Heart health - The Diabetes-Heart Disease Connection

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Heart health
Author Info: Turner, Polly
Reviewer Name: Whorton, Donald, M.D.
Date Last Reviewed: 01-14-2008
Published Date: 01-14-2008
Healthline

Did you know that if you have diabetes, you have a two to four times greater risk for heart disease and stroke than people without diabetes? In fact, you’re more likely to experience a heart attack, stroke, or another cardiovascular health problem than any other complication of diabetes, says the Centers for Disease Control and Prevention.

Once you know the risk to your heart health, you can start focusing on something positive: You can take steps right now to keep your heart pumping soundly and your blood flowing smoothly. To help bring down your risk for heart disease and keep your diabetes under control, get to know the ABCs of diabetes:

* A is for A1C levels—a measure of your average blood-sugar levels over the past three months.
* B is for Blood pressure levels.
* C is for Cholesterol levels.

When you’re living with diabetes, closely monitoring your blood sugar, blood pressure, and cholesterol levels and aiming to keep them within a healthy range is like checking the levels of gasoline, oil, and transmission fluid in your car to prevent a breakdown. Not only can knowing your ABCs help lower your heart attack risk, it also can help prevent other possible complications of diabetes, such as amputation, kidney disease, or blindness.

“This is all about preventing complications,” says Marcy Bergeron, R.N., M.S., A.N.P., a nurse practitioner in Boston. “High blood sugar, high blood pressure, and high cholesterol don’t necessarily make us feel sick. The real reason for keeping these levels as normal as possible is to prevent what can happen if we don’t. Heart disease and stroke are the leading killers of people with diabetes.”
The link to heart disease

Diabetes doesn’t necessarily cause heart disease, and heart disease doesn’t cause diabetes, although the two conditions are often found together. People with uncontrolled diabetes have elevated levels of blood sugar, and according to Bergeron, this leads to a complex inflammatory process that affects the lining of the veins and arteries and speeds up the development of atherosclerosis, or hardening of the arteries.

With atherosclerosis, arteries and blood vessels become clogged with plaque. They also become narrow and prone to blockage, which eventually can lead to heart attack or stroke.

When the effects of high blood sugar are combined with the damaging effects of high cholesterol levels and high blood pressure, atherosclerosis tends to develop even faster.

“Your heart and circulatory system end up under a lot of strain,” says Bergeron. “We know that 10 years before a diagnosis of diabetes, some of the changes in the cardiovascular system have already started, so early diagnosis is key.”

Therefore, be sure your health care provider regularly monitors you for cardiovascular disease.

How can you put the ABCs into action? According to Bergeron, these are the best steps you can take to control your diabetes and lower your risk for heart disease:
Control blood sugar

Keep blood sugar under control by closely monitoring your glucose levels, and keep them as close to normal as possible through diet, exercise, and medication. This includes monitoring your blood sugar each day and checking your hemoglobin A1C level at least twice a year, aiming to keep it below 7 percent.

"We know that maintaining blood sugar as close to normal levels as possible is our strongest tool against complications over time,” says Bergeron.
Monitor your blood pressure

Have your blood pressure checked at every doctor visit or more often, and take steps to reduce it if it’s above 130/80. Buying a home blood-pressure monitor can give you even more control.
Check your cholesterol

Have your blood cholesterol levels checked at least once a year. Aim to keep your LDL cholesterol level at 100 or below.
Take your medications

Take any drugs prescribed for controlling your blood sugar, blood pressure, or blood cholesterol as instructed. Make them part of your daily life. Talk with your health care provider before changing or discontinuing their use—and ask about aspirin therapy to prevent heart disease.
Make a few changes

Adopt healthy lifestyle changes to keep the ABCs under control. With or without medication, it’s critical to your health that you:

* Lose weight if you’re overweight.
* Aim for 30 minutes a day of physical activity, five days a week.
* If you smoke, quit.
* Drink alcohol only in moderation.

“These basic steps can help you with both diabetes and heart disease—so you get a double bang for your buck,” says Bergeron.
Turn to your team

Ask your health care team for advice and support in lowering your risks. Have your eyes examined at least once a year to help prevent blindness; get a flu shot every year, since people with diabetes are more prone to infection; have a regular foot exam with a podiatrist and wear good-fitting, comfortable footwear to maintain your foot health.

“We can delay or completely eliminate some of the complications of diabetes, including heart disease, by paying attention to all these self-management issues,” says Bergeron. “We know more about diabetes today than we ever knew, and we have more treatment options as well.”