Lifestyle Changes Work as Well as Surgery for Type 2s Who Have Artery Disease


By: Patrick Totty

The combination of type 2 diabetes and mild heart disease is a double whammy that in many cases leads to such intrusive therapies as angioplasty* and can result in death from some sort of cardiovascular event. But a five-year university study of 2,368 type 2 patients with moderate heart disease shows that lifestyle changes and non-intrusive treatments can work just as well at lowering mortality rates as surgery.

Researchers at Saint Louis University School of Medicine, publishing their findings in Circulation, a journal of the American Heart Association, reported that that careful management of lifestyle choices and drug therapies gives type 2s with heart disease a much better chance of avoiding death from the disease than previously believed.  

Researchers set out to determine which surgical procedure is the best option for type 2s with heart disease-“revascularization” via angioplasty or heart bypass. The “Bypass Angioplasty Revascularization Investigation 2 Diabetes” study began following patients who were receiving their physician-recommended treatments, along with intensive medical treatments that included weight control, cholesterol and blood pressure drugs, blood sugar management, and smoking cessation.

The Saint Louis team found that type 2s following that regimen were no more likely to die from heart disease after five years than type 2s who had undergone angioplasty. Almost 5 percent of patients from both groups died from heart disease within five years.

However, the team found that in type 2s with more serious cases of heart disease, intense medical therapy worked best if accompanied by coronary bypass surgery. Of study group patients who received both treatments, 16 percent died or had a heart attack within five years, while 22 percent of patients who received only nonsurgical therapies died or suffered heart attacks. 

The study concluded that the existence of blocked arteries in type 2s may not always call for angioplasty. The success of lifestyle changes and drug therapy in alleviating blockages in some patients is a hopeful sign.

*Angioplasty clears a blocked artery by inserting a balloon into it and then inflating it. The inflation forces apart arteries walls and restores the free flow of blood through the artery.

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