Know Your Risk: Diabetic Heart Disease

Find out what factors contribute to this condition, from hypertension to high cholesterol.

Medically reviewed in November 2021

Whether it’s type 1 or type 2, having diabetes means you’re more likely to develop heart disease than those without the condition, more likely to develop heart problems at a younger age and more likely to die from a related cardiovascular event, like a heart attack.

There are several factors playing into whether you develop diabetic heart disease. Here are some of the actions and conditions that may contribute to your risk.

Cholesterol levels
Having high levels of LDL ("bad") cholesterol can increase your odds of developing diabetic heart disease, since LDL collects in arteries, slowing blood flow and adding to blockages. Low levels of HDL ("good") cholesterol also raise your chances; they're thought to guard against heart attack and stroke, and not having enough can be problematic. High triglycerides, another kind of blood fat, may also contribute when combined with high LDL and low HDL.

High blood pressure
Hypertension, or high blood pressure, occurs when blood pushes hard enough against artery walls that it threatens your health. A blood pressure reading of 130/80mmHg or more is usually considered to be hypertensive. Having diabetes and high blood pressure doubles your risk of cardiovascular disease, and can raise your odds of stroke, kidney issues and more. Among other things, excessive consumption of alcohol can raise your blood pressure.

Whether you have diabetes or not, smoking raises your chances of heart problems. It damages blood vessels and reduces blood flow, lowering HDL cholesterol levels, worsening the effects of high LDL cholesterol and limiting the transport of oxygen throughout your body. It’s not all bad news, though—over time, kicking the habit can reverse the risk.

Being overweight
Being overweight or obese ups your probability of both diabetes and heart disease. Among other things, it raises your odds of developing hypertension and high LDL cholesterol—central causes of cardiovascular disease—and is a major contributor to insulin resistance, a big factor in both prediabetes and type 2 diabetes. Losing weight is proven to improve these conditions.

Being inactive and eating poorly
Consuming too much sugar, saturated fat, trans fat and sodium is connected to diabetic heart disease, as is not getting enough physical activity. Both contribute to obesity and hypertension, among other risk factors. Regular exercise—from running to walking to gardening—and a healthy diet including fruits, vegetables, lean meats and whole grains can mitigate the risk.

A significant factor in heart disease, stress may cause you to overeat, sleep less, curb your physical activity and smoke. It can also elevate your blood pressure and heart attack chances.

Family history
Having close family members with heart disease—especially if they developed it before age 50—means you’re more likely to have problems.

As people with diabetes get older, they’re more likely to develop heart problems than people without diabetes. Older people are also more likely than younger people to have heart disease, period.

If you think you’re in danger of heart problems related to your diabetes, reach out to your doctor. Want more information? Check out these go-to resources for managing your diabetic heart disease.

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