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Why Does Diabetes Cause Chf

Sulfonylureas And Heart Disease In Diabetes Management

Sulfonylureas And Heart Disease In Diabetes Management

Diabetes Spectrum Volume 12 Number 2, 1999, Pages 95–97 These pages are best viewed with Netscape version 3.0 or higher or Internet Explorer version 3.0 or higher. When viewed with other browsers, some characters or attributes may not be rendered correctly. In Brief The sulfonylureas constitute a class of oral hypoglycemic agents widely used in the treatment of type 2 diabetes. This review examines their effects on risk factors for cardiovascular disease, issues of safety from hypoglycemia, and cardiac outcomes during management of diabetes with sulfonylureas. Future research should examine compounds specific to the -cell sulfonylurea receptor. N. Wilson Rodger, MD, FRCPC, CDE Sulfonylureas have been the mainstay of oral hypoglycemic management of type 2 diabetes since their development more than 50 years ago.1 By 1986, drugs of this class represented 1% of all prescriptions in the United States, mainly as the first-generation compounds chlorpropamide and tolbutamide.2 Subsequently glipizide, glyburide (glibenclamide), and glimepiride have entered the market for use as monotherapy and in combination with insulin and other oral hypoglycemic agents.3,4 The prevalence of coronary artery disease (CAD) in the diabetic population, i.e., major Q-QS electrocardiogram abnormalities, angina, or myocardial infarction (MI), is 24 times that observed in the nondiabetic population.5 Congestive heart failure, to which CAD and hypertension contribute, is increased three- to four-fold.5 MI is the most common cause of death.6 The reversal of the causes of these frightening features of type 2 diabetes has been and remains a challenge necessitating an examination of our management of risk factors and of cardiac disease itself in diabetes. This review will deal with the effects of sulfony Continue reading >>

Heart Failure And Nephropathy: Catastrophic And Interrelated Complications Of Diabetes

Heart Failure And Nephropathy: Catastrophic And Interrelated Complications Of Diabetes

Abstract Heart failure (HF) is a major contributor to poor quality of life, a leading cause of hospitalization, and cause of premature death. Both kidney disease and diabetes are major and independent risk factors for the development of heart failure, such that individuals with diabetic nephropathy are at especially high risk. Such patients not only are likely to have coronary artery disease and hypertension but also are likely to have diabetic cardiomyopathy, a distinct pathologic entity that is more closely associated with the microvascular than the macrovascular complications of diabetes. In addition to a better understanding of the epidemiology of HF, advances in noninvasive imaging have highlighted the importance of early cardiac dysfunction in diabetes and the high prevalence of HF with preserved left ventricular systolic function. Although significant renal dysfunction is usually an exclusion criterion in HF trials, diabetes is often a prespecified subgroup so that subanalyses of large multicenter clinical trials do provide some guidance in therapeutic decision-making. However, further therapies for both HF and nephropathy in diabetes clearly are needed, and a number of new therapeutic strategies that target both disorders have already entered the clinical arena. Epidemiology Chronic HF is a major and growing public health problem in industrialized nations. In the United States, for instance, the prevalence of HF was 4.9 million in 2002 and is estimated to reach 10 million by 2007 (4), such that at age 40, there will be an approximate one in five lifetime risk for developing new-onset HF in both men and women (5). Despite the advances in therapy, mortality in HF remains high, with a 5-yr age-adjusted death rate of 59% in men and 45% in women (6). Moreover, in add Continue reading >>

Prevention And Treatment Of Congestive Heart Failure In Diabetic Patients

Prevention And Treatment Of Congestive Heart Failure In Diabetic Patients

Article INTRODUCTION Cardiovascular diseases are the most important complication, by far, of diabetes mellitus. Nowadays, cardiovascular complications are the major risk factor for morbidity and mortality in diabetic patients.1 It is well known that the most frequent heart disease in diabetes is coronary artery disease, including the major epicardial arteries and microcirculation. Mortality from acute myocardial infarction is greater in diabetic patients in the short and long term.2 Likewise, poorly controlled hyperglycemia is associated with a greater mortality in the acute phase of acute myocardial infarction.3 However, it was not so long ago that there was less information available on the association between diabetes mellitus and the other major cardiovascular complication, heart failure. Interest in heart failure has grown dramatically in the last decade for several reasons: a) increasing prevalence; b) poor prognosis (similar to that of common types of cancer); c) increased rate of hospital admissions; d) very high incidence (particularly in older persons), and e) high economic cost. Likewise, the development of new drugs capable of improving the prognosis and quality of life of patients with congestive heart failure has also helped to raise interest. Although arterial hypertension and coronary artery disease are the fundamental causes of congestive heart failure in our geographic area, diabetes mellitus is also associated with a greater risk of developing heart failure, as well as with a worse prognosis. It is not known for sure if this increased incidence of heart failure in diabetes is due to the consequences of coronary artery disease associated to diabetes or if it is a direct consequence of diabetes that is independent of myocardial ischemia, the so-called Continue reading >>

Converging Risk Factors For Stroke

Converging Risk Factors For Stroke

Excerpted from "When Risk Factors Unite," appearing in the Stroke Connection Magazine January/February 2005 (Science updated November 2017). Common risk factors for coronary heart disease and stroke that can be controlled or treated include: high LDL cholesterol levels, low HDL cholesterol levels, high blood pressure, smoking, diabetes, physical inactivity, and being overweight or obese. High levels of LDL cholesterol contribute to the development of atherosclerosis as the cholesterol is deposited in artery walls, increasing the buildup of plaque. Low levels of HDL cholesterol raise stroke risk because HDL cholesterol carries cholesterol away from the arteries and back to the liver where it is removed from the body. High Blood Pressure High blood pressure, 120/80 mm Hg or higher, causes the heart to work harder than normal. Both the heart and arteries are then more prone to injury. High blood pressure increases the risk of heart attacks, strokes, CHF, atherosclerosis and kidney failure. High blood pressure damages the inner lining of the blood vessels, which promotes the formation of atherosclerotic plaques. Over time the arteries become narrowed, hardened and less elastic, contributing even more to the high blood pressure. African Americans are more likely to have high blood pressure. As a result, they have a greater rate of nonfatal stroke, fatal stroke, heart disease death and end-stage kidney disease. High blood pressure also increases the risk of hemorrhagic stroke by weakening blood vessels. Also increasing hemorrhagic risk are arteriovenous malformations (AVM) and aneurysms, which are both vascular diseases that can be affected by high blood pressure. “AVM and aneurysm are congenital anomalies rather than diseases with risk factors we can treat,” says Dr. Roa Continue reading >>

Heart Disease And Diabetes

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 >>

Recognizing Serious Copd Complications

Recognizing Serious Copd Complications

Chronic obstructive pulmonary disease (COPD) refers to a collection of lung diseases that can lead to blocked airways. This can make it hard to breathe and cause coughing, wheezing, and mucus production. People with COPD can often develop other conditions and diseases related to COPD. For those living with COPD, every breath can be difficult. People with COPD can be at risk for serious complications that can not only put their health in jeopardy, but can also be fatal. Here are a few of those complications, along with some tips for preventing them. Pneumonia Pneumonia occurs when bacteria or viruses enter the lungs, creating an infection. According to the Centers for Disease Control and Prevention, bacterial pneumonia is the most common form of pneumonia in the United States. It’s ranked evenly with influenza as the eighth leading cause of death in the country. The illness is especially dangerous for those with a weakened pulmonary system, such as those who have COPD. For these people, pneumonia can further damage the lungs. This can lead to a chain reaction of illnesses that can weaken the lungs even further. This downward spiral can lead to a rapid deterioration of health in people with COPD. Overall good health is key to preventing infections in people with COPD. Here are some tips for reducing your risk of infection: Drink plenty of fluids, especially water, to maintain healthy bronchioles while thinning out mucus and secretions. Quit smoking or avoid smoking to maintain a healthy immune system and lung health. Wash your hands consistently. Avoid contact with people you know are ill. Discourage sick friends and family from visiting your home. Get pneumonia vaccines and a yearly flu vaccine. COPD heart failure One of the most critical complications of COPD is heart Continue reading >>

Hypothyroidism And The Heart

Hypothyroidism And The Heart

For people with almost any type of heart disease, disorders of the thyroid gland can worsen old cardiac symptoms or contribute to new ones. New research now strengthens the evidence that thyroid disorders and heart disease may also be a deadly combination. In the June issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a large study revealed that among participants with congestive heart failure, having hypothyroidism — even the mild form — significantly increases the risk of death compared to people with normal thyroid function. “Hypothyroidism has known effects on multiple cardiovascular pathways, including adverse effects on systolic and diastolic function, endothelial function, and lipid levels, and our study suggests that if someone has higher underlying cardiovascular risk, they may be more vulnerable to the effects of mild hypothyroidism,” says Connie Rhee, MD, of Brigham and Women’s Hospital in Boston, and lead author of the study. In hypothyroidism, an underperforming thyroid gland makes insufficient thyroid hormone, which may affect nearly every organ in the body, including the heart. According to the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases, nearly 5% of the U.S. population over the age of 12 (more than 9.5 million people) has hypothyroidism, which is diagnosed by measuring the levels of thyroid stimulating hormone (TSH) and thyroxine (T4) in the blood. In the JCEM study, researchers analyzed data from 14,879 participants from the “Third National Health and Nutrition Examination Survey”. Almost 750 of the participants had hypothyroidism, and 691 had a mild (“subclinical”) form of the condition. Patients were divided into two groups: those with heart failure and those without heart failure. In th 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 >>

Congestive Heart Failure: The Essence Of Heart Failure

Congestive Heart Failure: The Essence Of Heart Failure

Heart disease is the No. 1 cause of death in the world and the leading cause of death in the United States, killing approximately 380,000 Americans a year. Heart disease accounts for 1 in 6 deaths in the U.S. A person dies from heart disease about once in every 90 seconds (AHA, CDC, NIH, 2013). Each year an estimated 550,000 new cases of heart failure, also called congestive heart failure (CHF), both terms used interchangeably throughout this program, are diagnosed. Half of all newly diagnosed cases will die within five years of diagnosis. It is time to focus on recognition and management of the number one killer of our time, CHF. This course is an update and overview of congestive heart failure, or heart failure which simply exists when the effective cardiac output is not sufficient to meet the metabolic demands of the body. After completing this course, the student will be able to: Identify the prevalence of CHF Relate the history of CHF Discuss the pathophysiology of CHF Identify the signs and symptoms of CHF Discuss classification systems for CHF Congestive heart failure (CHF), also called heart failure, is a life-threatening condition in which the heart can no longer pump enough blood to meet the metabolic needs of the body. The very name echoes with the sound of doom. To the person being informed that they have it, the term CHF possesses an impact equal to cancer as a diagnosis. Nearly 5 million Americans live with CHF, with 550,000 new cases diagnosed each year. Of those hearing these words applied to them for the first time, nearly half will die of complications related to this condition within the first 5 years after diagnosis, bringing the annual death rate to nearly 380,000 cases in the United States each and every year. Despite such horrendous statistics, ne Continue reading >>

Impact Of Diabetes On Cardiovascular Disease: An Update

Impact Of Diabetes On Cardiovascular Disease: An Update

Copyright © 2013 Alessandra Saldanha de Mattos Matheus 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 diseases are the most prevalent cause of morbidity and mortality among patients with type 1 or type 2 diabetes. The proposed mechanisms that can link accelerated atherosclerosis and increased cardiovascular risk in this population are poorly understood. It has been suggested that an association between hyperglycemia and intracellular metabolic changes can result in oxidative stress, low-grade inflammation, and endothelial dysfunction. Recently, epigenetic factors by different types of reactions are known to be responsible for the interaction between genes and environment and for this reason can also account for the association between diabetes and cardiovascular disease. The impact of clinical factors that may coexist with diabetes such as obesity, dyslipidemia, and hypertension are also discussed. Furthermore, evidence that justify screening for subclinical atherosclerosis in asymptomatic patients is controversial and is also matter of this review. The purpose of this paper is to describe the association between poor glycemic control, oxidative stress, markers of insulin resistance, and of low-grade inflammation that have been suggested as putative factors linking diabetes and cardiovascular disease. 1. Introduction Diabetes is an important chronic disease which incidence is globally increasing and though considered as an epidemic [1]. The World Health Organization (WHO) estimated there were 30 million people who had diabetes worldwide in 1985. This number increased to 135 Continue reading >>

Congestive Heart Failure: Causes, Symptoms, And Treatments

Congestive Heart Failure: Causes, Symptoms, And Treatments

Even though it may sound like it, congestive heart failure does not necessarily mean that the heart has failed. However, heart failure is a serious condition where the heart does not pump blood around the body efficiently. We depend on the pumping action of the heart to deliver nutrient- and oxygen-rich blood to every cell in the body. When cells are not nourished adequately, it is not possible for the body to function properly. If the heart is weakened and cannot supply the cells with sufficient blood, the patient becomes tired and breathless. Everyday activities that were once taken for granted become challenging. Heart failure is a serious condition, and there is usually no cure. However, with the right treatment, the patient can still lead an enjoyable, meaningful, and productive life. According to the National Heart, Lung and Blood Institute, approximately 5.7 million people in the United States have heart failure. Contents of this article: Heart failure, heart attack, and cardiac arrest Here, we explain some important terms: Heart attack - this is death of heart muscle due to the blockage of a coronary artery. The heart muscle dies because it is starved of oxygen (because blood is not getting to it). Heart failure - this means the heart muscle cannot pump blood around the body properly. It is not a heart attack. Cardiac arrest - this means the heart stops, blood circulation stops, and there is no pulse. Causes of heart failure Heart failure is caused by any conditions that damage the heart muscle. These include: Coronary artery disease - the coronary arteries supply the heart muscle with blood. If these are blocked or the flow is reduced, the heart does not receive the blood supply it needs. Heart attack - a sudden block of the coronary arteries; this causes scars Continue reading >>

American Indian And Alaska Native Heart Disease And Stroke Fact Sheet

American Indian And Alaska Native Heart Disease And Stroke Fact Sheet

Heart disease is the leading cause of death among American Indians and Alaska Natives. In 2014, heart disease caused 3,288 deaths. Source: Stroke is the seventh leading cause of death among American Indians and Alaska Natives. In 2014, stroke caused 649 deaths among American Indians and Alaska Natives. Source: Heart disease and stroke are also major causes of disability and can decrease a person’s quality of life. American Indian and Alaska Native Adults Ages 35 Years and Older 2000 Census Population Estimates Data Source: CDC National Center for Health Statistics (NCHS) and U.S. Census Bureau. Population estimates are based on Bridged Race Vintage 2003 Postcensal Population Estimates from NCHS. The American Indian and Alaska Native Population There are approximately 4.5 million American Indians and Alaska Natives in the United States, 1.5% of the population, including those of more than one race. The median age of American Indians and Alaska Natives is 30.7 years, which is younger than the 36.2 years of the total U.S. population. California has the largest population of American Indians and Alaska Natives (696,600), followed by Oklahoma (401,100), and Arizona (334,700). Alaska has the highest proportion of American Indians and Alaska Natives in its populations (20%), followed by Oklahoma and New Mexico (11% each). Los Angeles County is the county with the most American Indians and Alaska Natives (154,000). A language other than English is spoken at home by 25% of American Indians and Alaska Natives aged 5 years and older. A high school diploma is held by 76% of American Indians and Alaska Natives over age 25; 14 percent have a bachelor’s degree or higher. The poverty rate of people who report American Indian and Alaska Native race only is 25%. Approximately 177,000 Continue reading >>

Heart Disease & Stroke

Heart Disease & Stroke

Health Alert: Preeclampsia May Be Associated with Heart Disease and Stroke Later in Life Heart disease is the leading cause of death for women and appears to be increasing in women aged 35 to 54 years. Women who have had preeclampsia have three to four times the risk of high blood pressure and double the risk for heart disease and stroke. They also have an increased risk of developing diabetes. For women who had preeclampsia and delivered preterm, had low-birthweight babies, or suffered from severe preeclampsia more than once, the risk of heart disease can be even higher. While still unknown whether the risk is caused by preeclampsia or if the woman was already predisposed, these risks first emerge in the years following a complicated pregnancy. Although this may seem daunting, ample research shows that there are many ways for women to protect their heart health and that of their families! This research does not mean you will definitely develop heart problems if you had preeclampsia, but for some women pregnancy can serve as an early warning sign for future heart disease. This kind of “heads up” gives you an opportunity to make changes now for a healthier tomorrow – and reap the benefits today, too! Many of the risk factors for preeclampsia and other conditions affecting your blood pressure and heart are similar. They include a family history of high blood pressure, heart disease and diabetes. While you can’t change your family history, you can adopt a heart-healthy lifestyle to significantly reduce these risk factors: Overweight or obese High blood pressure (greater than 140/90 mm hg) High blood sugar High blood triglycerides (a type of fat) Low HDL (“good” cholesterol) Smoking What can I do to reduce my risk for heart disease? If you had preeclampsia, you Continue reading >>

10 Silent Signs You Could Have Congestive Heart Failure

10 Silent Signs You Could Have Congestive Heart Failure

iStock/Portra Congestive heart failure is a condition in which the heart pumps less effectively, meaning blood flowing to the heart backs up throughout the body, and blood flowing from the heart is inadequate to meet the body’s needs. One of the first red flags may be noticing you’re feeling short of breath during normal daily chores or errands. “When the heart is impaired, blood backs up into the lungs making it hard to breathe,” says Gregg Fonarow, MD, spokesperson for the American Heart Association, heart failure cardiologist, and co-chair of the UCLA division of cardiology. “Patients present differently, but for some the most disturbing symptom is this shortness of breath,” he adds. “It can get so bad people have trouble breathing even during rest.” Other conditions like anemia can also cause shortness of breath. iStock/lzf The buildup of excess fluid in the body’s tissues, called edema, causes swelling most commonly in the feet and legs. “People may notice their shoes feel tight or their socks make lines on their ankles,” says Dr. Fonarow. In addition, with heart failure, the kidneys are less able to dispose of water and sodium, which also contributes to the retention of fluid in the tissues, says the American Heart Association (AHA). Here are some other common reasons you might experience swelling (and how to know when to call the doctor). iStock/Liderina The backup of fluids could also trigger coughing, says Dr. Fonarow. “It’s because of this symptom that heart failure can sometimes be misdiagnosed as asthma or bronchitis,” he explains. A cough that worsens at night and when lying down could be a sign of acute pulmonary edema, a condition in which too much fluid accumulates in your lungs requiring emergency attention, according to the Continue reading >>

Congestive Heart Failure And Heart Disease

Congestive Heart Failure And Heart Disease

Heart failure affects nearly 6 million Americans. Roughly 670,000 people are diagnosed with heart failure each year. It is the leading cause of hospitalization in people older than age 65. Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal. With heart failure, blood moves through the heart and body at a slower rate, and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart may respond by stretching to hold more blood to pump through the body or by becoming stiff and thickened. This helps to keep the blood moving, but the heart muscle walls may eventually weaken and become unable to pump as efficiently. As a result, the kidneys may respond by causing the body to retain fluid (water) and salt. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition. Heart failure is caused by many conditions that damage the heart muscle, including: Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients. Heart attack. A heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly. Cardiomyopathy. Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse. Condi Continue reading >>

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