Cardiovascular Complications and Diabetes
Robin Brain
November 22, 2008
According to the U.S. Centers for Disease Control (CDC), a staggering 65 percent of people with diabetes die from heart disease or stroke, yet few people with diabetes are aware of their increased cardiovascular risks. Bringing blood glucose, blood pressure, and LDL cholesterol levels down is the best way to combat diabetes-related cardiovascular complications. The National Diabetes Education Program (NDEP) and the Department of Health and Human Services (HHS) recommend following the "ABCs" of diabetes treatment to maintain optimal heart health. recommended. If these don't provide sufficient improvement, or if LDL and or triglyceride levels are significantly elevated to begin with, drugs called statins such as Lipitor (atorvastatin), Pravachol (pravastatin), or Zocor (simvastatin ) may be prescribed.
Atherosclerosis And CAD
Atherosclerosis, more commonly known as hardening or clogging of the arteries, is caused by a buildup of fatty material (also called plaque or cholesterol), which restricts blood flow. For patients with arterial obstructions, medications such as nitroglycerin, beta blockers, and angiotensin converting enzyme (ACE) inhibitors may be prescribed. Blockage to the arteries that feed the heart is called coronary artery disease (CAD). What makes CAD particularly dangerous is that symptoms don't typically appear until vessels are significantly blocked. Symptoms of CAD include:
Chest pain (angina)
Pain in the left arm or shoulder (referred pain)
Neck or jaw pain
Chest tightness or pressure
Shortness of breath
Nausea
Perspiration
Irregular heartbeat (arrhythmia)
An electrocardiogram (ECG), echocardiogram, and/or stress test may be helpful in diagnosing blocked arteries. If CAD is left untreated, the artery may become completely blocked. When blood flow is severely restricted to the heart, or completely blocked off, myocardial infarction (heart attack) occurs. Without oxygen from the blood, the affected area of heart muscle dies. Symptoms of a heart attack are the same as those described previously for CAD, except the pain is considerably more intense, and the symptoms prolonged. However, in people with diabetes who suffer from autonomic neuropathy, pain symptoms may not be felt at all, resulting in a "silent heart attack." In cases of stroke or heart attack, where restoring blood flow is critical to prevent tissue death and damage, clot dissolving or "clot busting" (fibrinolytic or thrombolytic) drugs may be administered such as Activase (alteplase), Streptase (streptokinase), Abbokinase (urokinase), Eminase (anistreplase), or Retavase (reteplase).
E Fact
In those at risk, an aspirin a day may keep heart disease away. The ADA recommends that adult men and women with a history of or risk factors for CAD, PVD, stroke, or heart attack take a daily dose of 81 to 325 milligrams of coated aspirin. Aspirin therapy is not recommended for those with aspirin allergy, liver problems, bleeding disorders, or young people. You may also require an angioplasty, a procedure in which a catheter is inserted into the artery and an attached balloon is expanded to clear the blockage. Sometimes, a device called a stent, which is expanded inside the artery to hold the vessel open, is used. Atherectomy, a procedure that strips fatty blockages out of the artery, may also be performed.Studies have indicated that coronary bypass surgery may have better long term outcomes than angioplasty for people with diabetes. Bypass involves rerouting the circulation by grafting a healthy piece of artery onto the obstructed blood vessel and around the blockage.
Atherosclerosis And CAD
Atherosclerosis, more commonly known as hardening or clogging of the arteries, is caused by a buildup of fatty material (also called plaque or cholesterol), which restricts blood flow. For patients with arterial obstructions, medications such as nitroglycerin, beta blockers, and angiotensin converting enzyme (ACE) inhibitors may be prescribed. Blockage to the arteries that feed the heart is called coronary artery disease (CAD). What makes CAD particularly dangerous is that symptoms don't typically appear until vessels are significantly blocked. Symptoms of CAD include:
Chest pain (angina)
Pain in the left arm or shoulder (referred pain)
Neck or jaw pain
Chest tightness or pressure
Shortness of breath
Nausea
Perspiration
Irregular heartbeat (arrhythmia)
An electrocardiogram (ECG), echocardiogram, and/or stress test may be helpful in diagnosing blocked arteries. If CAD is left untreated, the artery may become completely blocked. When blood flow is severely restricted to the heart, or completely blocked off, myocardial infarction (heart attack) occurs. Without oxygen from the blood, the affected area of heart muscle dies. Symptoms of a heart attack are the same as those described previously for CAD, except the pain is considerably more intense, and the symptoms prolonged. However, in people with diabetes who suffer from autonomic neuropathy, pain symptoms may not be felt at all, resulting in a "silent heart attack." In cases of stroke or heart attack, where restoring blood flow is critical to prevent tissue death and damage, clot dissolving or "clot busting" (fibrinolytic or thrombolytic) drugs may be administered such as Activase (alteplase), Streptase (streptokinase), Abbokinase (urokinase), Eminase (anistreplase), or Retavase (reteplase).
E Fact
In those at risk, an aspirin a day may keep heart disease away. The ADA recommends that adult men and women with a history of or risk factors for CAD, PVD, stroke, or heart attack take a daily dose of 81 to 325 milligrams of coated aspirin. Aspirin therapy is not recommended for those with aspirin allergy, liver problems, bleeding disorders, or young people. You may also require an angioplasty, a procedure in which a catheter is inserted into the artery and an attached balloon is expanded to clear the blockage. Sometimes, a device called a stent, which is expanded inside the artery to hold the vessel open, is used. Atherectomy, a procedure that strips fatty blockages out of the artery, may also be performed.Studies have indicated that coronary bypass surgery may have better long term outcomes than angioplasty for people with diabetes. Bypass involves rerouting the circulation by grafting a healthy piece of artery onto the obstructed blood vessel and around the blockage.
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