The relationship between diabetes and coronary disease is based on diabetes' effects on the body's vascular and metabolic systems. Diabetics frequently have high blood pressure and these two disorders together double a person's risk of heart disease, the American Heart Association reports. The effects of diabetes on coronary disease can be minimized through proper control of blood sugar. Medications, diet and lifestyle modifications aid in blood glucose stabilization.
Decreased Blood Flow
Over time, diabetes interferes with microcirculation affecting blood flow through small capillaries. Blood flow to the entire body, including the coronary vessels, is affected, according to Donna D. Ignatavicius and M. Linda Workman, authors of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care." Diminished circulation through the heart damages the heart muscle, leading to coronary heart disease. Long-term repercussions of coronary disease include heart attack and heart failure.
Impaired microcirculation also affects nerve-impulse transmission. A person with diabetes may not feel the pain of a heart attack. People who experience a silent heart attack are vulnerable to serious complications or sudden death because symptoms go unnoticed until significant heart muscle damage occurs.
Elevated Cholesterol
The American Heart Association, or AHA, explains the link between diabetes and high blood cholesterol levels. Diabetes causes dyslipidemia, a condition in which bad cholesterol, called LDL, and triglyceride levels in the blood increase, and good cholesterol levels, referred to as HDL, decrease. Dyslipidemia increases atherosclerosis or the build-up of plaque and fat in the arteries and reduces the protective properties of HDL. The AHA reports that patients with diabetes and dyslipidemia have the same risk for heart attack and stroke as patients who already have diagnosed coronary artery disease. The AHA advises that diabetic patients maintain an LDL below 100 milligrams per deciliter, triglyceride levels below 150 mg/dl, and an HDL level above 60 mg/dl.
Hypertension
Diabetes and high blood pressure, or hypertension, tend to occur together. Impaired microcirculation and dyslipidemia combined create conditions that elevate blood pressure. For example, blood vessels lose elasticity, becoming rigid and inflexible. High blood pressure increases the work load of the heart because the heart must overcome the high pressures in the arterial system every time it beats. Chronic hypertension and diabetes damage the heart and increase the risk for heart attack and heart failure. The AHA recommends that a diabetic maintain a blood pressure of no more than 130 over 80 to help prevent complications.
References
- American Heart Association: Diabetes and Hypertension
- "Medical-Surgical Nursing: Critical Thinking for Collaborative Care"; Donna D. Ignatavicius & M. Linda Workman; 2006
- American Heart Association: Diabetes and Cholesterol
