Preventing heart disease

Heart disease is common in people with diabetes. The numbers can be frightening: About 80% of sufferers will develop major complications of the circulatory system, including cardiovascular disease (CVD). Individuals with diabetes have twice the risk of heart attack and stroke as other people. And the risk of dying after one of these events is higher for people with diabetes than for the general population. In fact, CVD is the major cause of death in people with diabetes.

Despite these grim statistics, you can do several things to reduce your chances of developing heart disease. To help you in this effort, the American Diabetes Association and the American Heart Association recently updated their guidelines for preventing heart disease.

How to Decrease Your CVD risk
The best ways to decrease your risk of CVD are:

• Have your blood tested by your doctor on a regular basis to determine your lipid profile.
• Decrease blood levels of LDL (“bad”) cholesterol and raise levels of HDL (“good”) cholesterol.
• Lower levels of triglycerides (a blood fat).
• Lower high blood pressure (below 130/80 is best).
• Control blood glucose (sugar) levels.
• Keep your weight within normal range.
• If you smoke, quit.
• If you are willing to eat a healthier diet and exercise regularly, you may be able to prevent or delay the need for medications.

Benefits of proper diet and exercise
Another way people with diabetes can reduce their risk of heart disease is by following a proper diet and being physically active. These lifestyle measures help lower “bad” cholesterol and high blood pressure, control blood sugar levels, and maintain weight.

A proper diet includes eating lots of fresh fruits and vegetables and low-fat dairy products. One major purpose of a good diet is to maintain a healthy weight. When obese people lose weight—even as little as 10% of their body weight—they lower their blood sugar and reduce other risk factors for CVD. A good diet may also control cholesterol levels. To accomplish that goal, choose foods that are low in saturated and “trans” fats, and eat plenty of fiber. To decrease blood pressure, avoid consuming too much sodium (salt), limit alcohol drinking, and include foods rich in potassium and calcium in your diet.

Some popular diets are very low in carbohydrates. Research suggests that “low-carb” diets do not achieve greater weight loss than other diets, and they are not recommended for people with diabetes. Check with your doctor before taking vitamins or other supplements.
Regular physical activity also helps control weight, blood sugar, and the risk of CVD. Experts recommend at least 30 minutes of moderately vigorous physical activity (such as brisk walking) five or more days a week, plus other activities. People with diabetes who plan to do more intense exercise should check with their doctors first.

When medical treatment is needed
Medications for CVD are generally added to diet and exercise if patients still have a high CVD risk despite other measures. Sometimes more than one drug is necessary. Your doctor can explain the various medications that are available. Some decrease blood pressure and others lower LDL. Your doctor may also recommend taking low daily doses of aspirin to decrease your risk of heart attack and stroke. Before and during treatment, your doctor should check your blood pressure and lipid levels.