The role of diabetes mellitus in cardiac disease in Spain. The CARDIOTENS Study 1999

We analyse the characteristics of the patients with diabetes and cardiac disease included in the CARDIOTENS 1999 study. 32,051 outpatients who were seen the same day by 1,159 primary healthcare physicians (79%) and cardiologists (21%) were prospectively registered in a database including demographic and clinical data and therapeutic profile. History of cardiac disease was present in 19% (6,194 patients) of the whole population, and 1,275 of them (20.6%) were diabetics. Hypertension was present in 74% of diabetic patients with cardiac disease. Coronary heart disease (angina pectoris or previous myocardial infarction) was present in 45% of diabetic patients with heart failure. Less than 30% of these patients had blood pressure levels under 130/85 mmHg, as recommended by international guidelines. An LDL-cholesterol level lower than 100 mgrs/dl was observed in only 12% of diabetic patients with coronary heart disease; the mean values of total cholesterol and LDL-cholesterol of these patients were significantly (p < 0.01) higher in those seen by primary healthcare physicians. Less than 40% of diabetic patients with cardiac disease were treated with an angiotensin converting enzyme inhibitor, a therapy which was otherwise used in 50% of diabetic patients with heart failure. A beta-blocker therapy was used in 26% of diabetic patients with coronary heart disease and 39% of them were being treated with statins. More than 20% of patients with cardiac disease in this study were diabetics. Blood pressure and cholesterol levels recommended by current guidelines were attained in a limited proportion of these patients. The use of drugs with demonstrated prognostic benefit in diabetic patients with heart disease is scarce.