Learn about the link between diabetes and heart disease

When you have diabetes, checking your blood sugar is a priority, but also pay close attention to what's happening to your heart and blood vessels. Cardiovascular disease is the most common and most serious complication of diabetes, increasing your risk of heart attack and stroke.

The good news is you can reduce this risk by managing your blood sugar and blood pressure, controlling cholesterol and making healthy lifestyle changes through diet, exercise and sometimes medications, when needed.

Diabetes can damage your blood vessels, including the arteries that supply blood to your brain and heart. This damage makes it easier for fatty deposits (plaques) to form in the arteries. This buildup of arterial plaque can choke off blood supply and drive up your blood pressure.

Why diabetes is called a heart disease equivalent:

• You're at a higher risk to have a heart attack or stroke than someone without diabetes.

• You're more likely to die of a heart attack than if you did not have diabetes.

• Your risk of sudden death from a heart attack is the same as that of someone who has already had a heart attack.

Most people with diabetes aren't aware they're at an increased risk of heart attack and stroke. Rather, many people with diabetes believe that foot or leg amputation and blindness are their biggest threats.

For who don't have diabetes, heart disease speaks loud and clear. Inadequate blood flow to the heart muscle causes chest pain or pressure, a pounding heartbeat, shortness of breath, jaw or arm pain, and sweating. People with these signs and symptoms know something's wrong and are likely to seek help.

In people with diabetes, however, the symptoms of heart disease are not as noticeable, so you may not seek medical care until more serious complications have occurred. In other words, you can have a "silent" heart attack and not know it.

Being proactive about your health is key. You can be empowered with the help of your healthcare team and, yes, you can take key actions to help lower your risk of heart disease if you have diabetes.

• Keeping blood sugar levels within optimal ranges can prevent or delay blood vessel damage. The best way to assess blood sugar level over time is the hemoglobin A1C test. It reflects your average blood sugar control over the last three months. The goal is a hemoglobin A1C level of less than seven. If it is seven or higher, a physician will need to adjust the diabetes treatment. Also, keep blood pressure in check.

• High blood pressure can lead to a variety of cardiovascular complications for anyone, not just people with diabetes. However, for those with diabetes, these complications are more severe. The goal is a blood pressure lower than 120/80. If blood pressure is higher, a physician likely will prescribe medication to bring it down.

• Unhealthy cholesterol and triglycerides also can cause cardiovascular disease in anyone, with or without diabetes. But again, the damage is usually worse and more rapid with diabetes. For those with a higher risk of heart disease, targets are as follows: LDL ("bad" cholesterol) should be below 70; HDL ("good" cholesterol) should be above 50 for women and above 40 for men; and triglycerides should be below 150. If necessary, medications can be used to reach these goals.

Blood sugar, blood pressure and cholesterol aren't the only things that can lead to cardiovascular disease. Lifestyle choices like poor eating habits, inactivity, smoking, stress and alcohol also can add to the risk.

Understanding the strong link between diabetes and cardiovascular disease is an important step in preventing life-threatening complications. Talk to your healthcare team about your risk factors, how you can change them and about periodic assessments, which will help determine if you're meeting your goals.

(Lilly Negron is a clinical exercise physiologist in the Cardiopulmonary department at Flagstaff Medical Center. Information in this article was provided by Mayo Foundation for Medical Education and Research .

Is there a health topic you'd like to know more about? Please write to Mountain Medicine, c/o Flagstaff Medical Center, Public Relations, 1200 North Beaver Street, Flagstaff, AZ 86001, or visit FMC's Web site at www.FlagstaffMedicalCenter.com. For more information, please see your physician.)

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