cholesterol (LDL-C) and very low density
lipoprotein cholesterol (VLDL-C), and lowered
blood levels of high-density lipoprotein choles-
terol (HDL-C)- altered myocardial cell structure and activity,
resulting in CARDIOMYOPATHY(myocardial dys-
function) - increased levels of fibrinogen and clotting sub-
stances that increase the blood’s tendency to
clot, raising the risk for STROKEand HEART ATTACK - elevated blood GLUCOSElevels damage periph-
eral blood vessels and the nerves that supply
them, raising the risk for PERIPHERAL VASCULAR
DISEASE(PVD) - damage to the glomerular structures of the KID-
NEYS, resulting in NEPHROPATHYof diabetes and
its slate of complications, key among them
being hypertension
Cigarette smoking, itself a significant risk factor
for cardiovascular disease, doubles the cardiovas-
cular risk of diabetes in people who smoke and
have diabetes. Increasing age is a risk factor for
both diabetes and cardiovascular disease. As well,
diabetes slows HEALING, increasing the risk for
complications with surgical treatment options for
forms of cardiovascular disease such as CORONARY
ARTERY DISEASE(CAD).
Early diagnosis of INSULIN RESISTANCE with
lifestyle and medication, if appropriate, to delay its
progression to type 2 diabetes, improves the car-
diovascular risk. Once diabetes develops, meticu-
lous control of blood glucose levels slows many of
the changes that create increased risk for cardio-
vascular disease. Aggressive medical interventions
such as lipid-lowering medications, ASPIRIN
THERAPY, and antihypertensive measures (lifestyle,
medication, or both) help moderate risks related
to changes in lipid, clotting, and blood pressure
mechanisms.
Health experts recommend these targets for
people who have diabetes to lower their risk for
cardiovascular disease:
- A1c (also called HbA1c or glycohemoglobin)—6
percent or lower (indicates blood glucose levels
over time)- blood pressure—129/79 millimeters of mercury
(mm Hg) or lower - LDL-C —100 milligrams per deciliter (mg/dL)
or lower - BODY MASS INDEX(BMI)—24.9 or lower (healthy
weight) - no smoking
- 30 minutes of moderate physical exercise (such
as walking) daily
- blood pressure—129/79 millimeters of mercury
With diligent control of diabetes and efforts to
reduce cardiovascular disease risks, most people
who have diabetes can achieve near-normal car-
diovascular health for years to decades.
See also CARDIOVASCULAR DISEASE PREVENTION;
CHOLESTEROL BLOOD LEVELS.diet and cardiovascular health The influence of
eating habits and food consumption on the health
and function of the cardiovascular system.
Researchers first conclusively connected diet with
cardiovascular health in the 1950s when they rec-
ognized that dietary fat was a key source of cho-
lesterol for the body. Health experts issued the
first statements about this correlation in the early
1960s. Though researchers now understand much
more about how the body acquires and uses NUTRI-
ENTS, they continue to investigate the ways in
which dietary factors, independent of as well as in
conjunction with other lifestyle variables such as
physical exercise, affect cardiovascular health.
Much of this research has focused on the role of
dietary cholesterol and fats, as excesses of these
nutrients in the body are key RISK FACTORS FOR CAR-
DIOVASCULAR DISEASE(notably ATHEROSCLEROSIS).
Through the years doctors have recommended
various “diets” (proportions and restrictions of
nutrients) to support cardiovascular health and
reduce the risk for CARDIOVASCULAR DISEASE(CVD).
Research has shown, however, that variety and
moderation are factors most important for meet-
ing the body’s nutritional needs. The body needs
carbohydrates, proteins, and fats—the core nutri-
ents—in varying proportions according to age,
activity level, and other variables. Rather than
focusing on these proportions, however, health
experts recommend instead shifting emphasis to
the kinds of foods consumed todiet and cardiovascular health 49