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Simple Test Points to Diabetics' Heart Risks
posted 02/13/04
A "cold pressor" test, which involves immersing hands in ice water for 2 minutes, can tell doctors if a person with type 2 diabetes is likely to experience heart problems, even when there are no other risk factors presents.
The "cold pressor test is a very simple method" to show if arteries are functioning properly or not says lead investigator, Dr. Alain Nitenberg.
Nitenberg, of University Hospital Jean Verdier in Bondy, and colleagues note in the January issue of Diabetes Care that the test causes coronary arteries to expand in healthy people, while in diabetics it constricts coronary arteries.
To determine whether this might be a useful means of detecting increased cardiovascular risk, the researchers studied 72 diabetes patients without other major coronary risk factors and a comparison group of 56 "control" participants.
The average change in the diameter of the coronary arteries was an increase of 17.2 percent in controls. In diabetics, the corresponding response was a 14.4 percent decrease.
No changes were seen in 8.9 percent of controls and none showed constriction. No changes were seen in 26.4 percent of diabetics and none showed dilation.
After 45 months, there were 26 cardiovascular events -- heart attack, severe angina or stroke, for example -- in 18 diabetic subjects, but only one cardiovascular event in the control group.
Furthermore, 23 of the events in diabetic patients occurred in 16 of the 53 who showed coronary artery constriction. The remaining three occurrences were in 2 of the 19 diabetic patients who had had no diameter change.
Thus, the researchers conclude, constriction of seemingly normal coronary arteries in response to the cold pressor test predicts cardiovascular problems.
Nitenberg added that the method "does not require drug administration or an intravascular device." It also might be used as "an easy means to evaluate the efficiency of therapy in high-risk patients."
Source: Diabetes In Control.com: Diabetes Care, January 2004.
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