Diabetes poses additional heart risks for Hispanics

Washington -- By their sheer numbers, 40 million and growing, the nation's Hispanic population commands attention. The group has also attracted notice for an unfortunate reason -- its high diabetes rate.

Now, the prevalence of that disease is generating concern that many Hispanics will be stricken with another serious condition. Diabetic cardiomyopathy can result from years of living with high blood glucose levels, said Francisco J. Villarreal, MD, PhD, professor of medicine, at the University of California, San Diego School of Medicine. He described the condition March 24 at the annual meeting of the National Hispanic Medical Assn., held in Washington, D.C.

Characterized by enlargement of the heart, diabetic cardiomyopathy may be caused by the growth of increasingly constricting fibrous tissue that surrounds the organ, Dr. Villarreal said. Long-term exposure to high blood glucose levels is thought to be the culprit behind the abnormal growth of this tissue.

The risk for Hispanics is particularly high. At least 15% of all adults in this population already have type 2 diabetes, and a significant number of Hispanic children and adolescents have developed or are at risk of developing the disease, according to the Joslin Diabetes Center in Boston.

Climbing rates of obesity are contributing to the disease's early onset, and concern is mounting over the harms to blood vessels, kidneys and eyes that can be caused by many years of living with diabetes.

"Fibrosis of the heart is something we will need to watch in the future," Dr. Villarreal said. "Diabetic cardiomyopathy may not be well known now, but it will become so."

Statin drug trial results

The markedly higher prevalence of obesity and metabolic syndrome among Hispanics also makes them more likely candidates for cardiovascular disease, said Ramon Lloret, MD, director of the Miami Cardiac and Vascular Institute at the University of Miami in Florida. But despite these risk factors, the population has not always been well studied, he said at the NHMA meeting.

AMA policy encourages the continued study of health issues unique to the Hispanic community as well as targeted health education and promotion efforts. The AMA is also joining with the Hispanic medical association to help end health disparities.

Meanwhile, new research suggests that more work is being done. For example, Dr. Lloret was the lead investigator in a clinical trial that examined the benefits of two statin drugs in more than 600 Hispanic participants.

The six-week trial, funded by AstraZeneca, maker of the statin drug Crestor (rosuvastatin) compared the ability of that drug and Lipitor (atorvastatin) to lower LDL cholesterol and C-reactive protein levels. There were four trial arms with 10 mg and 20 mg doses for each drug examined.

LDL levels fell significantly in all arms of the trial after six weeks, Dr. Lloret said. But rosuvastatin at both doses produced the greatest LDL reduction. Both drugs had similar beneficial effects on participants' CRP levels and similar safety profiles.

The trial is one of several mounted by AstraZeneca in its Galaxy Program to test the benefits of Crestor at reducing cardiovascular disease and heart attacks. The drug has faced criticism from the Washington, D.C, consumer organization, Public Citizen Health Research Group, over reports that it causes more muscle and kidney damage than other statins.

However, according to an AstraZeneca spokeswoman, the new finding adds to other results from the Galaxy Program that show Crestor to be just as safe and effective as all the other drugs in its class.