Cardiovascular disease and diabetes often appear together. It isn’t entirely clear how the two diseases affect each other, but the most pertinent facts are clear enough: If you have diabetes, you’re two to four times more likely than the general population to have heart disease.
Heart attacks are what ultimately kill 80 percent of people with diabetes.The risks are so high that, according to the American Diabetes Association (ADA), having diabetes puts you in the same danger zone as a person who has already had a heart attack — and is thus likely to have another. Heart attack is just one of several problems to watch out for when you have cardiovascular disease. Most of them come down to two basic conditions, both of which you can take steps to control.
Cardiovascular is an umbrella term that includes both the heart (the cardio part) and the blood vessels (the vascular part). In a healthy person, a strong heart sends blood through the body via a network of smooth and elastic blood vessels. But problems arise when blood vessels become stiff, narrowed, or clogged — a condition known as atherosclerosis.
Atherosclerosis can occur in a number of ways related to diabetes. High blood sugar can slow blood circulation and promote the formation of clots. Being overweight (especially if you carry fat mostly in the abdomen) and having high levels of such blood fats as cholesterol and triglycerides (common with diabetes) can lead to obstructions in blood vessels. Depending on where they occur, these slowdowns in blood flow can trigger a number of different problems.
- When arteries that feed the heart become obstructed, the heart can’t pump as efficiently as it should. Initially, this can cause chest pain from angina, a condition in which heart tissue is damaged from lack of nutrients. If a coronary artery becomes completely blocked, the result is a heart attack.
- If blood flow slows down in the arteries that feed the brain, lack of oxygen can cause what’s known as cerebrovascular disease, in which areas of the brain become impaired. Often, the condition starts with temporary loss of brain function that can produce symptoms like slurred speech, weakness, and numbness. A total blockage can cause a stroke.
- When blood flow to the arteries feeding the legs is impeded, a condition known as peripheral vascular disease develops. A partial blockage can cause temporary pain (called claudication) in the thighs, calves, or buttocks. A total blockage can cause gangrene, although this doesn’t happen often, because blood to the legs can usually bypass the clog using other arteries. Still, poor leg circulation, often combined with nerve damage, can lead to serious problems in the feet.
High blood pressure can build up silently, just as diabetes can, and the two diseases often develop in tandem. If you have diabetes, you’re twice as likely to have high blood pressure than the average person is, and about 60 percent of people with type 2 diabetes do. Controlling high blood pressure is critical if you have diabetes because the damage it causes contributes not only to atherosclerosis but also to kidney and eye disease. All told, it has a hand in 35 to 75 percent of all complications that go along with diabetes.
You need a certain amount of blood pressure (the force that blood exerts against artery walls) for good circulation. But too much gradually weakens the heart by making it work harder and damages the lining of blood-vessel walls, making it easier for atherosclerosis to set in. High blood pressure can also weaken arteries in the brain and cause them to balloon, a condition called an aneurysm. The bursting of an aneurysm is potentially fatal.
According to the ADA, you should strive to keep your blood pressure down to at least 130/80 mm Hg if you have diabetes — and lower than that is even better.