A surprising reason why people get heart attacks

This article presents a study showing why people not previously diagnosed with diabetes get heart attacks.[1]

Diabetes is a risk factor for Acute Coronary Syndromes (ACS). ACS includes those with heart attacks and those who almost have heart attacks suffering chest pains due to an occluded coronary artery.

Having diabetes increases the risk factor for a heart attack, like smoking, hypertension, and obesity.

In the study made in Japan, they found that many people who are not diabetic and have a heart attack have glucose intolerance.

Diabetes blood sugar tests

Glucose intolerance, including prediabetes and diabetes, is tested by the Oral Glucose Tolerance Test (OGTT), where 75 gms of glucose is ingested, and the blood sugar is tested after two hours.

According to the American Diabetes Association,

A normal blood glucose level is below 140 mg/dL (7.8 mmol/L).
Prediabetes or Impaired Glucose Tolerance is present if the blood glucose level is between 140 and 199 mg/dL (7.8 and 11 mmol/L),
A diagnosis of diabetes is most likely if the blood glucose level is 200 mg/dL (11.1 mmol/L) or higher.

Seventy-five grams of glucose may seem like a lot. However, a 12-ounce can of soda contains 39 grams of sugar. According to the USDA, 100 gm of cooked white rice has 28 gms of carbohydrates immediately converted to sugar, and so is a bagel with 68 gms of carbs.

The study involved 134 patients who were not diagnosed with diabetes and were treated for Acute Coronary Syndromes. 89 patients had an acute myocardial infarction, and 45 had unstable angina.

Before their discharge, three blood tests were done to know if any of them had diabetes.

They were the Fasting Blood Sugar, the Hemoglobin A1c, and the Oral Glucose Tolerance Test.

Fasting blood sugar is done after at least an eight-hour fast. It is commonly used as a screening test for diabetes. Many people get this done when their doctors order a routine blood test.

A fasting blood sugar level of less than 100 mg/dL (5.6 mmol/L) is normal.
Prediabetes is a fasting blood sugar level between 100 and 125 mg/dL (5.6 and 6.9 mmol/L).
If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes.

The Hemoglobin A1c measures the average blood sugar in the preceding three months.

The normal range for the hemoglobin A1c level in people without diabetes is between 4% and 5.6%.
Hemoglobin A1c levels between 5.7% and 6.4% mean you have prediabetes and a higher chance of getting diabetes.
Levels of 6.5% or higher mean you have diabetes.

Results

There were no significant differences among the groups in sex, diagnosis, Body Mass Index, the prevalence of hyperlipidemia, current smoking, obesity, or family history.

The total cholesterol, triglycerides, HDL, and LDL levels did not differ across the three groups. Hypertension was more common in diabetic subjects than those with normal glucose tolerance or prediabetes.

All patients had normal fasting blood sugar. The HbA1c was normal in 90% of the patients.

Among those with impaired glucose tolerance (prediabetes and diabetes patients), most, n = 45, 33.6% or 89% of all IGT, had normal fasting plasma glucose.

However, Prediabetes and diabetes were found in 50 (37%) and 13 patients (10%), respectively.

The significance of the findings is that many of these patients did not know they were at high risk for developing heart attacks even if they regularly had routine fasting blood sugar tests and even an HbA1c to screen for diabetes.

That’s because OGTT is not routinely ordered.

The findings in this study are in line with other research that I talked about in

What can be done?

Anyone can screen for prediabetes at home. An inexpensive glucometer, like the Care Touch Blood Glucose Monitor Kit, includes One Glucometer, 100 Blood Sugar Test Strips, 1 Lancing Device, and 100 Lancets.

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The $34 cost is less than a copay for most emergency room visits, the succeeding cardiologists’ consultation, and loss of income after a heart attack.

Blood sugar can be tested two hours after a meal. If it is more than 140mg/dl or 7.8 mmol/L, there is a risk of prediabetes, and your physician should be informed. They may order an oral glucose tolerance test to confirm prediabetes.

In the meantime, there are ways to prevent glucose spikes. Lifestyle changes can be made that would prevent acute coronary syndromes, strokes, and other diseases associated with diabetes. Recall that having prediabetes makes a person more likely to develop diabetes.

I have been testing my blood sugar after high-carb and low-carb meals with and without walking, and I find the methods presented in the abovementioned articles are effective. I got 137, 138, and 122 mg/dl results.

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Reference:

Hashimoto K, Ikewaki K, Yagi H, Nagasawa H, Imamoto S, Shibata T, Mochizuki S. Glucose intolerance is common in Japanese patients with acute coronary syndrome who were not previously diagnosed with diabetes. Diabetes Care. 2005 May;28(5):1182-6. doi: 10.2337/diacare.28.5.1182. PMID: 15855586.

As an Amazon Associate, I earn from qualifying purchases.