Diabetes is a major risk factor for cardiovascular disease (CVD), but research suggests that the risks may be much greater for women than for men. This means women need to be especially vigilant about their heart health.
“I think women with diabetes who follow up closely with their health-care providers are most likely to be hsyncoban educated about their risks of increased heart disease,” says So-Young Kim, MD, an endocrinologist and assistant professor of clinical medicine at Weill Cornell Medical College. “However, the women who do not have regular follow-up visits with their providers may not realize their risks. And they may miss out on important screenings for other risks, such as obesity, hypertension, and cholesterol abnormalities.”
Diabetes and Your Heart
In simple terms, diabetes is a disease in which elevated levels of blood glucose (sugar) circulate in the bloodstream. Although diabetes often is asymptomatic, especially in the early stages, the long-term complications of the disease can have significant impacts on your body. For example, excessive blood glucose can damage the walls of the arteries, leading to high blood pressure. High levels of blood glucose also can harm the small arteries that nourish nerves in the eyes, kidneys, and other parts of the body. To avoid these complications, controlling blood gluose levels is a must.
“People with type 2 diabetes are considered to have the same risk of a heart attack as a person who has existing coronary heart disease,” says Dr. Kim.
The risks associated with diabetes are a reality for women and men alike. But researchers have found some startling gender differences among diabetes’ effects. In one study, the risk of having a heart attack or angina (chest pain) was about 38 percent higher among women with diabetes, compared to men.
There may be several reasons for the discrepancy: High blood pressure may be more severe for women with diabetes than it is for men, and the drop in HDL (“good”) cholesterol that occurs with diabetes may be steeper for women than for men. Previous studies also have suggested that part of the reason women have worse outcomes could be due to the difference in the ways women experience heart attacks; they tend to be older than men when they have a heart attack, and they are more likely to have atypical symptoms, which often means they don’t get the prompt medical attention that could help them.
Manage More Than Diabetes
Because women with diabetes have these added risks and health burdens, Dr. Kim says it’s imperative that they understand all the risk factors for CVD and cardiovascular events, such as heart attack and stroke. Along with diabetes, some of the major controllable CVD risk factors include hypertension, obesity, a sedentary lifestyle, smoking, and lipid (cholesterol) abnormalities. Lipids are fats in the bloodstream, such as LDL (“bad”) cholesterol, that can clog the arteries with plaque and raise your risk of a cardiovascular event.
“Women with diabetes need to be educated about the cardiovascular risks they have and the risk factors that they may have in addition to diabetes,” says Dr. Kim. “Most studies that have looked at risks of heart disease in persons with diabetes found increases in coronary heart disease, myocardial infarction (heart attack), and cardiovascular mortality and morbidity.”
Of course, controlling your blood glucose levels with medications and healthy behaviors is vital if you have diabetes. But Dr. Kim says some of the same lifestyle changes you can make to help manage your diabetes will also help improve or at least maintain your heart health. For instance, exercising for 30 to 60 minutes a day several times a week will help you burn calories, lower your blood glucose levels, help with weight loss, and benefit other medical conditions, such as high blood pressure and high LDL cholesterol.
“It is important to minimize your risks for heart disease by controlling your blood sugar, as well as maintaining a healthy lifestyle with diet and exercise,” says Dr. Kim. “In addition, smoking should be avoided, as it increases cardiovascular mortality and morbidity. Finally, if a diabetic patient also has high cholesterol or elevated blood pressure, it is critical that these conditions be diagnosed and treated to protect her cardiovascular health.”
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