Cardiovascular Disease: A Major Complication of Diabetes

Cardiovascular disease is a major complication of diabetes and the leading cause of premature death in people with diabetes. An adult with diabetes is two to four times more likely to develop heart disease or suffer a stroke than someone who does not have diabetes. In fact, more than 65 percent of deaths in people with diabetes are attributed to heart and vascular disease.

This is all more alarming when you consider that recent studies found that two-thirds of all people with diabetes do not consider heart disease a serious complication. Because majority of people with diabetes have cardiovascular risk factors that can be treated, such as high blood pressure or abnormal lipid (blood fat) levels, it is important that the connection between heart disease and diabetes be better understood.

The American Diabetes Association has launched an initiative called “Make the Link” that encourages health care providers to talk with their patients about the link between diabetes, cardiovascular disease, and stroke. The key components of diabetes care include control of blood glucose levels, blood pressure, and lipids. This triad of care often is referred to as the “ABC’s of Diabetes.”

A– stands for A1C (A1C measures blood glucose control over the prior two to three months).

B– stands for blood pressure and blood glucose.

C– stands for cholesterol and lipids (blood fats).

What is the link between diabetes and heart disease?

The cardiovascular complications of diabetes are caused by changes in cholesterol that lead to deposits (plaque) on the inner walls of blood vessels. Over time, this build-up of plaque can cause the blood vessels to narrow or even become completely blocked. This is called atherosclerosis. Diabetes and high blood pressure promote the process of atherosclerosis and increase the risk of having a heart attack or a stroke.

What are the risk factors for developing cardiovascular disease?

• Age: Over 45 years old (male) and over 55 years old (female)
• Family history of heart disease
• Smoking
• High blood pressure
• High total cholesterol
• Low HDL (good) cholesterol
• High LDL (bad) cholesterol
• High triglycerides (a blood fat commonly elevated in people with diabetes and linked to heart disease)
• Little to no daily exercise
• Diabetes

Of course, the more risk factors that are present, the greater the likelihood is of developing cardiovascular disease. You can decrease your risk by managing your risk factors.

WHAT ARE MY BLOOD PRESSURE AND CHOLESTEROL GOALS?

• Health goal Desired level*
• Blood pressure Less than 130/80 mmHg
• Total cholesterol Less than 200 mg/dL
• LDL cholesterol Less than 100 mg/dL
• HDL cholesterol Men: greater than 45 mg/dL
• Women: greater than 55 mg/dL
• Triglycerides Less than 150 mg/dL
• A1C Less than 7%
• *ADA recommendations

HOW CAN YOUR PHARMACIST HELP YOU MAKE THE LINK?

Talk with your pharmacist about the ABC’s of diabetes and how to keep your A1C, blood pressure, blood glucose, and cholesterol levels in your target ranges. He or she can make suggestions to help you adopt a healthier lifestyle and reduce your risk of developing heart disease and stroke. He or she can also explain how medications may help you control your blood pressure, cholesterol, and triglyceride levels.

Your pharmacist can help you learn these keys to better health:

 1. A healthy eating plan.

 2. Reducing fat in your diet. Try some of these tips:

• Broil, bake, steam, barbecue, or microwave, instead of frying.
• Season with herbs and lemon juice rather than with butter or margarine.
• Choose products that are fat-free or low-fat.
• Choose lean cuts of meat and trim off fat.
• Eat small servings of meat, fish, and poultry.
• Avoid bacon, sausage, fatty lunch meats, and other processed meats.
• Remove the skin from turkey and chicken.

3.  Increasing fiber in your diet

• Eat five or more servings of fresh vegetables and fruits a day.
• Choose whole-grain breads and grains, such as oatmeal, bulgar, and brown rice.
• Try fiber supplements to help you meet the recommended daily fiber intake of grams per day.

4.  Lowering cholesterol with products that contain plant stanols and sterols. Brand names are Benecol® and Take Control®. Other products also include margarine spreads and oral supplement called Cholest-Off®made by NatureMade.

 5. Becoming more active. Health guidelines recommend participating in 30 minutes of moderate activity most days of the week. Check with your healthcare provider before beginning an exercise program.

 6. Reaching or maintaining a healthy weight

 7. Checking your blood glucose regularly.

 8. Taking your medications as prescribed.

 9. Quitting smoking.

10.  Undergoing aspirin therapy. Check with your healthcare provider if this suits you.