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Diabetes and Your Heart
Taking
care of the heart is a vital health concern for
all adults. Cardiovascular disease is the leading
cause of death among adults in the United States.
The two most common types of cardiovascular disease
are: hypertension, or high blood pressure,
and coronary artery disease, when arteries
feeding the heart become blocked with fatty deposits
(like cholesterol) in a process called atherosclerosis.
Diabetes
is one of the four major risk factors for developing
heart disease. The other factors are high blood
pressure (hypertension), cigarette smoking, and
high levels of blood fats (cholesterol). Other
risk factors include: a family history of heart
disease, obesity, a sedentary lifestyle, and stress.
Two of the four risk factors--high blood pressure
and high cholesterol--are frequency found in people
with diabetes.
Like
diabetes itself, hypertension and heart disease
are controllable. Every person with diabetes
can effectively improve their cardiovascular risk
factor. You will find that the same guidelines
that promote a healthy heart help in overal diabetes
self-care.
Hypertension
Blood
pressure is the force exerted by blood against
the blood vessel walls. Each time your heart beats,
it causes a surge of pressure, which is called systolic pressure. When the heart rests
between beats, the blood pressure is lower, and
this is called diastolic blood pressure.
Blood pressure is usually represented by two numbers,
which measure the systolic pressure against the
diastolic pressure. The ideal blood pressure is
considered 120/80 (systolic is the higher number).
If blood pressure readings are consistently higher
than 140/90, it usually indicates hypertension.
Blood pressure varies frequently during the day
so it is important to take readings over a period
of time.
Symptoms
Headaches,
dizziness, fatigue and spontaneous nosebleeds
are sometimes symptoms of hypertension. More
often, people with hypertension show no real
signs of trouble--so it is important to have
frequent check-ups. If hypertension is allowed
to continue unattended, the first sign could
be a major problem, such as a heart attack or
stroke.
Causes
In
people with diabetes several conditions contribute
to hypertension:
Coronary
heart disease occurs when arteries that supply
the heart muscle become narrowed by fatty deposits
(atherosclerosis). Symptoms Reduced blood flow
to the heart can cause a kind of chest pain called angina. Angina is usually experienced
during emotional stress, physical exertion, heavy
meals or even very high or low temperatures. Other
symptoms include shortness of breath and swollen
ankles--a sign that blood is not being pumped
efficiently through the body. If atherosclerosis
is allowed to go on undetected, the heart may
lose strength and fail to pump enough blood (congestive
heart failure). Eventually, an artery may become
completely blocked, causing permanent damage to
a part of the heart. This happens during a heart
attack (myocardial infarction). There are several
reasons coronary heart disease is more prevelant
among people with diabetes.
Take
Heart and Take Control
Diabetes,
hypertension and heart disease can be controlled
effectively. And the best news is, what's good
for the care of your heart is good for the care
of your diabetes.
Regular
Checkups
Like
other disorders, heart disease is easier to treat
when it is spotted early. Your physician will check
your blood pressure to make sure that you are within
a normal range. Your doctor will also take a blood
test to monitor fat and cholesterol levels.
If
any heart problems are suspected, your physician
will probably refer you to a heart specialist (cardiologist),
who is likely to give you the following tests:
- Electrocardiogram
(ECG): This machine measure electrical activity
in the heart and helps detect heart muscle damage
resulting from previous mild heart attacks.
- Stress
Test: To see how your heart responds to mild
stress, your cardiologist may have you walk on
a treadmill.
The
following measures can help prevent heart problems
and enhance your diabetes control:
Weight
Loss
Maintaining
your ideal body weight is part of good diabetes
control and good heart care. If you are overweight,
you should begin a supervised weight reduction plan.
Weight loss will decrease stress on the heart and
lower unhealthy blood cholesterol.
Exercise
Make
exercise (walking, jogging, cycling, swimming, etc.)
a part of your life. Not only does exercise expend
energy and make losing weight easier, it also improves
control of blood glucose and overall cardiovascular
fitness. Equally important, exercise lowers blood
cholesterol and triglycerides and raises the level
of "good cholesterol."
Be
sure and talk to your physician before starting
any exercise program.
Diet
The
following should be avoided or used minimally:
- Salt : Eating
a lot of salty food makes the body retain water
and raises blood pressure. Cut down on salt in
cooking and read labels for "hidden"
salt content.
- Saturated
Fats : Saturated fats like butter, lard, palm
and coconut oils, are high in unhealthy cholesterol,
increasing your risk of developing coronary heart
disease. Shift to polyunsaturated fats like safflower,
sunflower, corn and monosaturated fats like olive
and peanut oil.
- Alcohol : Moderate drinking of alcoholic beverages
may be approved by your doctor. However, alcohol
can interact badly with some cardiac drugs, causing
sudden drops in blood pressure or irregular heart
rhythms. Excessive drinking can also aggravate
hypertension. Alcohol will also affect blood sugar
levels dramatically.
Treatments
If
diet and exercise don't succeed in significantly
lowering blood pressure, medication is the next
step in treatment. A wide range of antihypertensive (blood-pressure-lowering) drugs are available. But
it may take some trial and error before your doctor
fines the best medication and dosage for you.
Medications
fall into several main categories. Often these drugs
are used in combination.
- Diuretics
(WaterPills) : These drugs help the body get
rid of excess water, lowering the amount of pressure
on blood vessel walls.
- Vasodilators :
A vasodilator dilates, or relaxes, the blood vessels,
thereby reducing blood pressure. Some common vasodilators
are: Hydralazine and Apresoline.
- Beta
Blockers These drugs lower blood pressre
by interfering with the action of hormones like
adrenalin, which speed up the heart. By lowering
the heart rate and decreasing blood pressure,
beta blockers make the heart's job easier.
- Cholesterol
Lowering Agents : A variety of new drugs have
been developed which can lower cholesterol levels.
Typically these drugs are not prescribed until
dietary modification has been tried. As these
drugs have a number of side effects, you should
consult your physician to determine if they are
appropriate.
Taking
Care of Your Heart For Life
Like
diabetes control, taking care of your heart is a
lifelong project. Sticking to the proper diet and
exercise program, taking your medication--all are
within your control and are your responsibility.
And even though it takes commitment, the rewards
are great--reduced chances of complications from
either diabetes or heart disease and a stronger,
healthier life.
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