If you have diabetes, your risk of heart disease is twice as high — and it rises the longer you've had diabetes. The good news: changing some everyday habits can improve your heart health.
Heart disease, briefly
Heart disease covers several problems that affect the heart; cardiovascular disease is broader, taking in all heart disease plus stroke and blood vessel disease.
The most common kind is coronary artery disease. Plaque — deposits of cholesterol — builds up inside the arteries that feed the heart, narrowing them and cutting blood flow. That's atherosclerosis, or hardening of the arteries:
| Less blood reaches | Result |
|---|---|
| the heart | heart attack |
| the brain | stroke |
| the legs and feet | peripheral arterial disease (PAD) — often the first sign of cardiovascular disease in someone with diabetes |
How diabetes harms the heart
Over time, high blood sugar damages blood vessels and the nerves that control the heart. People with diabetes are also more likely to have conditions that raise the risk further:
- High blood pressure pushes blood harder through the arteries and can damage their walls. Diabetes plus high blood pressure greatly raises heart disease risk.
- Too much LDL ("bad") cholesterol can form plaque on damaged artery walls.
- High triglycerides (a fat in the blood), with low HDL ("good") cholesterol or high LDL, add to hardening of the arteries.
Other risks: smoking, overweight or obesity, too little physical activity, a diet high in saturated fat, trans fat, cholesterol and salt, and too much alcohol.
Heart failure
People with diabetes are also more likely to have heart failure — the heart can't pump blood well. It can cause swollen legs and fluid in the lungs that makes breathing hard, and it tends to get worse over time — but early diagnosis and treatment can ease symptoms and stop or slow it.
Tests
Your blood pressure, cholesterol and weight help your doctor judge your overall risk. Your doctor may also suggest:
| Test | What it shows |
|---|---|
| Electrocardiogram (ECG or EKG) | the heart's electrical activity — each heartbeat is an electrical impulse traveling through the heart |
| Echocardiogram (echo) | how thick the heart muscle is and how well it pumps |
| Exercise stress test (treadmill test) | how the heart works when it's working hard |
Protecting your heart
These habits can lower your risk of heart disease or keep it from getting worse.
Eat well
- more fresh fruits and vegetables, lean protein and whole grains;
- fewer processed foods — chips, sweets, fast food;
- more water, fewer sugary drinks, less alcohol.
Aim for a healthy weight. If you're overweight, losing even a modest amount can lower your triglycerides and blood sugar.
Get moving. Physical activity makes your body more sensitive to insulin, helps manage blood sugar and lowers heart disease risk.
Manage your ABCs
| A — A1C | get regular A1C tests, which measure average blood sugar over 2 to 3 months, and stay in your target range as much as you can |
| B — blood pressure | keep it below 140/90 mm Hg, or the target your doctor sets |
| C — cholesterol | keep your levels managed |
| s — smoking | stop, or don't start |
Manage stress. Stress can raise blood pressure and push you toward overeating or drinking too much. Instead, try a mental health counselor, meditation or deep breathing, physical activity, or support from friends and family.
Your doctor may also prescribe medicines to keep blood sugar, blood pressure, cholesterol and triglycerides near your targets.
See a diabetes educator
A diabetes care and education specialist can help you avoid complications like heart disease, with support, solutions and news of the latest advances. If you don't have one, ask your doctor for a referral.
More: healthy eating · healthy weight.
Sources
Based on "Diabetes and Your Heart," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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