Diabetes and heart diseases are known to co-exist and contribute to the development of each other in various ways. From clogged blood vessels to cardiac failure, diabetes can affect the heart in many ways by interfering with the ability of this vital organ to pump blood to all the parts of the body. 

The risk of heart attacks, also called myocardial infarction, is also significantly high in diabetic patients. It is important to be aware of the impact of diabetes on your heart so that you can take steps to protect yourself against life-threatening acute and chronic cardiac disorders.

Read on to learn about how diabetes increases your risk of myocardial infarction and the heart diseases that are linked to diabetes.

The risk of heart diseases linked to diabetes

Patients who have diabetes are at a higher risk of developing cardiac disorders including heart attacks. The pathogenesis of heart attacks in patients with diabetes is often preceded by a decline in the functions of the heart. Hence, they may develop some other dysfunctions before the actual event of a myocardial infarction occurs. 

Hence, there is a need to be aware of the factors that are involved in the pathogenesis of myocardial infarction. It is also important to be watchful for the warning signs that point to the possible risk of developing heart attacks in the future.

Cardiovascular diseases primarily occur due to the abnormalities occurring in the circulation of blood to different parts of the body. Poor blood circulation can also make other diabetic complications like cataracts, diabetic retinopathy, and macular edema worse or more likely to occur.

This suggests that the link between diabetes and heart diseases works in both ways with each of these creating an adverse impact on the other.

Alarming statistics indicating the risk of cardiac disorders in diabetic patients

Heart diseases, including hypertension and myocardial infarction, are common in patients with diabetes. Results of research studies conducted by the National Heart Association in 2012 have revealed that nearly 65% of patients with diabetes tend to develop serious complications including death due to cardiovascular diseases such as heart attacks or stroke.

It has also been found that the risk of death due to heart diseases and stroke is more than double in patients with diabetes than in those with healthy blood sugar levels.

Also, while the increased chance of developing heart diseases is common in all people with diabetes, the link is found to be stronger in those with type 2 diabetes. Moreover, heart disease is the most common cause of death in patients with type 2 diabetes indicating that patients with this form of diabetes need to be more cautious about their heart health.

The Framingham Study has provided substantial evidence showing that diabetes patients are more vulnerable to develop cardiac diseases than those who do not have diabetes.

This study assessed the risk factors in the people of different generations, including those with diabetes, to determine the possible factors that could accelerate the development of heart diseases.

The findings of this study have shown that multiple factors play a role in increasing the chances of developing heart diseases in diabetic patients. Some of these factors include high cholesterol levels, high blood pressure, active or passive smoking, and a family history of heart diseases detected at a younger age. We covered the risks of high cholesterol in-depth on this post.

These are the same factors that are also known to worsen the risk of diabetes and diabetic complications. This establishes some of the mechanisms that could speed up the pathogenesis of heart attacks in patients with diabetes and vice versa.

The results of these studies have emphasized the need to take good care of the heart and be watchful for the early signs of cardiac diseases when you have diabetes.

Also, a heart attack can occur when a blood clot cuts off the blood flow through the arteries of the cardiac muscles. The warning signs of a heart attack include sudden severe pain in the chest that feels as if the heart is being clutched between iron hands.

But, in patients with diabetes, there is also a risk of developing silent heart attacks, wherein they may not experience any symptoms. As a result, the condition is likely to go unnoticed until an ECG performed in the future during routine tests reveals a history of a heart attack.  

The possibility of having a silent heart attack can deprive diabetic patients of timely treatment for preventing more severe attacks in the future. This suggests that diabetic patients should assess their heart health on a regular basis with the help of blood tests that measure cholesterol and triglyceride levels, or an ECG.  

How does diabetes increase the risk of heart diseases?

Diabetes occurs due to the increase in the blood sugar level as a result of the lack of adequate production of insulin in the pancreas or due to the reduced ability of the cells to respond to insulin due to insulin resistance.

The increase in the blood sugar level for a long period of time can result in slowly progressive damage to the blood vessels. The damage to the blood vessels of the vital organs such as the heart itself, the brain, eyes, kidneys, and legs is primarily responsible for triggering the development of complications.

For example; the damage to the blood vessels of the heart could interrupt the blood flow to the cardiac muscles completely or partially. As a result, the heart muscles may fail to pump blood efficiently due to which the patient can develop a heart attack.

Similarly, the damage to the blood vessels of the brain and legs can increase the risk of stroke and peripheral vascular disease, respectively. Damage to the small capillaries supplying blood to the tissues of the eyes like the retina and macula can trigger the development of diabetic retinopathy and macular edema.

The damage to the blood vessels can be the result of persistently high blood sugar levels.

These abnormal changes can also occur in patients with diabetes due to a loss of the ability of the cells to use sugars in the blood in the correct manner.

Insulin resistance linked to type 2 diabetes can prevent the cells in the vital organs from responding to the hormone insulin due to which the sugars are left unutilized and un-metabolized. As a result, a larger share of sugar in the form of glucose tends to stick to the red blood cells and build up in the blood.

This build-up could block the blood vessels or cause damage to the arteries carrying blood to your heart, brain, and other vital organs thus starving them of oxygen and other nutrients. This is how, the increased blood sugar level, as well as insulin resistance, can worsen your risk of heart attacks, stroke, and other cardiovascular diseases.

The risk of these conditions can be reduced to a great extent by maintaining your blood sugar levels within normal limits and keeping your HbA1c as close as possible to the target level. Maintaining optimum control over your blood sugar levels and improving your glycemic control are the keys to protecting your blood vessels and heart for reducing your risk of heart attacks.

How does diabetes affect your heart?

As discussed earlier, the development of a heart attack is often preceded by other conditions that gradually worsen the damage to the heart and blood vessels.

Let us have a look at the common precursors to heart attacks in patients with diabetes. We will also have a look at the various ways by which diabetes affects heart functions. 

High blood pressure

High blood pressure occurs when the blood pushes against the walls of the blood vessels with a force stronger than normal. It can make your heart work more strenuously than usual thus damaging the blood vessels.

It is very common for patients with type 2 diabetes to have high blood pressure. Diabetes and high blood pressure, together, can put more strain on the heart, thus worsening your chances of having serious cardiac diseases like heart attacks, stroke, and cardiac failure.

Peripheral artery disease (PAD)

This condition occurs due to the build-up of plaques in the arteries of the legs. It may cause pain in the calves. The legs may also feel numb, heavy, and weak. Patients with PAD often have difficulty in walking or climbing stairs. The pain usually goes away after taking a rest.

PAD is often a warning sign of an impending heart attack because having plaque in the legs indicates you might be having them in the heart as well. PAD can raise your chances of having a heart attack as well as a stroke.

The development of PAD can occur at a faster rate in patients with uncontrolled diabetes. It can not just accelerate the damage to the walls of the blood vessels but also reduce the efficiency of the healing mechanisms thus preventing the reversal of the changes.

Stroke

Having diabetes could lead to a substantially higher risk of cerebrovascular stroke. A stroke occurs when the blood flow to a part of the brain is cut off. The symptoms often develop suddenly and may include:

• Loss of consciousness
• Difficulty in talking, due to slurred speech
• Drooping of face that causes a lopsided smile
• Weakness in one arm and one leg, making it harder to lift things and keep the affected arm or leg in the air

Cerebrovascular stroke is a life-threatening condition that needs to be attended to immediately in order to prevent permanent damage to the brain tissues. The sooner you receive medical intervention, the more likely you would be able to avoid long-term complications such as paralysis.

Dyslipidemia

Dyslipidemia is a common condition in patients with diabetes and heart attacks. Too much of LDL cholesterol in the bloodstream can result in the formation of plaques in the arterial walls due to which the blood flow to the organs is reduced.

Similarly, the increased triglyceride levels and low HDL cholesterol levels can also contribute to the hardening of the arteries thus making patients vulnerable to develop heart attacks and stroke.

Since diabetes and dyslipidemia tend to co-exist, patients need to monitor their blood cholesterol and triglyceride levels regularly to assess the impact of these conditions on their hearts.

Coronary heart disease

Coronary heart disease is one of the most common heart diseases in patients with diabetes. It occurs when the arteries, which carry blood to the muscles of the heart, have a build-up of a waxy or fatty substance known as plaque.

Over a period of time, the plaque becomes harder and makes the arteries stiff. As more plaques get deposited inside the blood vessels, the amount of space available for blood to flow through them is reduced as a result of which the heart muscles do not get enough oxygen supply. 

Sometimes, clumps of plaques may burst apart, putting you at risk of having blood clots in these vessels. These changes could be attributed to the increase in cholesterol levels. The development of coronary heart disease due to increased cholesterol levels tends to be faster in patients with diabetes than those without diabetes.

Eventually, these changes can lead to more serious conditions such as:

• Angina: Angina refers to acute chest pain that starts abruptly and is sharp and severe in nature. Patients may feel sudden pain with a sense of grasping, pressure, and squeezing in the chest. They might also feel the pain radiating to their arms, jaw, or back.

In most cases, these symptoms resemble those of indigestion and are likely to be mistaken for the same resulting in misdiagnosis and delayed treatment. Physical activities and strong emotions can also set off the development of angina or make it worse.

• Arrhythmia: Arrhythmia refers to the conditions caused due to the irregular heartbeats. It occurs when the rate or rhythm of heartbeats is not normal. Patients with arrhythmia might feel as if the heart has skipped a beat, or that it flutters and beats too fast. It can also cause sudden cardiac arrest, wherein the heart stops beating.

The prevalence of angina and arrhythmia is higher in diabetic patients, which is why monitoring heart health is considered essential for them.

Heart failure

In spite of the name, heart failure does not mean the heart has stopped functioning. It indicates that the heart has become too weak to pump blood efficiently to all parts of the body.

Uncontrolled diabetes, over a period of time, can reduce the efficiency of the heart muscles to pump blood thus elevating your risk of cardiac failure, especially when coupled with high blood pressure and coronary heart disease.

These conditions can wear down the heart muscles as they are made to work more strenuously for too long.

When the organs of the body do not get enough blood due to cardiac failure, they are deprived of oxygen and the nutrients they need to perform their functions.

This can lead to symptoms such as:

• Feeling too weak and tired
• Difficult in performing minor physical activities
• Having a hard time performing simple exercises like walking
• Irregular or too fast heartbeats
• Difficult in maintaining focus during task
• Swelling in the ankles, legs, and feet
• Difficulty in breathing

Cardiac failure may precede or occur following a heart attack. In patients with diabetes, the changes in the blood vessels that can contribute to the development of cardiac failure tend to occur faster thus increasing the risk of serious complications including death.

Cardiomyopathy

Improper control of diabetes could speed up the pathogenesis of cardiomyopathy. Cardiomyopathy occurs when the heart muscles become thicker and stiffer due to which they cannot work efficiently.

Cardiomyopathy, if not detected and managed in an appropriate and timely manner, can lead to heart attacks, arrhythmias, and heart failure.

Cardiomyopathy may not cause any symptoms in the initial phase. However, as the condition becomes worse, it may lead to some symptoms like:

• Shortness of breath, even while resting
• Feeling too weak or tired
• Chest pain
• Dizziness and light-headedness
• Coughing, especially while lying down
• Swelling in the ankles, legs, and feet

Conclusion

Patients with diabetes are more likely to develop serious complications affecting the heart such as heart attacks, stroke, and cardiac failure. Maintaining optimum glycemic control and checking your blood sugar levels on a regular basis could help you assess your cardiac health and help you reduce your risk of heart attacks.

Checking your HbA1c levels, blood pressure, and blood cholesterol on a regular basis is also recommended to make sure you can receive timely treatment for the prevention of cardiac complications linked to diabetes.

Making healthy changes in your diet and lifestyle, avoiding smoking, and improving your physical activities are some other effective measures that can protect you against the risk of diabetic complications.