Stopping Heart Disease In People With Diabetes

By James R. Dudi, M.D.
Internal Medicine, Kaiser Permanente, San Diego, CA

A heart attack occurs when the arteries that carry blood to the heart muscle become blocked or damaged. There is good news and bad news about heart disease and diabetes. The bad news is that heart attacks are the main diabetes-related complication in six of ten people with diabetes. However, the good news is that it can be prevented up to 75% of the time.

You might be wondering, why do heart attacks occur so often in people with diabetes and what contributes to the problem? There are at least five different things that occur and it's as easy to understand them as the AABCs:

Aggregation (clotting of the blood) causes part of the artery blockage in heart attack.

Angiotension, a hormone, hurts the heart by preventing proper healing.

Blood pressure that is high causes stress on the arteries.

Cholesterol deposits (called plaque) build up inside the arteries and cause a narrowing and eventual blockage of one or more arteries.

Smoking damages the lining of the artery and makes it easier to break open.

To prevent a heart attack, it's important to find out how to modify or change any or all of the AABCs listed above. Again, it's as simple as the AABCs:

Aspirin: Taking small doses of aspirin, such as one baby aspirin daily, can reduce the risk of heart attack by more than 15% by decreasing aggregation (clotting).

ACE inhibitor: A medication such as lisninopril (Zestril and Prinivil) reduces heart attacks more than 30% by decreasing angiotension, a substance that hurts the heart.

Blood pressure: Medications such as beta-blocker (Atenolol or hydrochlorothiazide) lower blood pressure which decreases stress on arteries.

Cholesterol-lowering medication: A number of medications such as Lovastatin, Simvastatin, or Lopid reduce artery disease 10-50% by decreasing the plaque buildup in the arteries.

Smoking cessation: By stopping smoking, the risk of heart attack is reduced 25% by strengthening the inside lining of the artery.

By looking at the AABCs, it becomes obvious that if you want to prevent a heart attack, you need to know your risks for heart disease. Ask yourself the following questions:

Do you have high blood pressure?

Do you have cholesterol over 240 or LDL (bad) cholesterol over 130?

Do you have HDL (good) cholesterol under 35?

Do you smoke?

Are you over 55 years of age?

If you answered yes to two or more of the questions, you are probably at a higher risk for heart disease. You and your health care professional should consider treatment with any of the AABCs that apply to you. Once you have maximized your treatment options, you can rest knowing that you and your health care professional have contributed to helping you live longer and healthier.

Vtla Kaliseji's note: Diet and exercise also go hand in hand with helping to fight heart disease. Talk to your physician about setting up a good diet and exercise program in addition to discussing the issues in the above article.