Good points, Mattam!
From the OP, which seems to be a fairly news worthy report:
“After one year, 7% in the invasively treated group had one of those events versus 5% of those on medicines alone. At four years, the trend reversed — 13% of the procedures group and 15% of the medicines group had suffered a problem. Averaged across the entire study period, the rates were similar regardless of treatment.”.
From the previous link I supplied re: diabetes and heart disease: “Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes.
The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease………………….Abnormal cholesterol and high triglycerides
Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia ……………………..”.
So, the “bad” group from my OP, that had invasive procedures, had a 7% rate of bad cardiac/stroke events, and the “good” group had only 5%, leaving the bad group with a 40% worse rate of events during the 1st year, but that trend reversed after 4 years, with the medicine only group running 15% more bad events than the treatment group. IOW, a wash, or almost. The difference is not big, but I guess what is news worthy is that looking at large numbers, there is no big advantage as far as bad events to having the riskier procedure.
However, in the link on diabetes vs heart disease, the diabetics are 200 to 400% more at risk to die from heart disease than the non diabetics. And there is also this: “Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That's because people with diabetes, particularly type 2 diabetes, may have the following conditions that contribute to their risk”. IOW, it is not enough to simply get the blood sugar under control using treatment via drugs. Why? Because the insulin remains just as high or higher(you might even be injecting more insulin!)
It does no good- or not enough good- to simply end up with a better looking sugar # by attacking it with drugs. The damage behind the scenes is still going on. Just as “curing” pain with a stent might not be good enough, because in both cases the underlying problem should be addressed before it causes more problems.
And it is quite likely that the underlying problem is the same in both cases whether prediabetis, diabetes or the heart disease they appear to cause: to much sugar/carb input, leading to too much blood insulin.
The “bad” treatment might have 40% more bad events in the first year than meds only, only to end up a winner by a small amount at 5 years. The diabetes characterized by high blood insulins has 200-400% more bad events, and can be controlled by diet, maybe leading to no need for the procedures in the first place. Which one should we be most concerned about
? Especially as so many of us(about
1 in 3 adults prediabetic) are on our way to diabetes? And, oh yes, almost forgot: there is that pesky relationship of these same underlying causes with cancer.
Post Edited (BillyBob@388) : 11/19/2019 8:13:12 PM (GMT-7)