Friday, 24 June 2011

Diabetics at risk for second stroke

After suffering a first stroke or transient ischemic attack (TIA), people with type 2 diabetes are at greater risk of having another stroke or a heart attack. But, aggressively lowering cholesterol can help reduce that risk.

Previous research has shown that type 2 diabetes mellitus is associated with increased risks of both stroke and coronary heart disease (CHD). Metabolic syndrome or insulin resistance identifies individuals at higher risk for developing type 2 diabetes and is also associated with an increase in stroke and cardiovascular disease.  Metabolic syndrome is a group of conditions, including high blood pressure, high blood sugar and high cholesterol that increase the odds of developing diabetes and heart disease.

Researchers in the United States analysed data from the Stroke Prevention by Aggressive Reduction of Cholesterol Levels Trial, which was designed to look at whether taking high doses of cholesterol-lowering drugs called statins would reduce the risk of having a second stroke or TIA. The trial did find that lowering cholesterol reduced the likelihood of another cardiovascular event in patients with recent stroke or TIA. In their secondary analysis, the researchers also looked at the risk of having another stroke or a heart attack among diabetics and people with metabolic syndrome and whether statin treatment could reduce that risk.

Of the 4,731 people in the trial who had had a stroke or TIA, the researchers identified 794 diabetics and 642 with metabolic syndrome. Compared with non-diabetics, people with diabetes were more likely to have another stroke, TIA or other cardiovascular event. They were also more likely to need an angioplasty to open blocked arteries, it was found. However, people with metabolic syndrome were not at greater risk of another stroke or TIA or cardiovascular event but were at higher risk of needing an angioplasty. Treatment with the statin did significantly reduce the risk of these events in participants with type 2 diabetes or metabolic syndrome.

The study results confirm earlier findings but highlight the differences in risks between diabetes and metabolic syndrome while pointing out that statin use is protective in such patients.

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