Diabetes - preventing heart attack and stroke
Diabetes complications - heart; Coronary artery disease - diabetes; CAD - diabetes; Cerebrovascular disease - diabetes
People with diabetes have a higher risk for heart attacks, strokes, and kidney disease. Your doctor or nurse should check your blood pressure at every visit. Ask your doctor what your target blood pressure is. Exercising (such as walking), eating low-salt foods, and losing weight (if you are overweight) can lower your blood pressure. If your blood pressure is too high, your doctor will prescribe drugs to lower it.
Lower Your Risks
You can lower your chance of having a heart attack or a stroke by being active or exercising every day. For instance, a daily 30-minute walk can help lower your risks.
Other things you can do to lower your risks are:
- Follow your meal plan and watch how much you eat. This can help you lose weight if you are overweight or obese.
- Do not smoke cigarettes. Talk with your doctor if you need help quitting. Also avoid exposure to cigarette smoke.
- Take your medicines the way your providers recommend.
- Don't miss doctor appointments.
Blood Sugar
Good control of blood sugar can lower your risk of heart disease and stroke.
Review your diabetes medicines with your provider. Some diabetes medicines have a better effect than others in reducing the risk of heart attacks and strokes. This benefit is stronger if you have already been diagnosed with cardiovascular problems.
If you have had a heart attack or stroke, you are at high risk of having another heart attack or stroke. Talk to your provider to see if you are on the diabetes medicines that offer the best protection from heart attack and stroke.
Cholesterol
When you have extra cholesterol in your blood, it can build up inside the walls of your heart's arteries (blood vessels). This buildup is called plaque. It can narrow your arteries and reduces or stops blood flow. The plaque is also unstable and can suddenly rupture and cause a blood clot. This is what causes a heart attack, stroke, or other serious heart disease.
Most people with diabetes are prescribed a medicine to reduce their LDL cholesterol levels. Medicines called statins are most often used. You should learn how to take your statin medicine and how to watch for side effects. Your doctor will tell you if there is a target LDL level you need to aim for.
If you have other risk factors for heart disease or stroke, your doctor may prescribe higher doses of a statin drug.
Your doctor should check your cholesterol levels at least once a year.
Eat foods that are low in fat and learn how to shop for and cook foods that are healthy for your heart.
Get plenty of exercise, as well. Talk with your doctor about what kinds of exercises are right for you.
Blood Pressure
Have your blood pressure checked often. Your provider should check your blood pressure at every visit. For some people with diabetes, a good blood pressure goal is a systolic (top number) blood pressure between 130 to 140 mm Hg, and a diastolic blood pressure (bottom number) less than 90 mm Hg. Ask your doctor what is best for you. The recommendations may be different if you have already had a heart attack or stroke.
Exercising, eating low-salt foods, and losing weight (if you are overweight or obese) can lower your blood pressure. If your blood pressure is too high, your doctor will prescribe medicines to lower it. Controlling blood pressure is as important as controlling blood sugar for preventing heart attack and stroke.
Before You Exercise
Getting exercise will help you control your diabetes and make your heart stronger. Always talk with your doctor before you start a new exercise program or before you increase the amount of exercise you are doing. Some people with diabetes may have heart problems and not know it because they do not have symptoms. Doing moderate intensity exercise for at least 2.5 hours every week can help protect against heart disease and stroke.
Taking Aspirin May Help
Taking aspirin every day may lower your chance of having a heart attack. The recommended dose is 81 milligrams (mg) a day. Do not take aspirin in this way without talking to your doctor first. Ask your doctor about taking an aspirin every day if:
- You are a man over 50 or a woman over 60
- You have had heart problems
- People in your family have had heart problems
- You have high blood pressure or high cholesterol levels
- You are a smoker
References
American Diabetes Association. 10. Cardiovascular disease and risk management: standards of medical care in diabetes-2022. Diabetes Care. 2022;45(Suppl 1):S144-S174. PMID: 34964815
Arnett DK, Blumenthal RS, Albert MA, et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019;140(11):e563-e595. PMID: 30879339
Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;129(25 Suppl 2):S76-S99. PMID: 24222015
Marx N, Reith S. Managing chronic coronary artery disease in patients with diabetes. In: De Lemos JA, Omland T, eds. Chronic Coronary Artery Disease: A Companion to Braunwald's Heart Disease. Philadelphia, PA: Elsevier; 2018:chap 24.
Version Info
Last reviewed on: 4/29/2022
Reviewed by: Sandeep K. Dhaliwal, MD, board-certified in Diabetes, Endocrinology, and Metabolism, Springfield, VA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
