People with diabetes are often told to control their blood sugar well to prevent the development of coronary heart disease. The reason is that there is a strong association between diabetes and coronary heart disease.
Diabetes is considered “equivocal” to coronary heart disease
Equivocal risk, as the name implies, is equal to the risk of having diabetes as it is to having coronary heart disease, meaning that patients with diabetes who are not diagnosed with coronary heart disease are at the same risk for future events such as myocardial infarction and death from cardiovascular disease as patients with coronary heart disease who are not diagnosed with diabetes. Regarding the relationship between diabetes and coronary heart disease, researchers have made the following findings.
- Co-existing diabetes or abnormal glucose metabolism has been observed in about 2/3 of patients with coronary heart disease in both Europe and China.
- The annual rate of cardiovascular disease in patients with diabetes is 2 to 3 times higher than in non-diabetic patients, and myocardial infarction is the cause of death in about 1/3 of patients with diabetes.
- Patients with diabetes who have not had a myocardial infarction and those who have had a myocardial infarction without diabetes have a similar risk of cardiac-related death, myocardial infarction, and cerebral infarction in the long term, both with an incidence of about 20% over 7 years.
Why are people with diabetes vulnerable to coronary heart disease?
- Diabetes and coronary heart disease share common risk factors, such as age, lifestyle, and family history, and some factors may contribute to both diabetes and coronary heart disease, such as insulin resistance and hyperinsulinemia.
- Other risk factors for coronary artery disease, such as hypertension and hyperlipidemia, also share risk factors and pathogenesis with diabetes.
- Diabetes itself can contribute to the development of coronary artery disease through mechanisms such as inflammation.
What would be the characteristics of coronary artery disease in a diabetic patient?
People with diabetes who develop coronary artery disease often have some of the following characteristics.
- Because diabetes affects the nervous system, some patients often have mild or atypical symptoms at the onset of coronary heart disease that are difficult to detect early, so many patients with diabetes present with acute myocardial infarction when they first develop coronary heart disease.
- Coronary artery disease in patients with combined diabetes is usually diffuse, with lesions that may occur in multiple vessels, and the extent of involvement of the lesions is also longer.
- Coronary artery disease patients with comorbid diabetes have poorer outcomes than those without diabetes and are at higher risk for future recurrence whether they undergo coronary artery bypass surgery or interventional procedures.
- Coronary artery disease is also more difficult to treat in patients with diabetes who have comorbidities such as peripheral vascular disease and diabetic nephropathy.
How can diabetics stay away from coronary heart disease?
People with diabetes, pay close attention to any symptoms that may suggest coronary artery disease, especially atypical presentations, especially in some people who have developed atherosclerosis in large blood vessels outside the heart.
For diabetes, your doctor will assess the specific situation to determine treatment goals and choose a treatment plan that has a positive cardiovascular effect whenever possible. Be careful to follow your doctor’s treatment recommendations.
In addition, patients with diabetes should actively assess and intervene on risk factors under the guidance of their physician. Diabetics often have a combination of hypertension, dyslipidemia, and obesity, all of which are risk factors for coronary heart disease, and doctors often intervene holistically to reduce the risk of coronary heart disease and often recommend a healthy lifestyle, such as improving diet, physical activity, and quitting smoking.