Your heart is what keeps your body moving and it's important to keep it healthy. Heart disease is the leading cause of death for men and women in the United States. But what most people don't know, is that people with diabetes have a greater chance of being diagnosed with heart disease—and at a younger age—compared to patients without diabetes.
"Despite these statistics, there are lifestyle changes you can make to lower your chances of getting heart disease, make your heart healthier and better manage your diabetes," says Kaitlyn Ibrahim, MD, a cardiologist at Lankenau Heart Institute, part of Main Line Health, who specializes in preventive cardiology, women's heart health and the interplay of obesity and cardiovascular disease.
What exactly is heart disease?
Heart disease refers to several types of problems that can affect your heart. The most common type of heart disease is coronary artery disease, which impacts blood flow to the heart. This occurs when the arteries that carry oxygen and blood to your heart muscle are blocked by plaque—the buildup of too much fat and cholesterol in your arteries.
When plaque narrows the blood vessel, it blocks blood flow to the heart. This can lead to problems including:
- Angina pectoris (angina): This is chest pain caused by inadequate blood flow to the heart muscle.
- Heart attack: This occurs when there is severe or complete blockage of blood flow to the heart, typically resulting in death of part of the heart muscle.
- Heart failure: This is a condition where the heart muscle cannot pump enough blood and oxygen to meet the needs of the body.
- Arrhythmia: This is an abnormal heart rhythm that can be too slow, too fast and/or irregular.
There are also other types of heart disease that may affect your heart valves or heart muscle (cardiomyopathy).
People with diabetes are twice as likely to have heart disease or a stroke compared to someone without diabetes.
How does diabetes affect your heart?
If you have diabetes, you're already managing your blood sugar and may be routinely checking it. High blood sugar can be damaging to your blood vessels and nerves.
"When you have type 2 diabetes, you're twice as likely to have a heart attack or stroke than someone without type 2 diabetes," says Amanda Thomas, medical nutrition therapist at Main Line Health's Diabetes Management Program. "It's important to make healthy lifestyle choices to manage your blood sugar and keep your heart healthy."
Patients with diabetes are at higher risk for conditions that increase risk of heart disease including:
1. High triglycerides and high LDL
Triglycerides are a type of fat in the body. If you have diabetes along with high triglycerides and low levels of high-density lipoprotein (HDL, or "good") cholesterol, or high low-density lipoprotein (LDL, or "bad") cholesterol, this can potentially harden your arteries.
"Your provider might suggest more physical activity and that you limit sweets, sugar-sweetened beverages, refined carbohydrates, fast foods and fried foods to improve your cholesterol," says Thomas. "It can also be beneficial to add more fiber-rich foods into your diet."
Having elevated LDL cholesterol with your diabetes can also increase your risk of heart disease. This type of cholesterol is a small particle that can travel into the walls of the blood vessels leading to cholesterol plaque buildup.
When this happens, you may develop coronary artery disease. The plaque hardens or narrows in your arteries, preventing blood flow from reaching your heart. Your heart muscle needs the oxygen that your blood carries, so when it doesn't get enough, you can experience chest pain or even a heart attack.
Managing cholesterol levels—including triglycerides and LDL—is key in patients with diabetes.
2. High blood pressure
Some people with diabetes also have high blood pressure (called hypertension), which increases the risk for heart disease.
Diabetes can cause kidney damage, which leads to salt and water retention in the body. The retention of salt and water can cause high blood pressure, which increases the strain on the blood vessels in the body. This can cause damage to your artery walls.
To lower your blood pressure, your provider might recommend managing stress, eating a healthier diet and incorporating more physical activity into your day. If these measures don't work, then your provider may recommend medication to lower your blood pressure.
How do you lower your chances of getting heart disease?
Even though you may have a higher risk of heart disease because of your diabetes, there are still steps you can take to improve your heart health.
You can start by incorporating these lifestyle changes:
- Eat a healthy diet
- Be more active throughout your day
- Quit tobacco use
- Get enough sleep
- Manage your weight
- Control your cholesterol
- Manage your blood sugar
- Keep your blood pressure in a healthy range
If healthy lifestyle changes don't lower your cholesterol enough, your provider may also prescribe cholesterol lowering medications, such as statins. Your provider will work with you to determine the best plan of action to keep your cholesterol levels low and your heart healthy.
Recommendations are unique to each person. Talk with your doctor about how you can change your lifestyle to better support your heart health.
Schedule an appointment with Kaitlyn Ibrahim, MD
Learn more about our Diabetes Management Program and heart and vascular care at Main Line Health
Read about how controlling lipids can help manage heart disease risk