Diabetes Self-Management Articles

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Preventing Coronary Heart Disease

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

Dietary supplements

The American Heart Association does not currently recommend using vitamin, mineral, or herbal supplements to treat or prevent heart disease and stroke. Not only are no supplements proven safe and effective for this use, but some are known to have an effect on blood clotting and heart rate or to interact with the effects of certain drugs.

To avoid developing nutrient deficiencies, the American Heart Association recommends eating a variety of foods that includes five or more servings of fruits and vegetables per day.

If you are considering supplement use for any medical or health-related reason, you should discuss the potential risks and benefits with your physician before starting it. Your doctor may want to monitor you regularly for any adverse effects.

Screening for coronary heart disease risk

The guidelines for cardiovascular disease prevention recommend that cardiovascular risk factors be assessed at least annually to identify the presence of coronary heart disease in women with diabetes. They also recommend that people with diabetes be screened for the presence of micro- or macroalbuminuria, or the presence of albumin (a blood protein) in the urine. Albuminuria is a sign of nephropathy, or kidney disease. It is also associated with a higher risk of cardiovascular disease.

Your physician may also recommend certain diagnostic tests to assess your heart function. A stress test (also often called a treadmill test or an exercise test) is used by a physician to assess how well a person’s heart handles work. During the test, the person is hooked up to a heart monitor and is asked to walk on a treadmill at varying speeds. The heart monitor generates an electrocardiogram, or a graphic representation of the electrical impulses in the heart. As a person walks, his heart rate, blood pressure, electrocardiogram, and how he feels are monitored.

People with diabetes who experience typical or atypical cardiac symptoms or have had an abnormal resting electrocardiogram may be advised to have a stress test for diagnostic purposes. Additionally, people with diabetes who have a history of peripheral or carotid occlusive disease (clogged arteries in the limbs or neck); are older than 35, have a sedentary lifestyle, and plan to begin a vigorous exercise program; or have two or more major coronary heart disease risk factors may be advised to have a stress test for screening purposes.

Signs and symptoms of a heart attack

A heart attack occurs when the blood flow to your heart is reduced or blocked. Oxygen is unable to reach the heart muscle, and a part of the heart muscle dies. It is important to know that there is a wide range of severity for heart attack symptoms and that symptoms in women may be different from those in men.

The classic symptoms of a heart attack include chest pain or discomfort, arm pain, and chest tightness. However, women are more likely to experience some lesser-known symptoms, which include back, neck, or jaw pain; abdominal discomfort; shortness of breath; sweating or light-headedness; indigestion or nausea; unexplained fatigue; inability to sleep; headache; and a feeling of impending doom.

Because diabetes can affect nerve function, people with diabetes may have less pain with a heart attack or may experience a “silent” heart attack without the warning signs. By taking note of any signs or symptoms you do experience and seeking medical care immediately, you may be able to prevent damage to the heart muscle or even death associated with heart attack.

Questions for your health-care provider

Communication with your health-care provider is another key part of prevention. It may be helpful to keep a list of questions to bring with you to your physician visits. If your condition is particularly complex, it might also be helpful to bring a family member or friend with you to help to remember questions or to write down your physician’s responses.

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Statements and opinions expressed on this Web site are those of the authors and not necessarily those of the publishers or advertisers. The information provided on this Web site should not be construed as medical instruction. Consult appropriate health-care professionals before taking action based on this information.



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