But results of past studies of diabetes and atrial fibrillation have conflicted. Now in the Journal of General Internal Medicine Dr. Sascha Dublin of Group Health Research Institute has linked diabetes to a 40 percent greater risk of developing atrial fibrillation; and she found this risk rises even higher the longer people have diabetes and the less controlled their blood sugar is.
For three years, Dr. Dublin and her colleagues tracked more than 1,400 Group Health patients who had newly recognized atrial fibrillation. They compared these “cases” with more than 2,200 “controls.” The controls were matched to the cases by age, sex, year, and whether they were treated for high blood pressure; but unlike the cases, they had no atrial fibrillation.
Dr. Dublin’s study was the first to examine the relationship between atrial fibrillation and the duration of patients’ diabetes and their blood sugar levels. Unlike most prior studies, this one also adjusted for patients’ weight, which is important because both diabetes and atrial fibrillation are more common in heavier people. Here is what she found:
Patients with diabetes were 40 percent more likely to be diagnosed with atrial fibrillation than were people without diabetes.
The risk of atrial fibrillation rose by 3 percent for each additional year that patients had diabetes.
For patients with high blood sugar (glycosylated hemoglobin, also known as HBA1c more than 9 percent), the risk of atrial fibrillation was twice that for people without diabetes.
But patients with well-controlled diabetes (HBA1c 7 percent or less) were about equally likely to have atrial fibrillation as people without diabetes.
“When a patient with diabetes has symptoms like heart palpitations, clinicians should have a higher level of suspicion that the reason could be atrial fibrillation,” Dr. Dublin said. “This heart rhythm disturbance is important to diagnose, because it can be treated with medications like warfarin that can prevent many of the strokes that the atrial fibrillation would otherwise cause.”
It is hard to establish which comes first—diabetes or atrial fibrillation—with this kind of case-control study, unlike a randomized trial, Dr. Dublin said. “But our finding that the risk of atrial fibrillation is higher with longer time since patients started medications for diabetes, and with higher blood glucose levels, is strongly suggestive that diabetes can cause atrial fibrillation.” She used time since starting diabetes medication as a measure of how long patients had the disease.
Dr. Dublin’s work was funded through a Veterans’ Affairs Health Services Research & Development fellowship and a Paul Beeson Career Development Award from the National Institute on Aging. The Beeson Award is also supported in part by the American Federation for Aging Research, the Hartford Foundation, the Atlantic Philanthropies and the Starr Foundation. The National Heart, Lung, and Blood Institute funds the Heart and Vascular Health Study, which collects data on Group Health patients newly diagnosed with atrial fibrillation and other cardiovascular conditions. The study of atrial fibrillation, led by Dr. Dublin’s co-author Dr. Susan Heckbert, aims to find new factors that raise the risk of developing this quivering of the heart’s upper chambers (atria).
About one in 100 people—and nearly nine in 100 people over age 80—have atrial fibrillation, according to Dr. Heckbert, a professor of epidemiology and scientific investigator in the Cardiovascular Health Research Unit at the University of Washington (UW) and an affiliate investigator at Group Health Research Institute. In many cases, atrial fibrillation has no symptoms, and it is not necessarily life threatening. But it can cause palpitations, fainting, fatigue, or congestive heart failure. Atrial fibrillation can also make blood pool—and sometimes clot—in the atria. When parts of clots break off and leave the atria, they can lead to embolic strokes, as happens in more than 70,000 Americans a year.
Other co-authors were Group Health Research Institute Senior Investigator Bruce M. Psaty, MD, PhD, who co-directs the UW’s Cardiovascular Health Research Unit; and Nicole L. Glazer, PhD, Thomas Lumley, PhD, Kerri L. Wiggins, MS, RD, of the UW; Nicholas L. Smith, PhD, of the UW and Veterans Affairs Puget Sound Health Care System; and Richard L. Page, MD, of the University of Wisconsin School of Medicine and Public Health in Madison.
Joan DeClaire | EurekAlert!
New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM
A promising target for kidney fibrosis
21.04.2017 | Brigham and Women's Hospital
More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.
Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...
Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.
"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...
The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.
Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...
The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...
Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.
Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...
20.04.2017 | Event News
18.04.2017 | Event News
03.04.2017 | Event News
26.04.2017 | Materials Sciences
26.04.2017 | Agricultural and Forestry Science
26.04.2017 | Physics and Astronomy