Diabetes and your Heart

Reviewed by Di Bush, PhD

Unfortunately, people with diabetes are more likely to have a heart attack than people without diabetes. But there are five simple steps you can take to help lower your risk for heart disease. It is important to establish a target for each step, to know your numbers and to work with your health care provider to achieve these targets. You may need to make ongoing changes to your health care routine, including the medicines you take, to achieve your established targets. If you work hard and reach these targets, you will reduce your risk of developing heart disease.

A heart attack happens when blood flow to the heart is interrupted and the heart doesn’t get the oxygen it needs. The blood flow is interrupted when the blood vessels that provide oxygen become diseased and narrowed because of a plaque. This narrowing is called Coronary Artery Disease, or more generally, just heart disease. Since people with diabetes are more likely to have a heart attack than people without diabetes, you must work to keep your heart as healthy as possible. Even if you don’t have diabetes, it is still important for you to keep your heart healthy.

5 Steps to reducing your risk for heart disease

  1. Lower your blood glucose to as close to normal as possible
  2. Lower your blood pressure
  3. Lower your blood lipids (cholesterol and triglycerides)
  4. Don’t smoke. If you do smoke, quit.
  5. Take one baby aspirin (81mg) per day.

1. KEEPING YOUR Blood Glucose IN A HEALTHY RANGE

Managing your blood glucose may prevent or delay blood vessel damage. The American Diabetes Association (ADA) recommends the following ranges for adults with diabetes:

  • A1C under 7%
  • Blood glucose before meals of 70-130 mg/dL
  • Blood glucose 2 hours after meals below 180 mg/dL

It is important to check your blood glucose at home every day and keep a log to take to your health care provider. Blood glucose changes day to day and over time. Often oral medicines and/or insulin are necessary to achieve your target blood glucose. Your health care provider will work with you in making changes so you can achieve your best possible blood glucose level, thereby helping to reduce the chance of heart disease.

2. Controlling Blood Pressure

People with diabetes often have high blood pressure, which raises the risk of heart disease. It is important to control your blood pressure so that you can help reduce your risk of heart disease. The ADA recently revised its recommendations on blood pressure. It now recommends that all people with diabetes should aim for a blood pressure that is less than 140/80 mm/Hg, instead of the older target of 130/80 mm/Hg. You should work with your healthcare provider to find the best way to lower your blood pressure to achieve your target. Start with lifestyle changes, such as physical activity, and add medicines if they are necessary to keep your blood pressure is in the target range.

3. Controlling Cholesterol

Not only do high blood glucose and high blood pressure increase your risk of heart disease, high blood cholesterol and fats also increase your risk. It is important to know your LDL and HDL cholesterol levels, as well as your triglyceride numbers, to help reduce your risk of heart disease. The LDL cholesterol is “bad” because it builds up in the walls of your arteries to form hard plaques. HDL cholesterol is “good” because it helps your body get rid of the harmful cholesterol. Triglycerides are another type of fat that can raise your risk of heart disease or stroke. Your healthcare provider can measure your cholesterol levels with a simple blood test, which you should have at least once every year. The ADA recommends that your LDL cholesterol should be lower than 100 mg/dL. Some data even suggest that lowering your cholesterol to 70 mg/dL further reduces the risk of developing heart disease. Your HDL cholesterol should be greater than 40 mg/dL if you are a man and greater than 50 mg/dL if you are a woman. Your triglycerides should be under 150 mg/dL. Like managing your blood glucose and blood pressure, it is important to achieve target numbers for blood lipids. Your health care provider will work with you and recommend lifestyle changes and medicines to lower your LDL cholesterol and increase your HDL cholesterol.

4. Stop Smoking

If you smoke cigarettes, you are taking part in narrowing the blood vessels in your body. You also promote the build-up of fats and cholesterol on blood vessel walls. Smoking also makes blood clot faster. These are all ingredients in a recipe for a heart attack or stroke. If you smoke, toss the cigarettes. Quitting smoking is one of the best things you can do to lower your risk of heart disease.

5. An Aspirin a Day

Taking a low-dose aspirin (also called “baby” aspirin) every day can help reduce your risk of heart attack. Research throughout the 1990s showed that people with diabetes who take aspirin have a reduced risk of heart attack and stroke compared to people who do not take aspirin. The ADA recommends daily aspirin for people with diabetes who have heart disease or who are at high risk for heart disease (for example, a family history of heart disease or a personal history of high blood pressure, high blood lipids, obesity or smoking). Talk with your healthcare provider to see if aspirin therapy is right for you.

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