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10 months ago
Why diabetics are at a high risk of coronary heart disease

A person who has suffered a heart attack is more prone to another one in the future. However, if you are a diabetic without a prior history of heart attack, then the risk of developing a heart attack is equal to the risk faced by a non-diabetic who has previously suffered a heart attack. In other words, a diabetic carries a high risk of heart attack. Not just this, coronary artery disease (CAD) in pre-menopausal women, as compared to men of the same age, is quite uncommon. However, in the presence of diabetes, the risk of CAD in women is the same as men, which means diabetes ups the risk of heart disease in women. But why is this so? Dr Hemraj Chandalia, Director, Endocrinology, Diabetes and Metabolism, Jaslok Hospital and Research Center, Mumbai explains why diabetics are at high risk of coronary heart disease than non-diabetics. Here’s more on why are diabetics at a high risk of silent heart attack.

Why do CVD and coronary artery disease affect young diabetics?

This is because diabetes accelerates atherosclerosis; a process where the arterial lining is damaged and thickened and prone to occlusion. This process is accelerated because of an increasing tendency of the blood to clot and block vessels. Uncontrolled diabetes also sets up an inflammatory process, which injures the lining of blood vessels.

Another important cause of increased CAD in diabetes is the presence of comorbities like high blood pressure, high cholesterol and obesity. Most diabetics have high LDL cholesterol (so-called bad cholesterol) and low HDL cholesterol (so-called good cholesterol). Additionally, they also have high triglycerides, another type of blood fat. High blood pressure is seen in about 60-80% of people with diabetes and is 2-3 times as common as seen in non-diabetics. Obesity is a highly prevalent comorbidity. It is usually seen that 52% of type 2 diabetics are overweight or obese. Obesity can also be a constellation of several morbidities like increased abdominal girth (> 90 cm in man, >80 cm in women), high blood pressure and high cholesterol. This is called metabolic syndrome which is a deadly alliance of several comorbities, which further increases the pressure on the heart. Also read about Diabetes and cardiomyopathy — what is the connection?

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