Diabetes Self-Management Articles

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Preventing Coronary Heart Disease

by Heidi Mochari, M.P.H., R.D.

Coronary heart disease is the single leading killer of women in the United States, and women with diabetes are at particularly high risk. High blood glucose itself is believed to contribute to this increased risk, but diabetes is also associated with many other coronary heart disease risk factors, including abnormal cholesterol levels, high blood pressure, abdominal obesity, and blood that has an increased tendency to clot.

Symptoms of coronary heart disease can include shortness of breath, nausea, clamminess, cold sweats, unexplained fatigue, palpitations, and chest pain. However, in many cases, coronary heart disease causes no symptoms. In fact, 64% of women who die suddenly of coronary heart disease have no previous symptoms.

Unlike symptoms, however, risk factors for coronary heart disease are readily detectable and in many cases can be controlled. Because coronary heart disease is often fatal, it is essential to prevent it by knowing its risk factors, knowing which you have, and knowing how to lower your risk as much as possible.

Risk factors

Coronary heart disease is a condition in which arteries supplying the heart become hardened and narrowed because of plaque buildup. The results of this narrowing and hardening can include myocardial ischemia (lack of oxygen to the heart due to reduced blood flow around the heart’s blood vessels), angina pectoris (chest pain due to myocardial ischemia), and myocardial infarction (heart attack).

Some of the risk factors associated with the development and progression of coronary heart disease can be modified, and some cannot. Among those that cannot be modified are age, heredity, and ethnic or racial heritage.

A woman’s risk for developing heart disease and for dying as a result of a heart attack increases as she ages. People whose parents had coronary heart disease are more likely to develop it themselves. And African-Americans, Mexican Americans, Native Americans, native Hawaiians, and some Asian Americans are at higher risk for coronary heart disease.

Many more risk factors can be modified by making lifestyle changes or taking medicines as prescribed. The following are the major modifiable risk factors for coronary heart disease:

High blood pressure. High blood pressure forces the heart to work harder and leads to thickening and stiffening of the heart itself. High blood pressure increases the risk of coronary heart disease, especially when other risk factors are present.

Abnormal blood lipid levels. High low-density lipoprotein (LDL) cholesterol levels, low high-density lipoprotein (HDL) cholesterol levels, and high triglycerides are associated with increased risk of coronary heart disease.

Obesity and overweight. People with excess body fat, especially if it is located around the waist, are more likely to develop coronary heart disease, even if they have no other risk factors. Additionally, excess weight can raise blood pressure, LDL cholesterol, and triglyceride levels, and it can lower HDL cholesterol levels.

Smoking. A smoker’s risk of coronary heart disease is 2–4 times that of nonsmokers.

Lack of physical activity. Regularly performing moderate to vigorous physical activity can help to prevent coronary heart disease by improving cholesterol levels and lowering blood glucose levels, body weight, and blood pressure.

Some additional factors that may contribute to the risk of coronary heart disease include stress and excessive consumption of alcohol.

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