure with worse health outcomes among people with Type 2 diabetes and among people with heart failure. The new study—the first to assess blood pressure and health outcomes in patients who have both Type 2 diabetes and acute heart failure — found that those with a systolic blood pressure above 150 mmHg were 45 percent less likely to die but 47 percent more likely to be hospitalised for heart failure during a 12-month follow-up period.
Systolic blood pressure is the top number in blood pressure readings and indicates the amount of pressure exerted on artery walls when the heart beats. It is measured in millimetres of mercury (mmHg) and is often used as a marker for cardiovascular risk.
“Current guidelines for patients with Type 2 diabetes suggest that systolic blood pressure should be lower than 140mm Hg, and lower than 130mm Hg in some individuals,” said the study’s lead author, Dr Charbel Abi Khalil, Assistant Professor of Medicine and Genetic Medicine at WCM-Q and cardiology consultant at Hamad Medical Corporation’s Heart Hospital.
“However, patients with both Type 2 diabetes and acute heart failure have a distinct pathophysiology of the heart and may benefit from different guidelines.”
Doctors typically prescribe medications and lifestyle changes as needed to lower blood pressure to a recommended range in patients with Type 2 diabetes. Although the study results show significantly better survival among patients with higher systolic blood pressure, Dr Abi Khalil noted that further studies, such as a randomised controlled trial, would be needed before changing medical guidelines for managing blood pressure for patients with both Type 2 diabetes and acute heart failure.
Dr Abi Khalil, along with Dr Jassim Al Suwaidi, Dr Kadhim Sulaiman and other colleagues, analysed health records of 2,492 patients with Type 2 diabetes among 5,005 individuals who were hospitalised with acute heart failure in seven Middle Eastern countries: Oman, Saudi Arabia, Yemen, Kuwait, United Arab Emirates, Qatar and Bahrain. Based on the systolic blood pressure recorded on patients’ hospital discharge papers, they divided patients into four blood pressure levels: below 120 mmHg (low blood pressure), 120-129 mmHG (normal), 130-149 mmHG (moderate) and above 150 mmHG (high).