How Diabetes Affects the Heart
By Rhonda Mann
Beth Israel Deaconess Medical Center Staff
When Dave was diagnosed with Type 2 diabetes in 1985, he never thought about the impact on his heart — until tests done prior to an elective back surgery found blockages in his arteries.
"I had no symptoms," says Dave. "They told me I basically had a silent heart attack."
Research has shown diabetes can take a toll on the heart. High glucose levels put abnormal stress on the blood vessels, increase the risk of blood clots, and can cause inflammation that is associated with vascular disease. Diabetes also increases the chance of developing other risk factors for coronary artery disease, including high blood pressure, high cholesterol and obesity.
"Seventy-five to 80 percent of people with diabetes will ultimately die of a cardiovascular event," says Dr. Martin Abrahamson, Chief Medical Officer of the Joslin Diabetes Center, a clinical partner of Beth Israel Deaconess Medical Center, and . "It is the biggest killer of people with diabetes."
According to the American Diabetes Association, some 26 million people in the United States, or eight percent of the population, have diabetes. Of those, nearly 25 percent are unaware that they have the disease. The impact on the heart is undeniable. Over the past 30 years, while deaths from heart disease in women, for example, have decreased by 27 percent, deaths from heart disease in women with diabetes have increased by 23 percent over that same timeframe.
Dr. Donald Cutlip, an interventional cardiologist at the Cardiovascular Institute at BIDMC, calls the trend an "epidemic." About 30 percent of the patients he sees with heart disease now are diabetic.
"People with diabetes have more extensive disease, tend to have more areas involved, and they're more likely to die or have a heart attack related to their cardiovascular disease," explains Dr. Cutlip.
But there is hope - especially when steps are taken to identify heart disease risk factors early on and to prevent damage. Aggressive control of glucose, lipid, and blood pressure can reduce the risk of having a major cardiac event by as much as 50 percent, according to Dr. Abrahamson.
"The concerning thing is we're seeing people develop Type 2 diabetes at younger and younger ages," he says, adding that this puts them at risk for heart disease earlier in life. "There is a certain amount of denial, but we need to empower these patients. We need to get them to seek out education and information so they can make the changes necessary to head off heart disease."
Among the changes that can make a difference - eating better, exercising and getting to a healthy weight.
After learning he had heart disease, Dave quit smoking and started working out on a treadmill four days a week. He also takes many medications - nine pills in the morning and eight at night - to keep both his diabetes and his heart disease in check.
"I have a doctor check out my diabetes twice a year and go to my cardiologist twice a year," he says. "I'm trying to stay on top of everything. So far, I feel good."
Above content provided by Beth Israel Deaconess Medical Center in partnership with the Joslin Diabetes Center. For advice about your medical care, consult your doctor.
Posted November 2012