Cardiovascular Disease and Diabetes

The American Heart Association considers diabetes one of the seven major controllable risk factors for cardiovascular disease (CVD).

In fact, people living with Type 2 diabetes are two times more likely to develop and die from cardiovascular disease, such as heart attacks, strokes and heart failure, than people who don’t have diabetes.

Why are people with diabetes at increased risk for CVD?

Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That's because people with diabetes, particularly Type 2 diabetes, may have the following conditions that contribute to their risk for developing CVD.

• High blood pressure (hypertension)
  High blood pressure is a major risk factor for heart disease and stroke. Studies have shown a link between high blood pressure and insulin resistance. When patients have both HBP and diabetes, which is a common combination, their risk for CVD increases even more.
  
  
• Abnormal cholesterol and high triglycerides
  Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This often occurs in patients with premature coronary heart disease. It's also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Download Type 2 Diabetes and Cholesterol (PDF).
  
  
• Obesity
  Obesity is a major risk factor for CVD and has been strongly associated with insulin resistance. Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity. Obesity and insulin resistance also have been associated with other risk factors, including high blood pressure.
  
  
• Lack of physical activity
  Physical inactivity is another modifiable risk factor for insulin resistance and CVD. Exercising and losing weight can prevent or delay the onset of Type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke. Any type of moderate-to vigorous physical activity is beneficial, such as sports, house work, gardening or work-related physical activity.

For overall cardiovascular health, the American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity per week (or a combination of the two), plus moderate-to high-intensity muscle-strengthening activity at least two days per week. Read the article: Get Motivated to Get Moving.

• Poorly controlled blood sugar (too high) or out of normal range
  Diabetes can cause blood sugar to rise to dangerous levels. Medications may be needed to manage your blood sugar.
  
  
• Smoking
  Whether or not they have diabetes, smoking puts people at higher risk for heart disease and stroke. Learn how to kick the habit.

People with insulin resistance or diabetes and one or more of these risk factors are at even greater risk of heart disease or stroke. People with diabetes may avoid or delay the development of heart and blood vessel disease by managing their risk factors. Your health care team will do periodic testing to assess whether you have developed any of these risk factors associated with CVD.

Find more tools and resources for managing your diabetes and reducing your risk for cardiovascular disease at KnowDiabetesbyHeart.org.