Heart disease is common in people with diabetes.
Data from the National Heart Association from 2012 shows 65% of people with diabetes will die from some sort of heart disease or stroke. In general, the risk of heart disease death and stroke are more than twice as high in people with diabetes. While all people with diabetes have an increased chance of developing heart disease, the condition is more common in those with type 2 diabetes. In fact, heart disease is the number one cause of death among people with type 2 diabetes. (1)
The Framingham Study was one of the first pieces of evidence to show that people with diabetes are more vulnerable to heart disease than those people who did not have diabetes. The Framingham Study looked at generations of people, including those with diabetes, to try to determine the health risk factors for developing heart disease. It showed that multiple health factors including diabetes could increase the possibility of developing heart disease. Aside from diabetes, other health problems associated with heart disease include high blood pressure, smoking, high cholesterol levels, and a family history of early heart disease. (2)
What Causes Heart Disease in People with Diabetes?
- High blood pressure (hypertension)
High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles. (3)
- 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 in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes.
Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure. (4)
- Lack of physical activity
Physical inactivity is another modifiable major risk factor for insulin resistance and cardiovascular disease. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke. It’s likely that any type of moderate and/or vigorous intensity, aerobic physical activity—whether sports, household work, gardening or work-related physical activity—is similarly beneficial.
For overall cardiovascular health, the American Heart Association recommends:
At least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week (or an equivalent combination of moderate-and vigorous-intensity activities), plus moderate-to high-intensity muscle-strengthening activity at least 2 days per week for additional health benefits. (5)
- Poorly controlled blood sugars (too high) or out of normal range
Diabetes can cause blood sugar to rise to dangerous levels. Medications may be needed to manage blood sugar.
Smoking puts individuals, whether or not they have diabetes, at higher risk for heart disease and stroke. Learn how to kick the habit.
What Are Some Symptoms of a Heart Attack?
The symptoms of a heart attack include:
- Shortness of breath.
- Feeling faint.
- Feeling dizzy.
- Excessive and unexplained sweating.
- Pain in the shoulders, jaw, and left arm.
- Chest pain or pressure (especially during activity).
Remember not everyone has pain and these other classic symptoms with a heart attack. This is especially true for women. (6)
How Can Heart Disease Be Prevented in a Person With Diabetes?
The best way to prevent heart disease is to take good care of yourself and your diabetes.
- Keep your blood sugar as normal as possible.
- Control your blood pressure. The target for people with diabetes is under 130/80.
- Get your cholesterol numbers under control. You may need to take medication to do this.
- Lose weight if you are obese.
- Ask your doctor if you should take an aspirin a day.
- Exercise regularly.
- Eat a heart-healthy diet such as the Mediterranean diet or DASH diet.
- Quit smoking.
- Work to reduce daily stress. (7)
The most common cause of heart disease in a person with diabetes is hardening of the coronary arteries or atherosclerosis, which is a buildup of cholesterol in the blood vessels that supply oxygen and nutrition to the heart. Not only are people with diabetes at higher risk for heart disease, they’re also at higher risk for heart failure, a serious medical condition in which the heart is unable to pump blood adequately. This can lead to fluid build-up in the lungs that causes difficulty breathing, or fluid retention in other parts of the body (especially the legs) that causes swelling.
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