Hypertension, hyperglycemia and hyperlipidemia are common diseases in modern population, commonly known as “three highs”, which can cause multi-system damage, especially cardiovascular and cerebrovascular damage. Today, we will focus on the impact of abnormal glucose metabolism on cardiovascular disease, and we need to emphasize the consensus view that “diabetes mellitus is an etiology of coronary heart disease”, or also known as “etiology”. In 1999, the New England Journal of Medicine published the Finnish East-West Study, which showed that the prognosis of patients diagnosed with diabetes mellitus without myocardial infarction was comparable to that of patients with myocardial infarction without diabetes mellitus during a 7-year follow-up period, which laid the foundation of “diabetes mellitus as an equivocal condition for coronary heart disease”. This has been confirmed by more and more clinical observations and statistics, and in general terms, having diabetes is equivalent to having a heart attack. A domestic heart disease survey points out that 3/4 of Chinese hospitalized coronary heart disease patients have combined abnormal glucose metabolism, of which the prevalence of diabetes is 52.9%, mainly type 2 diabetes. There are many diabetic patients in China, but a large number of patients do not know they have abnormal glucose tolerance or even diabetes. Whether it is insulin resistance or diabetes, high glucose status will cause vascular endothelial cell dysfunction or even damage, and inflammation of the endothelium will lead to the formation of atherosclerotic plaques. Diabetes and coronary heart disease Diabetes can cause endothelial damage, leading to coronary atherosclerosis and increasing the risk of myocardial ischemia and heart attack. It is important to note that even patients without diabetes whose hyperglycemic status is below the threshold for diagnosis of diabetes are still considered to be at high risk for coronary heart disease. There is substantial clinical evidence that elevated glucose is an independent predictor of prognosis in patients with acute myocardial infarction. A study of acute ST-segment elevation myocardial infarction treated in the emergency setting without a history of diabetes found that the vast majority of patients with acute myocardial infarction without a history of diabetes had combined abnormal glucose metabolism, while one study found that persistent high glucose status increased 1-year and long-term mortality in patients with acute myocardial infarction. Diabetes and hypertension As mentioned above, high glucose can cause endothelial damage to the blood vessels and lead to the formation of atherosclerotic plaques, which leads to increased blood pressure due to vascular sclerosis and luminal narrowing. In addition, insulin can promote water and sodium reabsorption in the distal renal tubules, leading to an increase in blood volume, while it can excite the sympathetic nervous system and constrict the peripheral blood vessels, ultimately causing an increase in blood pressure. Therefore, diabetic patients and those with abnormal glucose tolerance need to monitor their blood sugar and follow diabetes education to maintain normal and stable blood sugar. Middle-aged and elderly people should also eat healthily, exercise more, regulate their emotions, and have regular annual checkups to monitor their blood glucose levels to maintain their cardiovascular health!