How to help reduce your risk of developing cardiovascular issues
If you have diabetes, you probably know that your risk of heart disease once you have been diagnosed with it increases significantly. In fact, some studies have suggested that patients with diabetes have a two-to-four-times increased possibility of developing heart disease.
One of the primary goals of managing diabetes is to reduce your chance of heart disease and other complications as much as possible with lifestyle and medication modifications. Steps to take to help reduce your risk of heart disease follow.
UNDERSTAND THE RISK
Having high levels of sugar in your bloodstream has significant impact on your blood vessels. One of the main ways this happens is with the production of what are called reactive oxygen species. Basically, having high levels of sugar in the bloodstream results in the creation of these chemicals, and they subsequently cause problems throughout the body (including in the eyes, nerves, etc.).
After being exposed to high levels of blood sugar and these reactive oxygen species over time, your blood vessels begin to lose their elastic ability and become much more rigid. Ordinarily, when the heart beats, what helps to keep your blood pressure low is the ability of your blood vessels to expand and absorb some of that increased pressure. However, with diabetes, the blood vessels become much more rigid and no longer have the ability to expand and assist in reducing blood pressure. This process is also seen in older patients which, in part, explains the increased cardiovascular risk as we age as well.
Once blood vessels reach a point of rigidity that prevents them from reducing blood pressure, the overall blood pressure in the body begins to rise. In turn, this significantly increases the amount of work that is required by the heart to pump blood throughout the body. When the heart eventually begins to fatigue, heart disease can develop.
In addition to the increased pressure generated by stiffening blood vessels, the kidneys also play a major role in increasing blood pressure. The kidneys are extremely needy organs when it comes to blood supply. In fact, they require almost a quarter of the entire body’s blood supply! When their demand of this massive amount of blood isn’t met, one of the main ways they force additional blood to themselves is to increase blood pressure.
One of the major causes of deficient blood supply to the kidneys is narrowing or hardening of blood vessels. Thus, increased blood sugar results in less blood supply to these organs because increased blood sugar can narrow and harden the arteries.
If you have high blood pressure and you have diabetes, your healthcare provider likely has started efforts in controlling your blood pressure with medications called ACE-inhibitors (commonly ending in the suffix pril, such as lisinopril), which work by reducing the ability of the kidneys to raise blood pressure.
This is why maintaining normal blood sugar is also important in managing your blood pressure. As you can see, when blood sugar rises, blood pressure can be directly impacted. This, in turn, significantly increases the strain on your heart and can, over time, increase your risk of a heart attack or a stroke, etc.
MANAGE RISK FACTORS
Similar to chronically elevated blood sugar levels, smoking also results in reduced elasticity of blood vessels, which causes an increased strain on your heart.
A major focus for all patients with diabetes is reducing cholesterol levels. Interestingly, how providers manage cholesterol today is much different than how they did it 10 or 15 years ago. Recent studies have shown that simply reducing cholesterol levels has made very little impact on lengthening a patient’s life.
Some cholesterol medications now improve cholesterol numbers and increase the lifespan of patients while reducing cardiovascular risk. The most beneficial are statin medications (such as atorvastatin). Not only do these medications lower cholesterol numbers, they also may have an ability to reduce inflammation inside blood vessels, thus further reducing the risk of having a heart attack or a stroke.
For the general population, instead of simply chasing cholesterol numbers, providers now calculate what is known as a “10-year cardiovascular risk.” By considering information such as blood pressure, cholesterol numbers, whether or not a patient has diabetes or smokes, etc., they can determine whether or not patients qualify for cholesterol medication. Although recommendations vary, providers generally do not start cholesterol medication unless your cardiovascular risk is above 7.5 percent. National experts recommend that cholesterol medication be used for patients with diabetes with the goal to keep their LDL (bad cholesterol) below 70.