Cardiovascular Disease - Diabetes Complications and Prevention

There are several kinds of cardiovascular disease, and they are all due to problems in how the heart pumps blood or how blood circulates throughout the body.

Blood flows through the blood vessels in your body to deliver all the oxygen, glucose, nutrients, and other substances needed to run your body and keep your cells alive. When blood can’t get to cells and tissues, they can become damaged or die.

Most of the cardiovascular complications related to diabetes have to do with a blockage or slowdown in blood flowing throughout the body. Diabetes can change the chemical makeup of some of the substances found in the blood, and this can cause the openings in blood vessels to narrow or to clog up completely. This is called atherosclerosis, or hardening of the arteries, and diabetes seems to speed it up.

Blood vessels can become clogged in several ways. If there are too many lipids (fats) in the blood, such as cholesterol and triglycerides, they can collect in the walls of the blood vessels.

Diabetes changes the number and makeup of proteins that deliver lipids to cells. But if you lower your blood glucose levels, these so-called lipoproteins will return to normal and do their job of delivering and removing lipids to cells in your blood vessels.

Blood lipids can also accumulate if you eat too much fat and cholesterol. And if there is also too much glucose in the blood, these lipids are more likely to clog blood vessels.

Your Risk, in General: Cardiovascular Disease

People with diabetes are

  • 2 to 4 times more likely to get heart disease;
  • 5 times more likely to have a stroke than people without diabetes;
  • at risk for cardiovascular disease, which causes more than half of the deaths in older people with diabetes.

That’s why it is important to pay attention to fats in your diet if you have diabetes. By keeping your glucose levels on target and limiting your saturated fat intake, you can prevent clogging of your blood vessels.  Diabetes can also affect the platelets in your blood, which play a role in blood clotting. Diabetes can cause blood platelets to churn out too much of a substance that causes blood to clot, and this can also cause blood vessels to narrow.

When blood vessels narrow or clog because of cardiovascular disease, the blood supply to the heart, brain, and other tissues and organs can be restricted. If blood to the heart is slowed for a time, it can cause chest pain known as angina. Angina is not itself a disease, but it can give a warning that something is slowing the flow of blood to the heart. A complete stoppage of blood is a heart attack. When the blood flow to the brain is cut off, this can cause a stroke. Blockages in the arteries of the legs can cause leg pain known as intermittent claudication.

Hypertension, or high blood pressure, can also contribute to cardiovascular disease.  Hypertension itself usually has no symptoms. If you have it, you probably won’t even realize it unless you have your blood pressure checked. Hypertension is especially common among people with type 2 diabetes. Over 70 percent of people with diabetes also have high blood pressure or use medicines to treat hypertension.

High blood pressure not only increases your risk for heart disease but also increases your risk for other diabetes complications. The recommended blood pressure for most people with diabetes is <130/80 mmHg. Along with exercise, weight loss, and watching salt intake, many people with diabetes also take one or more medications to lower their blood pressure. The most commonly used are angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs).
These lower blood pressure and help protect your kidneys.

Diuretics, beta blockers, and calcium channel blockers may also be used. It will take time to figure out the best medicine plan for you. Be sure to keep in close contact with your health care team during this time and let them know if you are experiencing any side effects from these medications.

If you have hypertension,  your heart is forced to work harder than usual. This extra stress can damage the lining of your arteries. If this goes untreated for a long period, a type of fatty tissue called atheroma can form. This can cause your arteries to narrow or become completely blocked. Even by itself, hypertension can damage small blood vessels and capillaries, especially in the eyes and kidneys. If you have hypertension on top of diabetes, there is an even greater chance that your arteries may become clogged. The risk of further damaging tissues and further aggravating cardiovascular disease increases dramatically if you have both hypertension and diabetes.

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