Diabetes Test for Your Heart

Hemoglobin A1C test helps predict heart disease in diabetes patients

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) If you have diabetes, it is important to keep track of your blood sugar levels. The A1C test is the best measure of blood sugar, but it may also let you know about risks to your heart health.

The hemoglobin A1C test is an effective way to predict the risk for heart disease in diabetes patients. However, the level of risk differs among patients with diabetes.

"Take the A1c test if you have diabetes."

According Nina P. Paynter, Ph.D., from Brigham and Women's Hospital in Boston, and other authors of the study, the presence of diabetes on its own was not a good measure of heart disease risk. When the researchers used the A1C test on diabetes patients, their ability to predict heart disease risk improved.

Current guidelines say that diabetes alone puts patients at high risk for coronary heart disease, writes Mark J. Pletcher, M.D., M.P.H., from the University of California, San Francisco. The findings by Paynter and colleagues show that different diabetes patients have different levels of risk for heart disease. Using the A1C test may help doctors see this difference in risk.

Pletcher points out that the guidelines are going to be updated soon, so these findings might be considered during the update process.

For their study, Paynter and colleagues used data from 24,674 women and 11,280 men. At the beginning of the study, 685 of the women and 563 of the men had diabetes. Questionnaires gave information on participants' health history. The researchers also took blood samples to measure levels of cholesterol, C-reactive protein (a protein that can show diabetes risk), hemoglobin A1C.

Over the course of the study, 125 cardiovascular events (any incident that may hurt the heart) occurred in the 685 women with diabetes. Among the 563 men with diabetes, 170 cardiovascular events happened.

When results from the A1C test were included in the calculation of heart disease risk, prediction of heart disease was much better than saying all diabetes patients had a high risk.

Using the A1C test especially helped for women. About 72 percent of women with diabetes had less than a 20 percent risk for heart disease over a 10-year period. In other words, using the current guidelines that all diabetes patients are high-risk, 72 percent of women would have to make fairly extreme lifestyle changes to lower cholesterol when they might not have to do so.

Using the A1C test, 24.5 percent of men with diabetes had less than a 20 percent risk for heart disease over a 10-year period.

Put simply, the A1C test led to great improvements in predicting heart disease in women, and led to modest improvements in predicting heart disease in men.

The results of this study appear in the Archives of Internal Medicine.

Reviewed by: 
Review Date: 
July 26, 2011
Last Updated:
July 27, 2011