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How to Avoid the Diabetes/Heart Disease Connection

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R. Todd Hurst, MD, FACC, FASE - Blogs
By R. Todd Hurst, MD, FACCBoard-certified cardiologistSeptember 10, 2018

If you have diabetes, is it inevitable that you’ll end up with heart disease as well? Traditional teaching suggested that it was, or at least highly likely – if you were diagnosed with diabetes, you were automatically categorized at “high risk.” But more recent data suggest that, with a little work, you can stay out of that high risk category – even with diabetes.

This research not only provides hope, but also a road map to lowering your risk for heart disease.

John’s Story

John had been told for years that diabetes increases his risk for heart disease, but he didn’t take the risk very seriously until chest pain and pressure led to the discovery of a blocked artery. We inserted a stent that opened his artery and relieved his pain, but the experience left John deeply concerned about his future health. He worried that he had missed his chance, that the damage was already done because he didn’t pay attention to his health when he was younger.

John’s new interest in his health resulted in some big changes. He started participating in cardiac rehab and exercising every day. He is eating nutritious food and has already lost 10 pounds! He is taking his medications and his blood sugar and cholesterol numbers are much improved.

But he is wondering if that is enough? Does he need to do more, or will his efforts even make a difference?

Diabetes and Heart Disease

One of the first major research studies to show that people with diabetes were at very high risk for heart disease was published in 1998. This was eye-opening to the medical community and led to a change in the way doctors treat patients with diabetes. Based on the recommendations from researchers, we began taking an aggressive preventive approach for all patients with diabetes, emphasizing lower blood pressure, improved blood sugar and statin medications. Around ten years later, a small study looked at the effects of this “multifactorial” approach to prevention and found that it does, in fact, lower the risk of death and heart disease in patients with diabetes. And now we have evidence in large populations that death rates and heart disease rates are falling in patients with diabetes.

These research findings are important because they show that heart disease is not inevitable if you have diabetes. A recent study goes a step further, not only showing that some people with diabetes can lower their risk for heart disease and stroke to the same levels as those without diabetes, but also provides a 5-step road map on how to do it.

(Lots of) Hope for People with Diabetes

A recently published study in the New England Journal of Medicine of over 1.6 million people showed that if 5 good health targets are met, those with diabetes have a similar risk for death, heart attack and stroke as those without.

Those 5 good health targets are:

  • Good blood sugar control (Hemoglobin A1C < 7.0%)
  • Good blood pressure control (Systolic blood pressure < 140 mm Hg, Diastolic < 80 mm Hg)
  • No protein in the urine
  • Not smoking
  • Good LDL cholesterol (LDL < 97 mg/dL)

We now have good evidence that if you have diabetes, you have a lot of control over your risk for heart disease. John was very happy to hear the news that his recent efforts are likely to pay big dividends for his future health. If you have diabetes, work with your doctor to identify the ways you can manage your diabetes and not let it manage you.

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About the Author
R. Todd Hurst, MD, FACC

R. Todd Hurst, MD, FACC, FASE, is a board-certified cardiologist, director of the Center for Cardiovascular Health at Banner – University Medicine Heart Institute, and associate professor of medicine at the University of Arizona. He has written more than 50 publications in peer-reviewed journals and regularly speaks nationally and internationally at medical meetings, primarily on the prevention of heart disease.

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