Harvard Health Publications Focus on Diabetes: Part 6

Focus On: Diabetes — How diabetes affects heart disease risk In this Issue: How diabetes affects heart disease risk View this e-mail as a Web page » To ensure delivery of our e-mails, add healthbeat@mail.health.harvard.edu to your address book. Please note this is for outgoing mail only. If you need help, please contact healthbeat@health.harvard.edu. Share with a friend » | Unsubscribe »

ISSUE #6 OF 6 IN AN E-MAIL SERIES

Featured Report Get your copy of Diagnosis: Coronary Artery Disease This report helps you identify the risk factors you can control, which range from medical conditions such as high blood pressure to lifestyle choices such as an unhealthy diet or lack of exercise. You'll learn about the steps you can take to eliminate or at least manage these risks. A Special Bonus Section on cardiac rehabilitation explains what to expect from these heart-healing programs, which can reduce deaths by up to 25% during the years following a heart attack or heart procedure. This report also describes the latest improvements in diagnosis and treatment—including medications and surgical procedures—so that you are aware of your options and can talk with your doctor about them. Click here to read more » Additional Resources •   What to do About High Cholesterol •   Healthy Eating for a Healthy Heart How diabetes affects heart disease risk Diabetes raises the risk of heart disease by four to five times compared with people without the disease. For this reason, in addition to controlling blood sugar, people with diabetes need to pay close attention to controlling their blood pressure and cholesterol levels. The treatment goals for people with diabetes are more stringent than those for people without diabetes. The good news is that lifestyle changes — and weight loss in particular—to improve your blood sugar usually will have a beneficial effect on the other values as well. Blood pressure targets for people with diabetes Your blood pressure reading has two parts, the systolic blood pressure (the first number) and the diastolic blood pressure (the second number). The systolic number represents the pressure while the heart is contracting and pushing blood into your vessels, and the diastolic number represents the pressure while the heart is refilling with blood between beats. People with high blood pressure (known medically as hypertension) are more than twice as likely to suffer a heart attack or stroke as those with normal blood pressure. For that reason, people with diabetes are advised to keep their blood pressure as close to the ideal as possible, and always less than 130/80 millimeters of mercury (mm Hg). Much of the dietary advice commonly recommended for people with diabetes—such as restricting salt intake, increasing physical activity, and losing weight—should help to lower your blood pressure. To make sure, your health care provider will test your blood pressure regularly. If diet and exercise alone do not bring your blood pressure into a healthy range, medications may be necessary to lower it. The ABC's of diabetes control Having diabetes increases your risk for cardiovascular disease, including heart attack and stroke. If you have diabetes, you should pay close attention to factors that can put you at greater risk for heart trouble. These are often referred to as the "ABC's:" hemoglobin A1c (HbA1c) blood sugar test Blood pressure Cholesterol. "ABC" Goals HbA1c Less than 7% Blood pressure Less than 130/80 mm Hg LDL (bad) cholesterol Less than 100 mg/dL Triglycerides Less than 150 mg/dL HDL (good) cholesterol More than 40 mg/dL in men and 50 mg/dL in women Cholesterol levels Your blood cholesterol level reflects the amount of one of the circulating lipids (fats) in your blood. This material travels in the bloodstream within spherical particles called lipoproteins. About two-thirds of blood cholesterol is in the form of low-density lipoprotein (LDL). This is sometimes referred to as "bad" cholesterol, because the higher the level of LDL cholesterol, the greater the risk for heart disease and stroke. High-density lipoprotein (HDL), on the other hand, counteracts the harmful effects of LDL. For that reason, HDL is sometimes referred to as "good" cholesterol. Another aspect of your lipid profile is the triglyceride level. Triglycerides are the main form of stored fat in the body and are carried by another type of lipoprotein. High triglyceride levels also increase the risk for heart disease, although not as much as LDL cholesterol. Blood tests for cholesterol, which are measured after a fast of eight hours or more, provide information on total cholesterol as well as LDL, HDL, and triglyceride levels. These measurements provide another indicator of whether the changes you have made in your diet and activity levels and any medications you take have reduced your risk for heart disease, and whether you need to make any further adjustments. The goals for LDL cholesterol in people with diabetes are quite stringent, as diabetes, in and of itself, places people at high risk for heart disease. The National Heart, Lung, and Blood Institute (NHLBI) recommends that everyone with diabetes keep LDL levels below 100 mg/dL. For people with diabetes whose cardiovascular risk is particularly high because they have a history of previous heart disease or other poorly managed risk factors (such as smoking cigarettes), the NHLBI suggests lowering LDL levels even further, to less than 70 mg/dL. Although dietary approaches are an important first step, medications are often required to reduce LDL cholesterol to ideal levels.

Featured In This Issue Diagnosis: Coronary Artery Disease Featured Content: • Recognizing and reducing risk factors • Diagnosing heart disease • Dealing with a heart attack • Healing your heart: Cardiac rehabilitation Click here to read more »

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