Diabetes and Heart Disease: What You Need To Know

If you didn’t know diabetes was a risk factor for heart disease, you are not alone. More than 66% of people surveyed in a recent study—led by the American Heart Association and investigators from the Smith Center for Outcomes Research in Cardiology at BIDMC—were also unaware of the connection.

“The knowledge gap identified in our study has important public health consequences,” said lead author Dhruv Kazi, MD, section head of Health Economics and the Associate Director of the Smith Center. Kazi adds, “People with this knowledge may also be more likely to get screened and treated once they develop diabetes, and follow strategies for preventing cardiovascular disease.” 

Understanding health risks could make a big impact on the estimated 38 million Americans living with diabetes in the US, nearly five and a half times the population of Massachusetts. Physicians and researchers also hope this information reaches the estimated 97 million adult Americans who have prediabetes. “Our findings underscore the need for concerted efforts to raise public health awareness,” emphasized first author Richard Chaudhary, MD, resident physician at Beth Israel Deaconess Medical Center.

How Does Diabetes Hurt the Heart?

Over time, consistently high blood sugar can damage blood vessels (veins and arteries) and the nerves that control one’s heart. Excess blood sugar can make blood vessels hard and cause them to narrow, reducing the supply of blood and oxygen to your body. This can eventually increase the risk of high blood pressure (hypertension) and heart disease. Nearly 74% of adults with diabetes have hypertension.

“Even if blood sugar levels are well managed, people with diabetes are still at risk of developing heart disease,” cautions Mark D. Benson, MD, PhD, Director of Preventive Cardiology at BIDMC. “This is because many people with diabetes also have other conditions that put them at greater risk for heart disease, including obesity and high cholesterol.”

Diabetes tends to alter cholesterol in the body by raising triglycerides or "bad" cholesterol and lowering the “good” fats. This type of cholesterol imbalance is characteristic of a lipid disorder associated with insulin resistance, often found in patients with diabetes. The disorder can usually be controlled with lifestyle changes and medication.

“The great thing about the role of cholesterol in preventing cardiovascular disease is that it can be modified. The first step is getting a cholesterol test to know your numbers. The next step is to talk with your physician to design a strategy to help you reach your personal cholesterol goals,” adds Benson.

How Can People with Diabetes Protect Their Heart Health?

For adults living with diabetes, it’s possible to manage the condition and have a healthy heart. Monitoring blood sugar, blood pressure, and cholesterol helps to prevent associated health problems. Lifestyle changes are also key in managing diabetes effectively, including:

• Stopping the use of all tobacco products
• Eating a heart-healthy diet
• Maintaining an active lifestyle and exercising regularly
• Managing stress

In addition to lifestyle changes, doctors often prescribe medications that decrease the risk of stroke and heart attack. Talk to a healthcare professional if you have questions or need support.

The Diabetes and Heart Disease Program at BIDMC and the Joslin Diabetes Center help patients with diabetes protect their heart health. The program offers early diagnosis and prevention strategies to enable patients to reduce their chances of heart attack, stroke, and vascular complications from diabetes.

Call 617-667-8800 to schedule an appointment.