The Pathophysiology Of Cardiovascular Disease And Diabetes: Beyond Blood Pressure And Lipids
In Brief The pathophysiology of the link between diabetes and cardiovascular disease (CVD) is complex and multifactorial. Understanding these profound mechanisms of disease can help clinicians identify and treat CVD in patients with diabetes, as well as help patients prevent these potentially devastating complications. This article reviews the biological basis of the link between diabetes and CVD, from defects in the vasculature to the cellular and molecular mechanisms specific to insulin-resistant states and hyperglycemia. It concludes with a discussion of heart failure in diabetes, a clinical entity that demonstrates many of the mechanisms discussed. Diabetes is a prime risk factor for cardiovascular disease (CVD). Vascular disorders include retinopathy and nephropathy, peripheral vascular disease (PVD), stroke, and coronary artery disease (CAD). Diabetes also affects the heart muscle, causing both systolic and diastolic heart failure. The etiology of this excess cardiovascular morbidity and mortality is not completely clear. Evidence suggests that although hyperglycemia, the hallmark of diabetes, contributes to myocardial damage after ischemic events, it is clearly not the only factor, because both pre-diabetes and the presence of the metabolic syndrome, even in normoglycemic patients, increase the risk of most types of CVD.1–4 In 2002, a survey of people in the United States with diagnosed diabetes found that, surprisingly, 68% of patients did not consider themselves at risk for heart attack or stroke.5 In addition, only about half of patients surveyed reported that their health care providers discussed the high risk of CVD in diabetes and what steps they could take to reduce that risk.5 Fortunately, we are now making the link. Health care providers are now focuse Continue reading >>
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Heart Disease & Erectile Dysfunction
Erectile dysfunction, or impotence, is the inability to achieve and sustain an erection suitable for sexual intercourse. The condition is not considered normal at any age. Premature ejaculation, infertility, or low sex drive are not the same as erectile dysfunction, though one or more of these conditions may be associated with it. How serious a problem is erectile dysfunction? It is estimated that erectile dysfunction affects about 1 in 10 adult males on a long-term basis. A much more common problem that affects most men at some point is the occasional failure to achieve an erection. Occasional failure can occur for a variety of reasons, such as from drinking too much alcohol or from extreme fatigue. Failure to achieve an erection less than 20 percent of the time is not unusual and treatment is rarely needed. Failure more than 50 percent of the time generally means there is a psychological or physical problem (or combination of both) that requires treatment. Is erectile dysfunction a normal part of aging? No. ED doesn't have to be a part of getting older. While it is true that older men may need more stimulation (such as stroking and touching) to achieve an erection, they should still be able to get an erection and enjoy sex. What causes ED? In order to achieve an erection, three conditions must occur: the nerves to the penis must be functioning properly the blood circulation to the penis must be adequate there must be a stimulus from the brain If there is something interfering with any or all of these conditions, a full erection will be prevented. Diseases that commonly cause ED include: Vascular disease: Vascular diseases are those that affect the blood vessels. These diseases include atherosclerosis (hardening of the arteries), hypertension (high blood pressure), and Continue reading >>
Link Between Diabetes And Heart Disease Scrutinized
The link between diabetes and heart disease is well-known -- diabetics are two to four times more likely to have cardiovascular disease than nondiabetics, and two-thirds will die of an early heart attack or stroke. But the link itself is poorly understood. "A person with diabetes and no cardiovascular history has the same risk of having a heart attack as a person who has had a prior heart attack," said Dr. Ruchi Mathur, an endocrinologist at Cedars-Sinai Medical Center in Los Angeles. Now researchers are attempting to figure out both the precise connection and what it means for treatment. "We need to understand why there is this risk because it has profound implications for therapy," said Dr. Jorge Plutzky, director of the vascular disease prevention program at Brigham and Women's Hospital in Boston. "You should conceivably treat every patient with diabetes as aggressively as a heart attack survivor." That means going beyond the traditional focus on dramatically lowering blood sugar levels. Patients should also minimize a cluster of other risk factors that are common to both diabetes and cardiovascular disease: obesity, hypertension, unhealthy cholesterol profiles and, recent research indicates, inflammation. It also means that doctors should screen patients with heart disease for diabetes, and visa versa. By learning more about the mechanisms through which diabetes damages the heart, scientists may be able to interrupt or forestall the injury, extending patients' life span and improving their quality of life along the way. "People always think of diabetes as a sugar problem because it is diagnosed based on the amount of glucose in the blood," said Dr. Richard Nesto, chairman of the cardiology department at the Lahey Clinic in Burlington, Mass. "However, we now recogniz Continue reading >>
Uncovering The Genetic Link Between Diabetes And Heart Disease
Type-2 diabetes (TD2) is a significant risk factor for coronary heart disease (CHD), and these two common conditions are leading causes of disease and death globally. But the biological pathways that explain the connection between them have remained somewhat murky, as have the causes of T2D. In a large analysis of genetic data, an international team led by researchers in the Perelman School of Medicine sought answers about what causes T2D and clarified how the two diseases are linked. The researchers found evidence that, on the whole, the genetic link between the diseases appears to work in one direction: risk genes for T2D are much more likely to be associated with higher CHD risk than the other way around. And there also could be some pathways whereby pharmacological lowering of one disease increases the risk of the other. “Using evidence from human genetics, it should be possible to design drugs for type-2 diabetes that have either beneficial or neutral effects on CHD risk; however it is important to identify and further de-prioritize pathways that decrease the risk of type-2 diabetes but increase the risk of CHD," said co-first author Danish Saleheen, MBBS, PhD. The scientists also found that diabetes-linked gene variants differ in their apparent effects on CHD risk, depending on their mechanisms. Variants that increase the chance of obesity or high blood pressure, for example, appear to boost CHD risk more strongly than do variants that alter insulin or glucose levels. Interestingly, this work identified dual diabetes-CHD risk loci that include targets of some existing drugs such as icosapent--an omega-3 fatty acid component of some fish oils, which lowers cholesterol and is sold in concentrated form as a prescription pharmaceutical. Dr. Saleheen, co-senior autho Continue reading >>
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The Connection Between Diabetes, Heart Disease, And Stroke
Aaron contacted TheDiabetesCouncil with some questions related to diabetes and heart disease. Aaron is 57 years old. He has had Type 2 diabetes for 12 years. Aaron visited his doctor related to swelling in his ankles and feet, shortness of breath, and weight gain. After some tests, the doctor informed him that on top of his Type 2 diabetes, he now has congestive heart failure. He was now wondering why did he have heart disease now and was it because of his diabetes? In order to help Aaron and other people with diabetes understand the connection between diabetes and heart disease and how to prevent it, we decided to look into the specific link between the two diseases. What is the connection between diabetes and heart disease? According to the American Heart Association, there exist a relationship between cardiovascular disease and diabetes: 68% percent of people with diabetes who are aged 65 and older die from heart disease and 16% die of a stroke. People with diabetes are more likely to die from a heart disease than those without diabetes. The National Institute of Health states the following for people with diabetes: They have additional causes of heart disease They are at higher risk of heart disease than those who do not have diabetes They may develop heart disease at a younger age Risk assessment must take into account the major risk factors (cigarette smoking, elevated blood pressure, abnormal serum lipids and lipoproteins, and hyperglycemia) and predisposing risk factors (excess body weight and abdominal obesity, physical inactivity, and family history of CVD). Identification of risk factors is a major first step for developing a plan for risk reduction in persons with diabetes. – Scott M. Grundy et al, Diabetes and Cardiovascular Disease In two words, the conn Continue reading >>
What Is The Connection Between Heart Disease And Diabetes?
Adults with diabetes are two to four times more likely to have heart disease than nondiabetic people, and at least 65% of these patients will die from their heart disease. The most important advice for the diabetic patient is to control modifiable risk factors for heart disease with the following actions: Stop smoking. Lower your blood pressure. Control your weight. Exercise. Monitor your blood sugar levels. Diabetes doubles your risks for heart disease and stroke, according to the National Institutes of Health. Having diabetes also means you may develop these problems at a younger age. High blood sugar levels can lead to deposits of fat on the inside of blood vessel walls, increasing your chances of narrowed, hardened and/or clogged blood vessels. If you have diabetes, talk to your doctor about the best ways to lower your risks for heart disease. Continue reading >>
The 411 On Heart Disease + Diabetes
Last month, we launched a new series on diabetes complications. The idea is definitely not to use scare tactics to convince you to take better care of yourself, but rather to embrace the notion that "knowledge is power" and that if you are diagnosed with a complication, life goes on... (Hey, we're facing our own worst fears here, too) It just so happens that February is National Heart Month (go figure), so this month we're focusing on that nasty thing that can happen to your heart with diabetes: cardiovascular disease. Our expert help is Dr. Robert Eckel, an endocrinologist and past president of the American Health Association. Not only is he a professional expert, he's also had type 1 diabetes for the past 50 years! PWDs are two to four times more likely to suffer with cardiovascular disease, so listen up! Like retinopathy, there are several types of cardiovascular disease, with their own symptoms and treatments: 1. Coronary artery disease: This is the first type of heart disease and is caused by narrowing or blocking of the blood vessels that travel to your heart via fatty deposits. If the blood vessels to your heart become partially or totally blocked, then the blood supply is reduced or cut off. When that happens, a heart attack can occur. Coronary artery disease can cause a heart attack. During a heart attack, symptoms include: chest pain or discomfort pain or discomfort in your arms, back, jaw, neck, or stomach shortness of breath sweating nausea light-headedness Dr. Eckel points out that due to nerve damage from diabetes, a heart attack could be painless, and you might not even know if you've had one. Scary! If you have had a heart attack, your doctor may put you on a blood thinner, like aspirin, which can help reduce the chances of a second heart attack. 2. Hear Continue reading >>
Ed And Heart Disease
Many still see erectile dysfunction (ED) as a purely sexual issue, but research suggests it’s much more than that. In fact, there appears to be a link between ED and heart disease. As several studies have reported, ED may be one of the first signs of cardiovascular problems for many men. An erection is the result of extra blood flow to your penis that fills and swells its blood vessels. Any time something interferes with blood flow to your penis’s blood vessels, an erection will be difficult to get or maintain. This can happen when heart disease clogs or hardens your arteries, in a condition known as atherosclerosis. The small blood vessels and arteries in your body, such as those in your penis, are often affected by atherosclerosis. As a result, ED can be a sign of heart disease. Erectile dysfunction and heart disease share many of the same risk factors, including: age high blood pressure high blood cholesterol smoking obesity diabetes depression Age As you get older, your risk of both ED and heart disease increases. But the connection between these conditions is stronger among younger men, according to the Mayo Clinic. If you experience ED under the age of 50, it’s more likely to be a sign of underlying heart problems. If you experience it after the age of 70, it’s much less likely to be linked to heart disease. High blood pressure When your blood pressure is high for an extended time, it can damage the lining of your arteries and interfere with your blood flow. This appears to affect your ability to get and maintain an erection. A 2012 study published in the journal Current Opinion in Nephrology and Hypertension found that approximately 30 percent of men with hypertension complain of ED. High blood cholesterol High blood cholesterol can also damage your arter Continue reading >>
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Type 2 diabetes is a serious condition, but the number-one cause of death for people with type 2 diabetes is actually heart disease. Heart disease and diabetes often occur together, and the link between them is high blood sugar. Heart disease is the leading cause of death in the United States. In fact, the CDC reports heart disease is responsible for one of every four deaths. For this reason, it’s essential for anyone with type 2 diabetes to understand the link between heart disease and diabetes and take proper preventative measures to manage or reverse their diabetes. If you have type 2 diabetes, you probably already know about insulin resistance. Because the body does not use insulin properly, the pancreas tries to compensate by making extra insulin. Over time, it can’t keep up, and the body cannot maintain normal blood glucose levels. (Find out more information about insulin resistance here.) Those high glucose levels can harden arteries over time. Your arteries need to be spacious and flexible to get proper blood and oxygen circulation throughout the body; tight and rigid arteries force the heart to work harder to pump the blood around. This leads to heart disease. Additionally, people with type 2 diabetes may follow certain lifestyles that can trigger heart disease. The same diet and habits that lead to type 2 diabetes can also lead to heart disease because of their connection to high blood pressure and high cholesterol. And it doesn’t stop there: Those same problems can lead to other conditions, such as erectile dysfunction or stroke. The good news: Both type 2 diabetes and heart disease can be prevented or managed by lifestyle choices. Lean proteins and heart-healthy meals can help keep cholesterol levels low, and ample research supports eating a vegetarian Continue reading >>
The Link Between Diabetes And Heart Disease And Advanced Testing For Prevention
Since February is American Heart Month, Dr. Chad Larson has written an article looking at the link that exists between diabetes and heart disease and discusses advanced testing for heart disease prevention. Larson, is the Advisor and Consultant on Clinical Consulting Team for Cyrex Laboratories. He holds a Doctor of Naturopathic Medicine degree, a Doctor of Chiropractic degree, is a Certified Clinical Nutritionist and a Certified Strength and Condition Specialist who has a big interest in advanced developments in the field of endocrinology and environmentally-induced chronic disease (among other specializations). Heart Disease is Still Number One Larson writes that even though we’ve seen pharmaceutical and technological advances over the last decades, heart disease still ranks as the number one cause of death in the US. He points out that while various factors are known to lead to heart problems like, high cholesterol, high blood pressure, obesity, and smoking he writes that “there are actually hundreds of varying risk factors that can lead to heart disease, including an entirely different disease: diabetes.” Interestingly, Larson writes that almost 40 years ago it was discovered that “all types of diabetes can have an autoimmune component,” something that isn’t commonly known. How is Diabetes Linked to Heart Disease? Larson shares that the American Diabetes Association states that people with diabetes have more than double the risk of having a heart attack than people without diabetes. He writes that two of every three people with diabetes end up dying from heart disease or stroke. Something else that threatens people with diabetes regarding heart disease is that diabetes may cause nerve damage and as a result can cause persons in the midst of a heart attac Continue reading >>
Heart Disease And Diabetes
Heart disease is common in people with diabetes. Data from the National Heart Association from 2012 shows 65% of people with diabetes will die from some sort of heart disease or stroke. In general, the risk of heart disease death and stroke are twice as high in people with diabetes. While all people with diabetes have an increased chance of developing heart disease, the condition is more common in those with type 2 diabetes. In fact, heart disease is the number one cause of death among people with type 2 diabetes. The Framingham Study was one of the first pieces of evidence to show that people with diabetes are more vulnerable to heart disease than those people who did not have diabetes. The Framingham Study looked at generations of people, including those with diabetes, to try to determine the health risk factors for developing heart disease. It showed that multiple health factors -- including diabetes -- could increase the possibility of developing heart disease. Aside from diabetes, other health problems associated with heart disease include high blood pressure, smoking, high cholesterol levels, and a family history of early heart disease. The more health risks factors a person has for heart disease, the higher the chances that they will develop heart disease and even die from it. Just like anyone else, people with diabetes have an increased risk of dying from heart disease if they have more health risk factors. However, the probability of dying from heart disease is 2 to 4 times higher in a person with diabetes. So, while a person with one health risk factor, such as high blood pressure, may have a certain chance of dying from heart disease, a person with diabetes has double or even quadruple the risk of dying. For example, one medical study found that people with d Continue reading >>
The Link Between Type 2 Diabetes And Heart Disease
Insulin is a hormone that plays a crucial role in metabolizing glucose, or sugar. When a person has type 2 diabetes, the body does not produce enough insulin or does not use insulin effectively. Over time, this causes an increase of glucose in the blood, which interferes with the normal functioning and repair of cells throughout the body. The end result is cellular damage to vital tissues, organs and systems. One of the systems frequently damaged by this buildup of blood glucose is the cardiovascular system, including the heart. Diabetes is considered a serious risk factor for both developing heart disease and dying from heart disease. People with type 2 diabetes also develop heart disease at a younger age, have heart disease that is more severe, have more complications from heart disease and are more likely to have asymptomatic, or “silent,” heart disease. Healthcare providers sometimes refer to heart disease in patients with type 2 diabetes as “diabetic heart disease” or DHD. Why are people with type 2 diabetes at greater risk for heart disease? There is a well-documented association between type 2 diabetes and multiple forms of cardiovascular disease, including coronary artery disease (CAD), peripheral artery disease, heart failure and cardiomyopathy. Some of the ways in which diabetes has been shown to damage the cardiovascular system include: Atherosclerosis, or the buildup of arterial plaque, that results from the damage to blood vessels and excess of lipids in the blood. This leads to coronary artery disease (plaque collected on the arteries supplying the heart) and peripheral artery disease (plaque collected in the arteries of the limbs). Kidney problems, which cause a buildup of fluid in the body; excess fluid can cause chronic high blood pressure, whic Continue reading >>
Will Having Bad Teeth Kill Me Faster?
It depends on what you mean by bad teeth. Simply having non-perfectly aligned chompers isn’t going to kill you. However, there is a connection between Gum Disease and Heart Disease, or more broadly, Periodontal Disease and Heart Health. Oral bacteria can cause inflammation, blood clots, and release toxins into the bloodstream, although it is not fully known how they can lead to strokes. There is also evidence to suggest Geriatric Oral Health and Pneumonia Risk are linked, and Oral Hygiene Reduces the Mortality from Aspiration Pneumonia in Frail Elders. Then there is the reverse, where the bad teeth is indicative of another disease, as with the case of Diabetes and Teeth. Tl;dr- take care of teeth. Thanks for reading. Continue reading >>
The Connection Between Heart Disease And Diabetes
Ways for Diabetics to Protect Their Heart Most people living with diabetes are aware that they have an increased risk of cardiovascular disease. But the statistics can be truly staggering regarding heart disease and the diabetes. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over time, high blood glucose levels damage nerves and blood vessels, leading to complications such as heart disease and stroke, the leading causes of death among people with diabetes The Connection Between Heart Disease and Diabetes The connection between diabetes and heart disease starts with high blood sugar levels. With time, the high glucose in the bloodstream damages the arteries, causing them to become stiff and hard. Fatty material that builds up on the inside of these blood vessels can eventually block blood flow to the heart or brain, leading to heart attack or stroke. Your risk of heart disease with diabetes is further elevated if you also have a family history of cardiovascular disease or stroke. According to the National Institutes of Health, about 65 percent of people with diabetes actually die of heart disease or stroke, and a person with diabetes has twice the chance of developing heart disease as someone without diabetes. connection. DID YOU KNOW? A person with diabetes who has had one heart attack has a much greater risk of having another. A middle-aged person who has diabetes has the same chance of having a heart attack as someone who is not diabetic, but already had a heart attack. People with diabetes develop cardiovascular disease at a much earlier age than others. People with diabetes who have heart attacks are more apt to die as a result. People with diabetes have a higher-than-average risk of having a heart attack or stroke. Continue reading >>
Studies Link Eggs To Stroke, Diabetes, Heart Disease, Cancer
Don’t put your health at risk by following the findings of a new American Egg Board-funded study that suggests eating eggs reduces stroke risk. Eggs can actually increase stroke risk (more on that below). Industry-funded studies like this can mysteriously fail to reveal the health dangers that unbiased studies uncover. Just this week, Reuters reported that in an analysis of 60 studies looking at the link between sugar-sweetened beverages and obesity or diabetes, 100 percent of those that failed to find a link were industry-funded. Of the 34 studies that found a connection, only one was industry-funded. With that in mind, let’s take a look at some studies that have found eggs can actually increase stroke risk, as well as the risk for diabetes, heart disease, and cancer. Stroke In a study published in the journal Stroke, researchers followed the diets of 11,601 participants from the Atherosclerosis Risk in Communities (ARIC) Study and monitored protein sources and stroke incidence rates. Those who consumed the most eggs had a 41 percent increased risk for hemorrhagic stroke, compared with those who consumed the least. Diabetes and Heart Disease Eggs also increase the risk for heart disease and diabetes, according to a meta-analysis published in Atherosclerosis. Researchers reviewed 14 studies and found that those who consumed the most eggs had a 19 and 68 percent increased risk for developing cardiovascular disease and diabetes, respectively, compared with those who ate the fewest eggs. For those who already had diabetes, the risk for developing heart disease from eating the most eggs jumped by 83 percent. Another study published in Atherosclerosis found that participants who ate the most eggs, compared with those who ate the least, had 80 percent higher coronary arte Continue reading >>
