Diabetes and Heart Disease
What is the link between diabetes and heart disease?
Having diabetes means that there is too much sugar (glucose) in your blood. If blood sugar stays high for a long time, the inner lining of blood vessels may be damaged. This makes it easier for fatty deposits called plaque to build up in the blood vessels that bring blood to the heart. The plaque makes the blood vessels narrower. The narrowing decreases blood flow to the heart muscle. Small pieces of plaque may break off from the wall of a blood vessel and completely block a smaller blood vessel. This can cause chest pain (called angina), heart attack, or stroke.
Diabetes can also weaken the heart muscle. This can cause heart failure, which means that the heart is not able to pump enough blood to the body.
If you have diabetes:
- You are 2 to 4 times more likely to have a heart attack or stroke than someone without diabetes. You are also more likely to have a heart attack or stroke at a young age.
- If you have a heart attack, you are more likely to die from the heart attack.
How can I lower my risk?
Here are some of the things you can do to lower your risk of heart disease:
- Control your blood sugar. Keeping your blood sugar level in the proper range can prevent or delay blood vessel damage.
- Control your blood fats (cholesterol and triglycerides). Unhealthy levels of blood fats cause heart disease. This effect happens faster and is usually worse when you have diabetes. People with diabetes often have high levels of triglycerides and low levels of HDL (good cholesterol). Talk to your provider about what are healthy blood fat levels for you and what your heart disease risk is. You can improve your blood fat levels with a healthy diet, regular daily exercise, and keeping a healthy weight.
Your provider may recommend changes in your lifestyle or prescribe medicine to control your blood fats.
- Control your blood pressure. High blood pressure puts a lot of stress on your body and can damage blood vessels. It makes your heart work harder to pump blood, which carries oxygen to your body. Nearly two-thirds of adults with diabetes have high blood pressure. Ask your healthcare provider what a healthy blood pressure should be for you. Many people with diabetes need to use 2 or more medicines to keep their blood pressure at that the proper level.
- Carry insulin or emergency medicine, such as nitroglycerine or glucose tablets, with you and know how to take them properly. It also helps to have a list of the names and doses of medicines that you are taking and the instructions for taking them.
- Lose weight if you are overweight and stay at the lower weight. Weight loss can make it easier to control your blood sugar and blood pressure. It can lower your risk of heart disease.
- Exercise regularly according to your healthcare provider’s instructions. Regular exercise can help you lose weight and control your blood sugar level. It also helps lower your risk of heart disease.
- If you smoke, try to quit. When you have diabetes, smoking triples your risk of dying from heart problems.
Your provider may recommend a daily low dose of aspirin. Taking an aspirin every day may lower your risk for a heart attack or stroke. Not everyone should take aspirin. Daily use of aspirin can cause problems, such as stomach irritation, bleeding, and hearing loss. Ask your healthcare provider if you should take aspirin and if so, how much to take.
Talk with your healthcare provider about any questions you have. Follow the treatment plan your provider prescribes.
Diabetes and Heart Disease: References
Maahs DM, Daniels SR, de Ferranti SD, et al. (2014). Cardiovascular disease risk factors in youth with diabetes mellitus: a scientific statement from the american heart association. Circulation;130(17):1532-1558.
Buse JB, Ginsberg HN, Bakris GL, et al. (2007). Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation;115(1):114-126.
James PA, Oparil S, Carter BL, et al. 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults: Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311(5):507-520. doi:10.1001/jama.2013.284427.
Evidence Supporting a Systolic Blood Pressure Goal of Less Than 150 mm Hg in Patients Aged 60 Years or Older: The Minority View. Wright JT, Fine LJ, Lackland DT, et al. Annals of Intern Med. 2014
J Am Coll Cardiol. 2013 Nov 7. pii: S0735-1097(13)06028-2. doi: 10.1016/j.jacc.2013.11.002. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz CN, Lloyd-Jones DM, Blum CB, McBride P, Eckel RH, Schwartz JS, Goldberg AC, Shero ST,Gordon D, Smith SC Jr, Levy D, Watson K, Wilson PW.