Diabetes & How it Affects Your Heart
Diabetes can increase a person’s risk of developing other health conditions, including cardiovascular disease. Michael Bashline, MD, a cardiologist with St. Clair Medical Group, explains, “The major cause of death in patients with diabetes is heart disease.”
Risk Factors
Most people have at least a 5-10% risk of cardiovascular disease, but that risk can double or even triple when a person is diagnosed with diabetes. Their risk levels also depend on whether they have type 1 or type 2 diabetes.
Those with type 1 diabetes have a slightly higher risk of developing heart disease because they are either born with the condition or are diagnosed very early in their lives. Type 2 diabetes most often develops in people 45 or older, and their risk only increases once they are diagnosed.
The Effect on Your Heart
Diabetes can affect your heart in two main ways. The most common way is through coronary artery disease. “That occurs when a person develops a blockage within their coronary artery, which can lead to a heart attack. Coronary artery disease and heart attacks are the number one ways that patients with diabetes ultimately end up passing away,” explains Dr. Bashline. The blockages that develop can result in more than just a heart attack; they can weaken the muscles within a patient’s heart, which can cause heart failure.
The other way that diabetes can affect your heart is through heart failure that is independent of any blockages. Dr. Bashline explains, “Patients with type 2 diabetes are more prone to develop a form of heart failure where the heart does not relax as much as it should. This causes the pressures within the heart to be higher, which can send the patient into heart failure.” This is often associated with metabolic syndrome, which consists of diabetes, obesity, high blood pressure, and high cholesterol.
Conditions that Contribute to a Higher Risk
On top of having diabetes, there are certain conditions and lifestyle choices that can increase the risk of developing cardiovascular disease. Smoking, high blood pressure, obesity, and inactivity can greatly increase a person’s risk of heart disease.
Cardiologists also consider family history. If you have a history of heart attacks or heart disease within your family, the addition of diabetes can make that risk even higher.
High cholesterol can also be a large risk factor. Dr. Bashline specifically focuses on LDL cholesterol. “That is what we refer to as the bad cholesterol. There are other factors within a lipid panel that we look out for, but LDL cholesterol is the main thing. We want that number to be low,” explains Dr. Bashline.
Managing Your Heart Health
Overall, controlling sugar levels is important for diabetic patients when managing their heart health. For patients with type 1 diabetes, the better your blood sugar is controlled, the lower your risk of developing heart disease. Keeping your hemoglobin A1C at a low level can significantly reduce your risk.
Unfortunately, that is not always the same for those with type 2 diabetes. “We do know having high blood sugar is associated with a greater risk of heart disease. That has been very clearly established, but unfortunately, lowering a patient’s hemoglobin A1C to its target range does not necessarily significantly reduce their risk of heart disease,” says Dr. Bashline. It is still important to have control of your sugar levels, but that control is not as effective for those with type 2 diabetes as it is for those with type 1 diabetes.
Fortunately, there are now new medications that can help patients with type 2 diabetes reduce their risk of heart disease. Jardiance and Farxiga are two common medications that are now being prescribed to patients with type 2 diabetes, as they have been found to help reduce the risk of developing chronic kidney disease and coronary artery disease. These medications can also help decrease a patient’s chance of experiencing a heart attack and heart failure. Dr. Bashline also recommends that all patients with diabetes be prescribed Statin, which is a cholesterol medication that can help to reduce the risk of heart attack and stroke.
If you are concerned about your overall risk of heart disease, make an appointment with a cardiologist to discuss the steps you can take to maintain your heart health. If you are in need of a new cardiologist, please contact St. Clair Medical Group Cardiology at 412.942.7900.
About Michael Bashline, MD
Dr. Bashline specializes in cardiovascular disease and interventional cardiology and is board-certified by the American Board of Internal Medicine – Cardiovascular Disease. He earned his medical degree at the Lewis Katz School of Medicine at Temple University and completed a residency at UPMC Medical Education. Dr. Bashline then completed a fellowship at UPMC Medical Education. He practices with St. Clair Medical Group Cardiology.