Diabetes and Coronary Artery Disease: How Are They Related?

Yes. Heart disease is the leading cause of death among people with diabetes. Adults with diabetes are nearly twice as likely to have heart disease as those without diabetes.

Also, people with diabetes typically develop heart disease at younger ages than those who don’t have diabetes. This is because high blood sugar levels damage blood vessels and nerves all over the body, including the blood vessels that maintain a healthy heart.

Cardiovascular disease (CVD), or heart disease, is a category of diseases that involve narrowing or obstruction of blood vessels, which can lead to stroke or heart attack. CAD is one type of CVD.

Having any kind of diabetes or chronic high blood sugar levels will pose a risk to your heart health.

The risk factors for heart disease are similar in people with type 1 and type 2 diabetes.

However, other risk factors, such as obesity, kidney disease, chronic inflammation, insulin resistance, high blood pressure (hypertension), and age, may increase your risk for heart disease.

These ancillary risk factors are more likely to affect older adults and people with type 2 diabetes than those with type 1 diabetes.

While diabetes doesn’t cause CAD, it does increase your risk of developing it.

CAD is caused by a buildup of fatty deposits (atheroma) on the walls of the coronary arteries, which surround your heart.

If you have diabetes, especially for a long time, you may experience damage (atherosclerosis) and narrowing of your blood vessels and arteries, including the ones around your heart. This can increase your heart disease risk.

Diabetes on its own will not cause blocked arteries. But chronic high blood sugar levels, which often accompany diabetes, can contribute to blocked arteries.

When your blood sugar is high due to a lack of insulin in your bloodstream, excess glucose cannot get into your cells and is left floating around in your body.

Over time, this excess glucose can damage your blood vessels and cause hardening of your arteries, or atherosclerosis.

Atherosclerosis is caused by a buildup of plaque in the inner lining of your arteries. This plaque may be made up of fatty deposits, cholesterol, cellular waste, calcium, and fibrin. It can be a direct result of chronically high blood sugar levels.

This is why it’s crucial to maintain healthy blood sugar levels. Doing so will not only protect your blood vessels but also minimize damage to and hardening of your arteries, including the ones around your heart.

Even if you have diabetes, you can lower your risk for heart disease through a few strategies.

Blood sugar levels and A1C

The longer you live with diabetes, the higher your risk for heart disease. This is why it’s crucial to maintain healthy blood sugar levels and an A1C under 7%.

High blood sugar levels can damage your arteries, blood vessels, heart, kidneys, feet, and eyes, so keeping your blood sugar within a healthy range is ideal.

You can work with your doctor to determine your goal blood sugar level and A1C and ask them about any changes to your diet and daily physical activity habits that can help you reach your goals.

Blood pressure

Many people with diabetes also live with high blood pressure. Blood pressure is the force of your blood against your blood vessel walls.

If your blood pressure gets too high, your heart will have to work harder to pump blood throughout your body. High blood pressure can cause heart attacks and strokes.

Most people with diabetes should maintain a blood pressure below 140/90 mm Hg. You can work with your doctor to determine what your blood pressure goals should be.

Cholesterol

Cholesterol is a form of fat found in your blood. High levels of LDL (“bad”) cholesterol and low levels of HDL (“good”) cholesterol can lead to heart attacks and strokes. Many people with diabetes also have high cholesterol levels and must take statins to protect their hearts.

Ideally, your HDL level should be above 60 and your LDL should be below 100, for a total cholesterol level of less than 200.

You can talk with your doctor about strategies to lower your cholesterol, including medication, especially if you are over 40 years old.

Not smoking

If you currently smoke, consider quitting. And if you don’t smoke, don’t start. Smoking directly leads to heart attacks and strokes by causing your blood to thicken and form clots inside veins and arteries. A blockage from a clot can lead to heart attack and sudden death.

People with diabetes are predisposed to narrow and blocked blood vessels and arteries, and smoking only increases the risk of CAD.

But it’s never too late to quit. Large studies from 2013 suggest that quitting smoking before age 40 reduces the risk of death by 90% and that quitting before age 30 avoids more than 97% of the risk of death associated with continued smoking into adulthood.

Additionally, the Centers for Disease Control and Prevention reports that people with diabetes experience less insulin resistance within 8 weeks of quitting smoking.

Diabetes and CAD are closely associated. CAD is the leading cause of death for people with both type 1 and type 2 diabetes, and around 80% of people living with diabetes will die from a cardiovascular event. You are twice as likely to have develop heart disease if you live with diabetes than if you do not.

This is because chronic high blood sugar levels due to diabetes can damage and narrow blood vessels and arteries, including ones surrounding your heart. That means your heart must work much harder to pump blood around your body, increasing the risk of heart attack and stroke.

However, maintaining healthy blood sugar and A1C levels, managing your blood pressure and cholesterol levels, and avoiding smoking can go a long way toward preventing death from CAD and CVD.