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Why Diabetes Causes Heart Disease

Silent Heart Attack

Silent Heart Attack

A heart attack that does not produce the hallmark symptoms of chest pain and difficulty breathing. It is estimated that as many as 4 million Americans have had silent heart attacks, and diabetes raises the risk of having one. A heart attack, also known as a myocardial infarction, occurs when low blood flow to the heart starves it of oxygen, damaging it. Most heart attacks are caused by a blood clot that blocks one of the coronary arteries, the arteries that carry blood and oxygen to the heart muscle. A clot most often forms in a coronary artery that has been narrowed by atherosclerotic plaque. Risk factors for heart attacks include a family history of heart attack, being male, diabetes, older age, high blood pressure, smoking, and blood lipid abnormalities, especially high LDL (“bad”) cholesterol levels and low HDL (“good”) cholesterol levels. Typically, a heart attack produces chest pain, which may radiate to the arms, shoulders, neck, teeth, jaw, abdomen, or back. Other common symptoms include shortness of breath, nausea or vomiting, and anxiety. Anyone experiencing these symptoms should seek medical care immediately. But people with diabetes may not feel these symptoms due to diabetic neuropathy (nerve disease), which can damage the nerves that control the heart, as well as mask the chest and back pain that usually accompanies an attack. Continue reading >>

Diabetes And Coronary Heart Disease: A Risk Factor For The Global Epidemic

Diabetes And Coronary Heart Disease: A Risk Factor For The Global Epidemic

International Journal of Hypertension Volume 2012 (2012), Article ID 697240, 7 pages 1Division of Endocrinology, Department of Medicine, Loyola University Medical Center, 2160 South First Avenue, Fahey Bldg, Maywood, IL 60153, USA 2Division of Cardiovascular Medicine, Department of Medicine, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA 3Cardiovascular and Thoracic Surgery, University of Illinois at Chicago and Vanguard Weiss Memorial Hospital, 4646 North Marine Drive, Chicago, IL 60640, USA Academic Editor: Eoin O'Brien Copyright © 2012 Maguy Chiha et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Cardiovascular disease remains a leading cause of death in the United States and the world. In this we will paper focus on type 2 diabetes mellitus as a risk factor for coronary heart disease, review the mechanisms of atherogenesis in diabetics, the impact of hypertension and the treatment goals in diabetics, the guidelines for screening, and review the epidemiologic consequences of diabetes and heart disease on a global scale. The underlying premise to consider diabetes a cardiovascular disease equivalent will be explored as well as the recommendations for screening and cardiac testing for asymptomatic diabetic patients. 1. Introduction Cardiovascular disease is currently responsible for 30% of all deaths worldwide with most of the burden now occurring in developing countries [1]. After a peak around 1968, death from coronary heart disease (CHD) has declined significantly in the United States [2]. Based on a statistical mortality model previously validated in Europe, N Continue reading >>

Why Is There An Increased Rate Of Heart Disease?

Why Is There An Increased Rate Of Heart Disease?

Diabetes puts you at risk of heart disease (even if you have ‘normal’ looking cholesterol and no symptoms). This is because diabetes can change the chemical makeup of some of the substances found in the blood and this can cause blood vessels to narrow or to clog up completely. Heart attacks and strokes are up to four times more likely in people with diabetes For this reason, often people with diabetes are on blood pressure lowering medications, often in combination Maintaining fitness with regular physical activity combined with some weight loss can help reduce high blood pressure Diabetes can change the chemical makeup of some of the substances found in the blood and this can cause blood vessels to narrow or to clog up completely. Maintaining fitness with regular physical activity combined with some weight loss can help reduce high blood pressure. Blood pressure lowering medications are often required for people who have diabetes. Symptoms Often people do not know they have heart disease until they develop symptoms like chest pain, shortness of breath, dizziness or excessive fatigue when walking or exercising. It is important to note that symptoms may be mild to severe and sometimes there may be none at all. Examples of some other warning symptoms may be: Arm or jaw discomfort Indigestion Weakness Nausea. If you think you are having a heart attack, phone 000 IMMEDIATELY. How can I reduce the risk? One of the most important things to do to reduce the risk of heart disease is to meet with your doctor and/or Credentialled Diabetes Educator to discuss your individual risk factors and how to reduce them. In general terms you can reduce the risk by: Being physically active Losing weight if you are overweight Not smoking Managing blood fats Managing high blood pressure Ta Continue reading >>

More Evidence Links Inactivity To Diabetes And Heart Disease

More Evidence Links Inactivity To Diabetes And Heart Disease

(Reuters Health) - People who are inactive for hours on end each day may face an increased risk of diabetes and heart disease even if they also get regular exercise, a U.S. study confirms. While the study wasn’t designed to prove that a sedentary lifestyle causes heart disease or diabetes, the link between inactivity and risk factors for these illnesses remained strong regardless of age, gender, weight and whether participants got regular exercise. “The take-home message is that reducing sedentary behavior is very important for maintaining favorable levels of blood lipids and sugars, and thus for the prevention of diabetes and cardiovascular disease, even in those who already meet physical activity recommendations,” lead study author Qibin Qi, a researcher at Albert Einstein College of Medicine and Montefiore Health System in New York, said by email. To explore the link between sedentary time and heart disease and diabetes, Qi and colleagues analyzed data collected from 2008 to 2011 among Hispanic residents of Chicago, Miami, San Diego and the Bronx in New York. The researchers asked more than 12,000 people to wear activity monitors for 16 hours daily for one week; most participants followed through for at least one day. One average, they were inactive for about 12 hours daily. Then, researchers sorted participants into four groups based on the amount of sedentary time they logged. Compared to the group with the most physical activity, the least active group had 6 percent lower levels of high density lipoprotein (HDL) cholesterol, the good kind that helps reduce the risk for heart disease. The least active group also had 16 percent higher levels of triglycerides, fats in the blood that can increase the risk of coronary artery disease. This group also had higher le Continue reading >>

Congestive Heart Failure (chf)

Congestive Heart Failure (chf)

A type of heart disease in which the heart no longer pumps sufficient blood to meet the body’s needs. Diabetes is a risk factor for heart failure, but a number of measures, including tight blood glucose control, can greatly reduce this risk. The heart is essentially a muscular pump that circulates about 2,000 gallons of blood throughout the body every day. It has four chambers: two upper chambers called atria, which receive blood, and two lower chambers called ventricles, which pump blood out. The chambers are separated by four heart valves that open and close in such a way that blood flows only in the proper direction. Each heartbeat involves a series of expansions and contractions of the heart muscle, as the heart receives oxygen-depleted blood from the body, sends it to the lungs to release carbon dioxide and receive oxygen, and delivers the oxygen-rich blood to the heart and the rest of the body. A healthy heart adjusts its output of blood based on the body’s changing needs, pumping more blood when a person is active and less blood when he is at rest. In congestive heart failure, the heart does not actually stop beating, but one or both of the ventricles become weak and unable to pump vigorously. As blood flow slows down, blood and fluid build up, or congest, in parts of the body. If the left ventricle is not pumping properly, blood and fluid collect in the lungs or heart; if the right ventricle is weak, fluid builds up in the legs and feet. If CHF continues untreated, the heart muscle may thicken or enlarge to compensate for its diminished pumping capacity, a change that further weakens the heart muscle. Heart failure usually develops gradually over many years, most often as the result of underlying coronary artery disease, damage to the heart muscle from a pre Continue reading >>

Heart Disease: The Diabetes Connection

Heart Disease: The Diabetes Connection

Most people living with diabetes are aware that they have an increased risk of cardiovascular disease. But the statistics can be truly staggering: Nearly two-thirds of people with diabetes have high blood pressure, and, according to the American Diabetes Association, people with diabetes are two to four times more likely to die of heart disease or have a stroke than people who don't have the condition. The good news: Learning more about the link between heart disease and diabetes can help you take steps to help protect your heart and manage your diabetes. How Diabetes and Heart Disease Are Related The connection between diabetes and heart disease starts with high blood sugar levels. Over time, the high glucose in the bloodstream can damage the arteries, causing them to become stiff and hard. Fatty material that builds up on the inside of these blood vessels, a condition known as atherosclerosis. This 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. Other heart facts to consider: People with diabetes develop cardiovascular disease at a much earlier age than others. Heart disease that leads to heart attack or stroke is the leading cause of death among people with diabetes. A person who has diabetes has the same risk of heart attack as someone who is not diabetic, but already had a heart attack. Protecting Your Heart When You Have Diabetes If you believe you are at a higher risk for heart disease, don’t despair. There are several small lifestyle changes you can make to not only help prevent heart disease, but also manage your diabetes more effectively. Be active. The American Heart Association recomme Continue reading >>

8 Ways To Avoid Heart Attacks And Strokes If You Have Diabetes

8 Ways To Avoid Heart Attacks And Strokes If You Have Diabetes

Protect your heart Although many people with type 2 diabetes worry about losing their vision or having an amputation, the greater risk is to the heart and brain. About 65% of people with type 2 diabetes die of heart disease or stroke. They are two to four times more likely to die of heart disease than people without diabetes. "When someone does get a diagnosis of diabetes, they probably have had prediabetes for as long as 10 years," says Gerald Bernstein, MD. "By the time their diagnosis is made, their risk for cardiovascular disease is extremely high. And then 10 years later, they will have their first cardiovascular event." An enormous challenge "People with type 2 diabetes are faced with an enormous challenge. Because they not only have the problem of glucose metabolism that has gone astray, but in most patients, they have an associated problem related to their cholesterol and to their blood pressure, and obviously their weight," says Dr. Bernstein, director of the diabetes management program at the Gerald J. Friedman Diabetes Institute at Beth Israel Medical Center in New York City. "All of these things have to be attacked with the same vigor." To help prevent heart attacks and stroke, the National Institute of Diabetes and Digestive and Kidney Diseases recommends the following steps. Control your blood sugar If you've been prescribed medication, take it. To make sure your blood sugar is in the safe zone, get a hemoglobin A1C test at least twice a year. This test measures the amount of glucose stuck to red blood cells, which is a sign of blood sugar control in the previous three months. (Aim for below 7%). For a better sense of your daily blood sugar or how food affects it, you can prick your finger and use a blood glucose monitor to get a reading. (It should be 90 Continue reading >>

The Pathophysiology Of Cardiovascular Disease And Diabetes: Beyond Blood Pressure And Lipids

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 >>

Abdominal Fat May Cause Type 2 Diabetes, Heart Disease

Abdominal Fat May Cause Type 2 Diabetes, Heart Disease

Researchers have found that abdominal fat may either cause or relate to the cause of type 2 diabetes and coronary heart disease. People who are genetically at a greater risk of having a higher waist-to-hip ratio adjusted for body mass index are likely to have an increased risk of developing these conditions. New research detailing these findings was published in JAMA. Body mass index (BMI) is used to measure body fat based on height and weight, and it is a common method of working out whether a person is overweight or obese. Obesity is a major risk factor for both type 2 diabetes and coronary heart disease. Regardless of BMI, body fat distribution can vary from one person to the next. Some people carry more fat around their visceral organs, called abdominal adiposity (fat), while others carry fat on their thighs and hips. Previous observational studies have indicated that abdominal fat is associated with type 2 diabetes and coronary heart disease. However, it remains unclear whether these associations represent a causal relationship. Dr. Sekar Kathiresan, of Massachusetts General Hospital in Boston, and colleagues conducted a study to investigate whether being genetically inclined to have an increased waist-to-hip ratio (WHR) adjusted for BMI (a measure of abdominal fat) was linked to cardiometabolic traits (such as lipids, glucose, insulin, and systolic blood pressure), and type 2 diabetes and coronary heart disease. The team gathered data from four genome-wide association studies conducted between 2007 and 2015, which included up to 322,154 participants, and individual-level, cross-sectional data from the UK Biobank collected between 2007 and 2011, which included data from a further 111,986 people. Estimates for cardiometabolic traits were based on this combined data Continue reading >>

Diabetes And Heart Disease — An Intimate Connection

Diabetes And Heart Disease — An Intimate Connection

By By Om P. Ganda, M.D., Director, Lipid Clinic, Joslin Diabetes Center A strong link between diabetes and heart disease is now well established. Studies from Joslin Diabetes Center several years ago showed a two- to threefold increase in the incidence of heart disease in patients with diabetes compared with those without diabetes who were being followed in the Framingham Heart Study. Women with diabetes have an even greater risk of heart disease compared with those of similar age who do not have diabetes. In fact, cardiovascular disease leading to heart attack or stroke is by far the leading cause of death in both men and women with diabetes. Another major component of cardiovascular disease is poor circulation in the legs, which contributes to a greatly increased risk of foot ulcers and amputations. Several advances in the treatment of heart disease over the past two decades have improved the chances of surviving a heart attack or stroke. However, as the incidence of diabetes steadily increases, so has the number of new cases of heart disease and cardiovascular complications. Unfortunately, in patients with diabetes, improvement in survival has been less than half as much as in the general population. Why Is Heart Disease So Common in People With Diabetes? Diabetes by itself is now regarded as the strongest risk factor for heart disease; however, a variety of mechanisms—not solely blood glucose levels—most likely come into play. The blood vessels in patients with diabetes are more susceptible to other well-established risk factors, such as smoking, high cholesterol and high blood pressure, and more than 90% of patients with diabetes have one or more of these additional risk factors. Some of the increased susceptibility to blood vessel damage that people with diabe Continue reading >>

What Does Diabetes Do To Your Heart Disease Risk?

What Does Diabetes Do To Your Heart Disease Risk?

Many people with diabetes also have heart disease. When you do things to take care of your diabetes, like manage your blood sugar, exercise, and eat a healthy diet, that's also good for your heart. It's important to understand your risk and how you can lower it. Besides diabetes, do you also have: A waist that's larger than 35 inches in women or 40 inches in men? Low levels of "good" ( HDL) cholesterol? High levels of "bad" (LDL) cholesterol or triglycerides (another type of fat in the blood)? Even borderline elevated at 130/85 If you're not sure, your doctor can check all those numbers for you. Also, do you: Smoke? Have a family member with heart disease? Your doctor needs that information to work with you on a plan for better heart health. People with diabetes are at risk for: Coronary artery disease. Your coronary arteries are in your heart. Fatty deposits, called plaques, can narrow them. If plaque suddenly breaks, it can cause a heart attack. Exercise, eating a healthy diet, and not smoking are musts. It could be from coronary artery disease or from the diabetes. It can be dangerous and fatal, so aggressive management and follow up is essential Congestive heart failure. This is an ongoing condition in which the heart loses the ability to pump blood effectively. The main symptoms are shortness of breath when you're moving and leg swelling. Many people have both conditions. If you smoke, it's time to quit. Set a date and talk to your doctor. If you've tried to quit before, it's not too late. Many people try several times before they kick the habit for good. Nearly everyone with diabetes can benefit from getting more exercise. It's good for your heart and helps control your blood sugar. Even brisk walking counts, so you don't need a gym. If you're not active now, let Continue reading >>

What Percentage Of Chronic Disease (heart Disease, Hypertension, Diabetes Type 2, Etc.) Is Caused By Inactivity And Poor Eating Habits?

What Percentage Of Chronic Disease (heart Disease, Hypertension, Diabetes Type 2, Etc.) Is Caused By Inactivity And Poor Eating Habits?

Sedentary lifestyle and unhealthy eating habits are the plague of this era, with the all this advanced technologies and innovations we barely move, we use cars, phones and remote controls everywhere. This physical inactivity and the emergence of unhealthy fast food with the huge amount of fat and carbs in it predisposes the body to a wide range of diseases. Obesity is like the mother of all major chronic diseases like Diabetes type 2, Hypertension, and subsequently Ischemic Heart Disease. Diabetes type 2 have some hereditary component so a positive family history along with obesity and sedentary lifestyle are major risk factors. These are also a risk factors for Primary Hypertension along with Cigarettes smoking. Diabetes, Hypertension and their risk factors (Sedentary lifestyle, Obesity, Hyperlibidemia and smoking) predisposes to more devastating diseases like Ischemic Heart Disease, Chronic Kidney Disease, Stroke, Peripheral Neuropathy, Lower Limb Ischemia, Retinopathy... etc. A nightmare I know. So the sequence pretty much goes like this: Genetic predisposition(!) > Unhealthy diet > Sedentary lifestyle > Obesity > Diabetes or Hypertension > NIGHTMARES. Note that the more advance in this simple sequence you are, the more difficult to manage and to stop this from progressing. But in general if you discovered your Hypertension or Diabetes early you can prevent or delay the complication with diet, exercise and good medical control. So please eat healthy, practice, and make sure your family and your friends do the same, it's everyone's job to advise people and teach them about how valuable a healthy diet and a 20 minute jogging outside are for their health. Continue reading >>

Diabetic Cardiomyopathy

Diabetic Cardiomyopathy

Diabetic cardiomyopathy is a disorder of the heart muscle in people with diabetes. It can lead to inability of the heart to circulate blood through the body effectively, a state known as heart failure,[1] with accumulation of fluid in the lungs (pulmonary edema) or legs (peripheral edema). Most heart failure in people with diabetes results from coronary artery disease, and diabetic cardiomyopathy is only said to exist if there is no coronary artery disease to explain the heart muscle disorder.[2] Signs and symptoms[edit] One particularity of diabetic cardiomyopathy is the long latent phase, during which the disease progresses but is completely asymptomatic. In most cases, diabetic cardiomyopathy is detected with concomitant hypertension or coronary artery disease. One of the earliest signs is mild left ventricular diastolic dysfunction with little effect on ventricular filling. Also, the diabetic patient may show subtle signs of diabetic cardiomyopathy related to decreased left ventricular compliance or left ventricular hypertrophy or a combination of both. A prominent “a” wave can also be noted in the jugular venous pulse, and the cardiac apical impulse may be overactive or sustained throughout systole. After the development of systolic dysfunction, left ventricular dilation and symptomatic heart failure, the jugular venous pressure may become elevated, the apical impulse would be displaced downward and to the left. Systolic mitral murmur is not uncommon in these cases. These changes are accompanied by a variety of electrocardiographic changes that may be associated with diabetic cardiomyopathy in 60% of patients without structural heart disease, although usually not in the early asymptomatic phase. Later in the progression, a prolonged QT interval may be indicativ Continue reading >>

Diabetes Treatments And Risk Of Heart Failure, Cardiovascular Disease, And All Cause Mortality: Cohort Study In Primary Care

Diabetes Treatments And Risk Of Heart Failure, Cardiovascular Disease, And All Cause Mortality: Cohort Study In Primary Care

Abstract Objective To assess associations between risks of cardiovascular disease, heart failure, and all cause mortality and different diabetes drugs in people with type 2 diabetes, particularly newer agents, including gliptins and thiazolidinediones (glitazones). Design Open cohort study. Setting 1243 general practices contributing data to the QResearch database in England. Participants 469 688 people with type 2 diabetes aged 25-84 years between 1 April 2007 and 31 January 2015. Exposures Diabetes drugs (glitazones, gliptins, metformin, sulphonylureas, insulin, other) alone and in combination. Main outcome measure First recorded diagnoses of cardiovascular disease, heart failure, and all cause mortality recorded on the patients’ primary care, mortality, or hospital record. Cox proportional hazards models were used to estimate hazard ratios for diabetes treatments, adjusting for potential confounders. Results During follow-up, 21 308 patients (4.5%) received prescriptions for glitazones and 32 533 (6.9%) received prescriptions for gliptins. Compared with non-use, gliptins were significantly associated with an 18% decreased risk of all cause mortality, a 14% decreased risk of heart failure, and no significant change in risk of cardiovascular disease; corresponding values for glitazones were significantly decreased risks of 23% for all cause mortality, 26% for heart failure, and 25% for cardiovascular disease. Compared with no current treatment, there were no significant associations between monotherapy with gliptins and risk of any complications. Dual treatment with gliptins and metformin was associated with a decreased risk of all three outcomes (reductions of 38% for heart failure, 33% for cardiovascular disease, and 48% for all cause mortality). Triple treatment w Continue reading >>

The Connection Between Diabetes, Heart Disease, And Stroke

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 >>

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