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Why Does Diabetes Increase The Risk For Heart Disease

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 >>

Cardiovascular Disease & Diabetes

Cardiovascular Disease & Diabetes

The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people age 65 or older with diabetes die from some form of heart disease; and 16% die of stroke. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of the seven major controllable risk factors for cardiovascular disease. 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 cardiovascular disease. High blood pressure (hypertension) High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles. 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 triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Obesity Obesity is a major risk factor for cardiovascular disease Continue reading >>

Does Supplemental Vitamin C Increase Cardiovascular Disease Risk In Women With Diabetes?1,2,3,4

Does Supplemental Vitamin C Increase Cardiovascular Disease Risk In Women With Diabetes?1,2,3,4

Abstract Background: Vitamin C acts as a potent antioxidant; however, it can also be a prooxidant and glycate protein under certain circumstances in vitro. These observations led us to hypothesize that a high intake of vitamin C in diabetic persons might promote atherosclerosis. Objective: The objective was to examine the relation between vitamin C intake and mortality from cardiovascular disease. Design: We studied the relation between vitamin C intake and mortality from total cardiovascular disease (n = 281), coronary artery disease (n = 175), and stroke (n = 57) in 1923 postmenopausal women who reported being diabetic at baseline. Diet was assessed with a food-frequency questionnaire at baseline, and subjects initially free of coronary artery disease were prospectively followed for 15 y. Results: After adjustment for cardiovascular disease risk factors, type of diabetes medication used, duration of diabetes, and intakes of folate, vitamin E, and β-carotene, the adjusted relative risks of total cardiovascular disease mortality were 1.0, 0.97, 1.11, 1.47, and 1.84 (P for trend < 0.01) across quintiles of total vitamin C intake from food and supplements. Adjusted relative risks of coronary artery disease were 1.0, 0.81, 0.99, 1.26, and 1.91 (P for trend = 0.01) and of stroke were 1.0, 0.52, 1.23, 2.22, and 2.57 (P for trend < 0.01). When dietary and supplemental vitamin C were analyzed separately, only supplemental vitamin C showed a positive association with mortality endpoints. Vitamin C intake was unrelated to mortality from cardiovascular disease in the nondiabetic subjects at baseline. Conclusion: A high vitamin C intake from supplements is associated with an increased risk of cardiovascular disease mortality in postmenopausal women with diabetes. Continue reading >>

Gestational Diabetes May Increase Risk Of Heart Disease

Gestational Diabetes May Increase Risk Of Heart Disease

I was at the end of my second trimester, and the nurse filled a disposable cup with 50 grams of glucose powder – a tad less than the amount of sugar in a 16-ounce bottle of Coke – and sent me to the water fountain to dilute it. I dutifully drank the sugary concoction that constituted the first part of the glucose screening test, a routine procedure used to help determine whether pregnant women have gestational diabetes mellitus, glucose intolerance that first becomes apparent during pregnancy. As I waited the required one hour until the nurse could draw my blood, I wasn’t particularly concerned. After all, I figured, even if I did have gestational diabetes, all it meant was a few months of careful eating and then the condition would disappear by the time I got to meet my baby. I ended up being lucky enough to pass the glucose test in all my pregnancies, but as for the assumptions I made – well, they may have been commonplace, but it turns out they weren’t completely accurate. That’s because while gestational diabetes, which affects an estimated 5 percent to 9 percent of pregnancies, does disappear with delivery, it also leaves something behind: an elevated risk of type 2 diabetes and heart disease for the mother. “A woman with a history of gestational diabetes has a very high risk of developing diabetes later in life, even if their sugar goes back to normal after pregnancy, and that puts them at increased cardiovascular disease risk,” said Dr. Erin Michos, the associate director of preventive cardiology at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, and an associate professor of medicine at Johns Hopkins University. “Many women have no idea that this is a cardiovascular disease risk.” Gestational diabetes is more prevalent Continue reading >>

Playing The Odds With Statins: Heart Disease Or Diabetes?

Playing The Odds With Statins: Heart Disease Or Diabetes?

Last year my cholesterol shot up despite living nowhere near a decent barbeque joint. I was totally stressed. I wasn't overweight. But I was pretty sedentary. My doctor prescribed a high dose of Lipitor, a powerful statin. For women of a certain age, statins are supposedly the best thing since Lycra for keeping wayward bodies in check. Statins interfere with the synthesis of low-density lipoprotein, the "bad" cholesterol. LDL is a prime suspect in heart disease, the top killer of women. The statin cut my cholesterol like buttah. But statins can also increase the risk of developing Type 2 diabetes, muscle and/or liver damage. Heart trouble and diabetes run in my family. Was I trading a heart attack for diabetes? "We give statins to people with diabetes," was all my doc said. That didn't answer my question. I knew from an unrelated test that I did not currently have coronary artery disease, so I decided to investigate the statin situation. In 2012 the Food and Drug Administration slapped a black box warning on statins, saying that they could raise blood glucose levels in people at high risk of Type 2 diabetes. That meant an increase of anywhere from 9 to 27 percent in relative risk – in absolute terms about 0.3 excess cases of diabetes for every 100 people who are treated for a year with high-intensity statins (which lower cholesterol by 50 percent or more) and 0.1 excess cases of diabetes for every 100 people treated with moderate-intensity statins (which lower cholesterol by 30 to 50 percent.) Because doctors disagree on who should get statins, in 2013 the American College of Cardiology and the American Heart Association issued guidelines advising doctors not to treat to a cholesterol target, but to prescribe statins if patients fit into one of four risk categories an Continue reading >>

Heart Disease

Heart Disease

Print Overview Heart disease describes a range of conditions that affect your heart. Diseases under the heart disease umbrella include blood vessel diseases, such as coronary artery disease; heart rhythm problems (arrhythmias); and heart defects you're born with (congenital heart defects), among others. The term "heart disease" is often used interchangeably with the term "cardiovascular disease." Cardiovascular disease generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina) or stroke. Other heart conditions, such as those that affect your heart's muscle, valves or rhythm, also are considered forms of heart disease. Many forms of heart disease can be prevented or treated with healthy lifestyle choices. Symptoms Heart disease symptoms depend on what type of heart disease you have. Symptoms of heart disease in your blood vessels (atherosclerotic disease) Cardiovascular disease symptoms may be different for men and women. For instance, men are more likely to have chest pain; women are more likely to have other symptoms along with chest discomfort, such as shortness of breath, nausea and extreme fatigue. Symptoms can include: Chest pain, chest tightness, chest pressure and chest discomfort (angina) Shortness of breath Pain, numbness, weakness or coldness in your legs or arms if the blood vessels in those parts of your body are narrowed Pain in the neck, jaw, throat, upper abdomen or back You might not be diagnosed with cardiovascular disease until you have a heart attack, angina, stroke or heart failure. It's important to watch for cardiovascular symptoms and discuss concerns with your doctor. Cardiovascular disease can sometimes be found early with regular evaluations. Heart disease symptoms caused b 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 >>

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 >>

Conditions That Increase Risk For Heart Disease

Conditions That Increase Risk For Heart Disease

Several medical conditions can increase your risk for heart disease. If you have one of these conditions, you can take steps to control it and lower your risk. High blood pressure is a major risk factor for heart disease. It is a medical condition that occurs when the pressure of the blood in your arteries and other blood vessels is too high. The high pressure, if not controlled, can affect your heart and other major organs of your body, including your kidneys and brain. High blood pressure is often called a “silent killer” because many people do not notice symptoms to signal high blood pressure. Lowering blood pressure by changes in lifestyle or by medication can reduce your risk for heart disease and heart attack. High Cholesterol Cholesterol is a waxy, fat-like substance made by the liver or found in certain foods. Your liver makes enough for your body’s needs, but we often get more cholesterol from the foods we eat. If we take in more cholesterol than the body can use, the extra cholesterol can build up in the walls of the arteries, including those of the heart. This leads to narrowing of the arteries and can decrease the blood flow to the heart, brain, kidneys, and other parts of the body. Some cholesterol is “good,” and some is “bad.” High cholesterol is the term used for high levels of low-density lipoprotein, or LDL, which are considered “bad” because they can lead to heart disease. A higher level of high-density lipoprotein cholesterol, or HDL, is considered “good” because it provides some protection against heart disease. A blood test can detect the amount of cholesterol and triglycerides (a related kind of fat) in your blood. Diabetes Diabetes mellitus also increases the risk for heart disease. Your body needs glucose (sugar) for energy. Continue reading >>

How Can Diabetes Increase The Risk Of Heart Disease?

How Can Diabetes Increase The Risk Of Heart Disease?

Diabetes is a disease that affects blood vessels. While we hear about the blood vessels in the eyes or the feet more commonly in diabetes, all blood vessels are affected. Usually we see the effect on the small vessels, but we also see an effect on the large vessels of the heart. People with diabetes, independent of other problems, have more heart attacks. An adult diagnosed with diabetes has the same high cardiac risk as someone who has already had a heart attack. At least 65% of people with diabetes will die from some type of cardiovascular disease -- a death rate that is two to four times that of the general population. Diabetes can also cause chronic kidney disease, which, in turn, can increase the risk of cardiovascular disease even more. The relationship between diabetes and heart disease is clear, but the causes are complex. Over time, too much glucose in the blood damages nerves and blood vessels. This in turn can cause heart disease and other cardiovascular diseases. Damage to the arteries leading to the brain can result in stroke. In addition, damage to the blood vessels in the legs can result in poor circulation and increase the risk of foot ulcers and amputations, while damage to the blood vessels that supply blood to the kidneys can cause kidney failure. Damage to the small blood vessels in the eye can eventually cause blindness. High blood glucose levels do not fully explain the relationship between diabetes and cardiovascular disease. People with diabetes also tend to have low-level inflammation of the lining of the arteries, which can interfere with the proper function of the blood vessels and make them more susceptible to developing atherosclerotic plaque - buildup of a fatty substance that narrows the artery. In addition, with diabetes there is a greate Continue reading >>

Statins May Seriously Increase Diabetes Risk

Statins May Seriously Increase Diabetes Risk

TIME Health For more, visit TIME Health. Doctors may have to weigh a serious potential risk before prescribing statins, the cholesterol-lowering drugs that are among most prescribed drugs in America. In a study published in Diabetologia, scientists from Finland found that men prescribed statins to lower their cholesterol had a 46% greater chance of developing diabetes after six years compared to those who weren’t taking the drug. What’s more, the statins seemed to make people more resistant to the effects of insulin—which breaks down sugar—and to secrete less insulin. The impact on insulin seemed to be greatest among those who started out with the lowest, and closest to normal, levels of blood glucose. And the higher the dose of the statin, and the longer the patients took them, the greater their risk of diabetes. Previous studies have suggested that statins can raise blood sugar levels, and increase the risk of diabetes by anywhere from 10% to 20%, but none have documented an effect this large. Doctors often consider statins for patients who are at higher risk of heart disease, and one of the risk factors for future heart trouble is diabetes. So how do these results affect that decision? “It’s a good news-bad news scenario,” says Dr. Robert Eckel, past president of the American Heart Association and professor of medicine at University of Colorado School of Medicine. “Although there is convincing evidence that patients on statins are at increased risk of new-onset diabetes, the benefit accrued [from statins] in reducing risks of heart attack, stroke and fatal heart disease trumps the effects of being new onset diabetics.” In other words, the good that statins can do for people who are not yet diabetic but at higher risk of heart problems outweighs the Continue reading >>

Skipping Breakfast Could Increase Your Risk Of Heart Disease

Skipping Breakfast Could Increase Your Risk Of Heart Disease

Magone via Getty Images (Reuters Health) - Planning meals and snacks in advance and eating breakfast every day may help lower the risk of cardiovascular disease, new guidelines from U.S. doctors say. Eating more calories earlier in the day and consuming less food at night may also reduce the odds of a heart attack, stroke or other cardiac or blood vessel diseases, according to the scientific statement from the American Heart Association. “When we eat may be important to consider, in addition to what we eat,” said Marie-Pierre St-Onge, chair of the group that wrote the guidelines and a nutrition researcher at Columbia University Medical Center in New York. As many as 30 percent of U.S. adults may routinely skip breakfast, a habit that has become more common in recent years as more people snack throughout the day instead of sitting down for three traditional meals, St-Onge and colleagues note in the journal Circulation. When people do eat breakfast daily, they’re less likely to have risk factors for cardiovascular disease like high cholesterol and elevated blood pressure. And people who skip this morning meal are more likely to have risk factors like obesity, poor nutrition and diabetes or high blood sugar. That’s because meal timing may affect health by impacting the body’s internal clock. We may not process sugars as well at night as we do during the day, and studies of shift workers have linked this schedule with a greater risk of obesity and heart disease than a typical day job, St-Onge said by email. “We know from population studies that eating breakfast is related to lower weight and healthier diet, along with lower risk of cardiovascular disease,” St-Onge said. “However, interventions to increase breakfast consumption in those who typically skip bre Continue reading >>

Diabetes And Heart Disease

Diabetes And Heart Disease

Tweet Heart disease is a complication that may affect people with diabetes if their condition is not managed well for a prolonged period of time.. Coronary heart disease is recognized to be the cause of death for 80% of people with diabetes, however, the NHS states that heart attacks are largely preventable. [48] How are heart disease and diabetes linked? People suffering from type 1 and type 2 diabetes are more likely to be at risk from heart attacks, strokes and high blood pressure. Vascular problems, such as poor circulation to the legs and feet, are also more likely to affect diabetes patients. Like diabetes itself, the symptoms of cardiovascular disease may go undetected for years. A Diabetes UK report from 2007 estimates that the risk of cardiovascular disease in people with diabetes is: [1] 5 times higher in middle aged men 8 times higher in women with diabetes. More than half of type 2 diabetes patients will exhibit signs of cardiovascular disease complications at diagnosis. Who does heart disease affect? Many people think that heart disease only affects the middle-aged and elderly. However, serious cardiovascular disease may develop in diabetics before the age of 30. Both type 1 and type 2 diabetics are at greater risk of developing heart disease. What is the cause of heart disease amongst diabetics? Hyperglycemia, which characterises diabetes, in combination with free fatty acids in the blood can change the makeup of blood vessels, and this can lead to cardiovascular disease. The lining of the blood vessels may become thicker, and this in turn can impair blood flow. Heart problems and the possibility of stroke can occur. What symptoms can identify heart disease? The following are common symptoms of heart disease, although this may vary from individual to indiv Continue reading >>

Diabetes Increases Heart Attack Risk By 48%

Diabetes Increases Heart Attack Risk By 48%

"People with diabetes 48% more likely to suffer heart attack, researchers find," says The Guardian. Meanwhile, the Daily Mail reports that people with diabetes are "65% more likely to have heart failure than the rest of the population". Both stories are based on the most recent report of the National Diabetes Audit, which presents data from England and Wales on the complications that arise due to diabetes. Diabetes makes it difficult for the body to control blood sugar levels. High blood sugar levels can damage blood vessels and lead to range of complications, such as: angina – chest pain that results from a temporary restriction of blood supply to the heart retinopathy – where the retina (the light-sensitive layer of tissue at the back of the eye) is damaged foot ulcers, which in the most serious cases, require a section of the foot or lower leg to be amputated People with type 1 diabetes can also experience a dangerous complication called diabetic ketoacidosis where the body breaks down fat as an alternative source of fuel. Left untreated, diabetic ketoacidosis can be fatal. The National Diabetes Audit report highlights these complications, as well as deaths in people with diabetes. The audit confirms and quantifies these risks, and provides recommendations on how the NHS can benefit from addressing the complications of diabetes, and how this can improve the lives of people with diabetes. Who produced the report? The National Diabetes Audit is produced by the NHS Information Centre each year. It looks at diabetes care and outcomes throughout England and Wales. The portion of the report covered in the media specifically focuses on complications and deaths related to diabetes. The current report covers the eighth year of the audit, and is based on data from 2010-11. Continue reading >>

Review Diabetes And Cardiovascular Disease: Insights From The Framingham Heart Study

Review Diabetes And Cardiovascular Disease: Insights From The Framingham Heart Study

In 1949, it was noted that “the proper control of diabetes is obviously desirable even though there is uncertainty as to whether coronary atherosclerosis is more frequent or severe in the uncontrolled diabetic” [1]. The role of diabetes in cardiovascular disease (CVD) had been uncertain until the prominent paper published by Kannel and McGee in 1979 [2] identified it as a major risk factor based on evidence from the Framingham Heart Study (FHS), the seminal prospective study of CVD and its determinants. This study provided an update to the FHS, using data that had been collected for 20 years. The results, hence, changed the way healthcare providers thought about diabetes and paved the way for its establishment as a major cardiovascular risk factor. The Kannel and McGee paper is briefly discussed here with its major implications and contributions to subsequent studies. Determinants of CVD from FHS Kannel and McGee studied the Framingham cohort of men and women 45 to 74 years of age at the time of the study who had been followed biennially over a 20-year period. At each biennial examination, participants diagnosed with the defined cardiovascular endpoints were identified. The diagnosis of diabetes in this study was made based on either a history of treatment with oral hypoglycemic agents or insulin, or a random blood glucose level >150 on 2 separate occasions; participants with these characteristics and an abnormal glucose tolerance test were classified as having diabetes. Selection was performed at each biennial examination based on age, status of diabetes, and other characteristics of interest. At each subsequent biennial examination, incidence of cardiovascular events was documented and the participants were then reclassified. The investigators looked at 3 variable Continue reading >>

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