Reducing Your Risk of Heart Disease When You Have Diabetes
Diabetes and Heart Disease Risk
Controlling blood glucose along with controlling cardiovascular disease (CVD) risk factors are important steps in treating diabetes, since diabetes can cause damage to the heart and blood vessels.
Millions of Americans are affected by ]]>diabetes]]>, a serious, chronic condition associated with numerous health complications. Diabetes is easy to diagnose by testing blood sugar levels. Although there is no cure, early detection, appropriate treatment, education, and a healthy lifestyle can help you avoid or delay diabetes-related complications.
Cardiovascular Disease (CVD)
]]>CVD]]> is one of the leading causes of death in the United States and the primary reason for ]]>heart attacks]]>. It is also a common complication associated with diabetes. According to the American Diabetes Association (ADA), people with diabetes are 2-4 times more likely to have CVD than the general population. Diabetes significantly increases the risk of heart attack compared to the general population.
Controlling Risk Factors: Getting Appropriate Treatment
Coronary artery disease occurs when there is a gradual build-up of plaques in blood vessels that supply blood to your heart. Over time the plaques narrow or block the arteries, limiting blood supply to the heart. Controlling risk factors that lead to CVD, can decrease your risk of having a heart attack.
High blood glucose levels can damage your heart and blood vessels and lead to CVD. Therefore, it is important to regularly monitor and control your blood glucose levels.
Cholesterol is a substance that is an important component of cell membranes as well as a building block necessary in the production of many hormones. However, abnormally high levels of cholesterol contribute to formation of fatty deposits (plaques) within the walls of blood vessels, which in turn lead to development of coronary artery disease. Cholesterol is transported through the bloodstream by high-density lipoproteins (HDL), low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL). LDL is frequently called “bad cholesterol” as it promotes accumulation of cholesterol in the walls of your arteries. Diabetes may make the LDL particles more likely to stick to and damage artery walls. HDL cholesterol is sometimes referred to as "good" cholesterol. It helps clear excess cholesterol from your body. Its level is raised mostly by regular exercise.
A report by the American College of Physicians recommends that anyone with diabetes, who also has known CVD or risk factors for CVD, take medication, specifically statins, to control cholesterol, even if cholesterol levels are currently normal.
Narrow blood vessels are one reason for high blood pressure (eg, ]]>hypertension]]>). Because ]]>high blood pressure]]> can make some of the complications of diabetes worse, the American Diabetes Association recommends aggressive treatment of hypertension for people with diabetes.
The primary groups of medications recommended to treat high blood pressure in diabetics are angiotensin converting enzyme inhibitors (ACE-inhibitors) or angiotensin receptor blockers (ARBs) which may provide additional protection for the cardiovascular system and the kidneys beyond simply reducing the blood pressure.
Controlling Risk Factors: Lifestyle Modifications
In addition to using medication to control cholesterol, blood pressure, and blood glucose levels, modifying certain lifestyle factors is essential for reducing the complications associated with diabetes and improving your length and quality of life.
Work with your doctor to devise an eating plan that you can follow. Include foods that are low in saturated fat and cholesterol, and high in fiber; consume salt and alcohol in moderation; choose fats that help lower cholesterol; and eat five servings of ]]>fruits and vegetables]]> every day. A ]]>healthy diet]]> can help manage your CVD risk by lowering your blood pressure, cholesterol, and blood glucose levels.
Being physically active every day for 30 minutes or more will have broad health benefits. Find ways to incorporate extra movement into your day—walk briskly for 30 minutes, take the stairs instead of the elevator, or park a little farther away from your destination than usual. Start slowly and build up your strength and endurance. Being physically active can be very enjoyable, and it’s good for your health!
Eating a healthy diet, reducing your calorie intake, and increasing your physical activity will all help you lose weight if needed. Weight loss and increased activity can also increase your healthy HDLs.
If you are thinking about ]]>quitting]]>, there are many smoking cessation programs and support groups which can help you. The benefits of quitting are both immediate and long-lasting.
Educate yourself about diabetes and how you can control it. There are many sources of information and organizations dedicated to managing and preventing this disease. Work closely with your healthcare team to monitor your health and help you address your individual health issues.
American Diabetes Association
American Heart Association
National Diabetes Education Program
Canadian Cardiovascular Society
Canadian Diabetes Association
Complications of diabetes in the United States. American Diabetes Association website. Available at: http://www.diabetes.org/diabetes-statistics/complications.jsp. Accessed June 12, 2009.
Gilbert S. Looking beyond sugar to the heart. New York Times. June 6, 2004. Special Section: Women’s Health.
Howard BV, Cowan LD, Go O, et al. Adverse effects of diabetes on multiple cardiovascular disease risk factors in women: the Strong Heart Study. Diabetes Care . 2004; 21(8).
Hu FB, Stampfer MJ, Solomon CG, et al. The impact of diabetes mellitus on mortality from all causes and coronary heart disease in women. Archives of Internal Medicine. 2001;161(14):1717-1723.
National Diabetes Information Clearinghouse. Prevent diabetes problems: Keep your heart and blood vessels healthy. National Institutes of Diabetes and Digestive and Kidney Diseases. Updated September 2003.
National diabetes statistics, 2007. National Diabetes Information Clearinghouse website. Available at: http://diabetes.niddk.nih.gov/DM/PUBS/statistics/. Published June 2008. Accessed June 12, 2009.
Tanasescu M, Cho E, Manson JE, et al. Dietary fat and cholesterol and the risk of cardiovascular disease among women with type 2 diabetes. American Journal of Clinical Nutrition. 2004;79(6).
Sandeep V, Haywood RA. Pharmacologic lipid-lowering therapy in type 2 diabetes mellitus. Annals of Internal Medicine. 2004;(8)140.
Webster’s New World Medical Dictionary. Foster City, CA: IDG Books Worldwide; 2000.
6/5/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/what.php : Bulugahapitiya U, Siyambalapitiya S, Sithole J, Idris I. Is diabetes a coronary risk equivalent? Systematic review and meta-analysis. Diabet Med. 2009;26:142-148.
Last reviewed May 2010 by ]]>Brian Randall, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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