By Tricia Santos Cavaiola, MD
Did you know that heart disease is the leading cause of death in the United States whether or not you have diabetes?
You all know that at TCOYD we are not about using scare tactics. But this is the reality folks. So, we should all do what we can to keep our hearts healthy and happy. If you have type 2 diabetes, you are at an even higher risk of having heart disease. The good news is there is a lot you can do to prevent it!
- Aspirin has been shown to decrease the risk of heart disease. Your doctor may recommend aspirin if you have had a heart attack or stroke in the past, or if you have additional increased risk factors for cardiovascular disease (diseases of the heart and blood vessels, such as heart attack or stroke.)
- Controlling your blood pressure is another important step in decreasing your risk for heart disease. The target blood pressure for people with diabetes is < 140/90 mmHg. If you have additional risk factors for heart disease (such as kidney disease), your doctor may want your blood pressure even lower, such as < 130/80 mmHg. Many people with diabetes require more than one blood pressure medication to meet this goal. Two classes of medications, ACE Inhibitors and ARBs, are the best blood pressure medications for people with diabetes because they also protect your kidneys from diabetes-related kidney problems. How great is that?
- Managing your cholesterol is one of the most crucial things you can do to prevent heart disease. You want to keep your “good” cholesterol (HDL) High and your “bad” cholesterol (LDL) Low. The most common medications used to treat high cholesterol are called statins. These work primarily by lowering your “bad” (LDL) cholesterol and they are some of the very best medications we have to prevent heart disease. Statin medications are recommended for most patients with diabetes, especially if you are between the ages of 40-75 years old. You should also try to keep your triglyceride levels low. Good blood sugar control can help you keep your triglyceride levels down. Your doctor may recommend additional medications to help control your cholesterol as well.
Many people think that the only risks associated with smoking are lung cancer and emphysema. Well, if you need another reason to quit smoking, here it is: Smoking is a major risk factor for cardiovascular disease. It can worsen cholesterol abnormalities, damage blood vessels, increase the plaque buildup in your arteries, and make your blood more “sticky.” All of these things can significantly increase your risk of heart attack or stroke. Quitting smoking is easier said than done – but don’t give up! Many people require more than one attempt at quitting. Your risk for heart disease and stroke begin to decrease even 1-2 years after quitting, so it is never too late to quit!
There are also some risk factors, like age (> 45 for females & > 55 for males) and a family history of heart disease that you can’t control. Additionally, if you have had a heart attack or stroke in the past, you are at increased risk to have another in the future. So, if you have these risk factors that you cannot control, then you will want to pay close attention to the other ways you can reduce your risk as we discussed above (aspirin, blood pressure, cholesterol, etc.)
Perhaps the most exciting new way to decrease your risk for heart disease comes right from our very own diabetes medications. Recent studies have shown that two medications used to treat type 2 diabetes can decrease the risk of cardiovascular disease. Empagliflozin (Jardiance, an SGLT2 inhibitor) and liraglutide (Victoza, a GLP-1 receptor agonist) have been shown to decrease the risk of heart attack, stroke, and/or death from cardiovascular causes.
Although type 2 diabetes increases your risk for heart disease and stroke, the good news is that the medications you take to lower your blood sugars could decrease your risk, and it’s motivating to know there is so much YOU can do to contribute to your heart health overall.