The term cardiovascular disease (CVD) includes heart disease, stroke and all other diseases of the heart and circulation, such as hardening and narrowing of the arteries supplying blood to the legs, which is known as peripheral vascular disease (PVD). However, heart disease and stroke are the two most common forms of CVD.
People with diabetes have an up to fivefold increased risk of CVD compared with those without diabetes. The reasons are prolonged, poorly controlled blood glucose levels, which affect the lining of the body's arterial walls. This increases the likelihood of furring up of the vessels, forming a narrowing (atherosclerosis). People with Type 2 diabetes also often have low HDL cholesterol and raised triglyceride levels, which both increase the risk of atherosclerosis. High blood pressure, smoking, obesity and physical inactivity are also risk factors for CVD.
How does cardiovascular disease happen?
The body needs a fresh supply of blood in order to work properly. The circulation of blood through the arteries of the body transfers oxygen and fuel to the tissues and carries away unwanted and waste products which the body does not need. If you don't follow a healthy lifestyle, or you have a family history of CVD, or diabetes, you are more likely to develop a build-up of fatty material on the walls of your arteries. This is known as atherosclerosis. If an artery becomes too narrow, or even blocked completely, it can lead to certain areas of the body being starved of the oxygen and nutrients they need.
If an artery leading to the heart becomes blocked, it can cause a heart attack (healthcare professionals will refer to this as a myocardial infarction or MI). If this happens to an artery leading to the brain it may cause a stroke (healthcare professionals refer to this as a cerebrovascular accident or CVA). If narrowing or blockage occurs in the legs (and sometimes arms), this is known as peripheral vascular disease (or PVD) and may lead to pain in the calf muscle (intermittent claudication), gangrene or amputation.
Reducing your risk of CVD
- Be more physically active.
- Lose weight if you are overweight.
- Stop smoking if you smoke.
- Eat a healthy balanced diet.
- Take your medication as prescribed by your doctor.
- Try to keep your blood glucose levels well controlled – between 4–6mmol/l before meals and less than 10mmol/ll 2 hours after.
- Try to keep your blood pressure well controlled – it should be treated if it is above 130/80 mmHg.
- Try to control your blood fats to – total cholesterol below 4mmol/l, low-density lipoprotein cholesterol (LDL – often known as 'bad cholesterol') below 2mmol/l, high density lipoprotein cholesterol (HDL – often known as 'good cholesterol') 1.0mmol/l or above if you are a man and 1.2mmol/l or above if you are a woman, triglycerides 1.7mmol/l or below.
- People with diabetes who have also had heart disease, a stroke, a transient ischaemic attack (or 'mini-stroke') or peripheral vascular disease are generally prescribed a small dose of aspirin. For those who have not, the benefit of taking aspirin is not as clear. These are general recommendations and your situation may be different, so talk to your healthcare team about whether you should be taking aspirin.
- Have regular medical examinations at least once a year.