The short answer to this questions is “Yes,” because diabetics are twice as likely to die from coronary artery disease than the non-diabetic population, and the incidence of cardiovascular sequelae development is increased at least two-fold in persons with diabetes. The long answer, however, is that understanding what heart disease is, and knowing the warning signs may help to keep your heart healthy.
Understanding heart disease means understanding Atherosclerosis, High Blood Pressure, Heart Attack, Angina, and Arrhythmias. The American Heart Association has excellent information which they will share with you for the asking.
Arteriosclerosis is the general term for thickening and hardening of the arteries, a process which occurs as we age. Atherosclerosis is a type of this process which is characterized by deposits of fatty substances, cholesterol, cellular waste products, calcium, and fibrin (a clotting material) in the inner lining of an artery. The resulting buildup is called plaque. Two things that can happen when plaque builds up are: hemorrhage on the plaque’s surface or formation of a clot or thrombus on the plaque’s surface. If either of these occurs and blocks the entire artery, a heart attack or stroke may occur.
Cholesterol is made by the liver and is used to form cell membranes, certain hormones, and other necessary substances. The body produces about 1,000 mg a day. The rest of cholesterol comes from foods we ingest from animals, especially egg yolks, meat, fish, poultry, and whole milk dairy products. Foods from plants do not contain cholesterol.
Typically the body makes all the cholesterol it needs so it is not necessary to take in more. Cholesterol is transported by lipoproteins which are produced in the liver and carried by the blood to and from various parts of the body. It can not dissolve in the blood. Low Density Lipoprotein (LDL) is the major cholesterol carrier in the blood and is used to build cells.
If too much LDL cholesterol circulates in the blood it may be deposited in artery walls and cause plaque and atherosclerosis, giving it the nickname of “bad” cholesterol. Another type of lipoprotein is High Density or HDL. It is thought that HDL (“good” cholesterol) picks up cholesterol and brings it back to the liver for reprocessing or excretion. The levels of HDL and LDL in the blood are measured to evaluate the risk for atherosclerosis.
High Blood Pressure
Blood pressure is the result of two forces — one created by the heart as it pumps blood into the arteries, the other created by the arterial blood vessels as they exert resistance to the blood flow from the heart. For most adults a blood pressure reading of less than 140/90 indicates there is no reason to worry.
However, in adults high blood pressure, called hypertension, exists when systolic pressure (the first number) is equal to or greater than 140 and/or diastolic pressure (the second number) is equal to or greater than 90 for extended periods of time. High blood pressure means that the heart has to work harder than normal, putting both the heart and arteries under greater strain.
When the heart is forced to work harder over time, it tends to enlarge. A slightly enlarged heart can function well, but a significantly enlarged heart has a hard time meeting the demands put on it. Arteries also suffer as over time they become scarred, hardened, and less elastic. As the arteries become hardened and narrowed they may be unable to supply enough blood for the body’s organs. The heart, brain, and kidneys are especially prone to damage by high blood pressure.
Angina and Heart Attack (Myocardial Infarction)
Angina is a pain or discomfort in the chest or adjacent areas caused by ischemia or lack of blood supply which causes a lack of oxygen to the heart. Angina symptoms are usually improved with treatment. If the blood supply is blocked completely, a heart attack (myocardial infarction) may occur. It can be caused by a blood clot that has formed due to the plaque of atherosclerosis. It can also be caused by a spasm which narrows the artery and the blood supply.
Heart Attack Signals and Action
- Uncomfortable pressure, fullness, squeezing or pain in the center of the chest that last more than a few minutes, or goes away and comes back.
- Pain that spreads to the shoulders, neck, or arms.
- Chest discomfort with light headiness, fainting, sweating, nausea, or shortness of breath.
Not all these warning signs occur, but if some do, get help immediately.
If you have coronary heart disease, know your hospitals — where there is a 24-hour emergency cardiac unit. Keep an emergency telephone list handy. If you can get to the hospital faster than using an ambulance, have someone drive you. Don’t drive yourself.
Risk Factors for Heart Disease That Can’t Be Changed
- Heredity: Look to your family for an idea of your risk for heart disease. Diabetes may telescope your risk to an earlier age so make sure to tell your doctor so that you will have the proper tests and be followed properly.
- Increasing Age: The older we get, the greater our risk for having a heart attack. Women die of heart attacks twice as often as men at older ages, so you women, please understand your blood tests and risk factors.
- Being Male: This is changing as women continue to live under more stress and have lives which raise their risk factors.
Risk Factors for Heart Disease That Can Be Changed
- Cigarette/Tobacco Smoke: Smokers have a two-fold higher risk of heart disease. If they have a heart attack, they are more likely to die than non-smokers. It is the biggest factor for peripheral vascular disease and in fact, this condition is almost exclusive in smokers.
- High Blood Cholesterol: A blood cholesterol of 240 mg/dl and over doubles the risk of coronary heart disease. Diet and lowering of saturated fat are important factors in lowering cholesterol levels. Medication may also be prescribed to control level of cholesterol in the blood as well as the ratio of LDL and HDL in the blood.
- High Blood Pressure: People with high blood pressure should work with their physicians to control it. Eating properly, losing weight, exercising regularly, restricting sodium, and following a program of medication may be prescribed to lower blood pressure.
- Physical Inactivity: The American Heart Association suggests 30 to 60 minutes of aerobic exercise 3 to 4 times a week to promote cardiovascular fitness. Inactivity, extra weight, and high cholesterol unquestionably contribute to the risk for heart disease.
- Diabetes: Need we say more? Strive to control blood sugar levels.
- Obesity: People who are obese are more likely to develop heart disease and stroke even if they have no other risk factors. The weight increases strain on the heart. It can lead to diabetes, high cholesterol, and high blood pressure.
- Individual Response to Stress: Under stress many people fail to take care of themselves. There are many ways of coping with stress and physicians know that there is a relationship between how we live with stress over the long haul and the development of heart disease.
The American Heart Association has an excellent book, Heart, Stroke Facts that you can get for the asking. Most of this article was gleaned from AHA information. Knowing your risk factors and understanding heart disease may save you or a loved one from the trauma of a heart attack.