Diseases of the heart or blood vessels are the leading cause of death in the United States, accounting for nearly half of all deaths. One American dies of heart disease every 33 seconds and one in four people in this country has some form of cardiovascular disease (CVD). Diabetes is a major risk factor for developing heart disease, and people with diabetes are at two to four times greater risk of developing CVD than people without diabetes.
Cardiovascular disease is an umbrella category for coronary heart disease, cerebrovascular disease, and peripheral vascular disease:
- Atherosclerosis, or hardening of the arteries, is a build-up of cholesterol-containing plaques in the interior walls of arteries and a thickening of their walls.
- Angina is the name given to the pain you feel when blood has trouble getting through the clogged coronary arteries in your heart.
- Heart attack, or myocardial infarction, occurs when a coronary artery is completely blocked or when a blood vessel in the brain leaks blood, allowing heart tissue to die.
- A stroke occurs when an artery to the brain is completely blocked.
- Peripheral vascular disease refers to narrowing of the arteries supplying blood to the legs.
- High blood pressure (hypertension) speeds the development of atherosclerosis and leads to enlargement of the heart (left ventricular hypertrophy).
Unlike its effect on the other complications of diabetes, good blood glucose control is not particularly effective in preventing CVD. However, many other preventive measures can be taken to decrease the risk of cardiovascular disease. The major targets are a reduction in blood lipids (cholesterol and triglycerides), cessation of cigarette smoking, and treatment of hypertension. A low-fat, low-cholesterol diet can decrease blood lipid levels, but cholesterol-lowering drugs are often necessary. Obesity is also associated with an increased risk of heart disease, and weight loss can help lower blood pressure and prevent heart disease. The importance of a low-fat, low-cholesterol diet cannot be overstated. In addition, a regular program of aerobic exercise not only helps with weight loss but also contributes on its own to cardiovascular health.