CHF gets a cameo at ADA Scientific Sessions

They assembled to talk about diabetes. But researchers discussing the long-awaited results of the United Kingdom Prospective Diabetes Study (UKPDS) had interesting findings to report on heart failure as well during the 59th Annual Scientific Sessions of the American Diabetes Society in San Diego in June.

Presenter James S. Sowers, MD, noted hypertension was the No. 1 cause of new cases of heart failure among the 1,148 patients who participated in the adjunct studies that ran during the 20-year span of the UKPDS. These patients, whose average age was 56, had Type 2 diabetes.

Keeping tight control of hypertension brought systolic blood pressures down an average of 10 mmHg and diastolic pressures down 5 mmHg, to 135/85 or lower. Patients under tight control also had 44% fewer strokes and 58% fewer fatal strokes.

Sowers also noted that hypertension is unique in diabetic patients because blood pressure does not decline at night like it does in non-diabetics, so diabetics are subject to longer periods of sustained hypertension.

British UKPDS investigator Robert C. Turner, MD, from the University of Oxford, England, reported that ACE inhibitors and beta-blockers worked equally well at controlling blood pressure during the main study. Patients with heart conditions at the onset of the study were not included, yet nearly 3% of the participants went on to develop CHF — emerging cases Turner called "right out of the blue."

During his presentation, Turner also announced his study did not find increased incidence of cardiovascular events that could be attributed to long-term insulin therapy. The finding, he said, is more good news for physicians trying to keep tight control of blood glucose levels in their diabetic patients.