Debora Grandison, a 63-year-old author from San Luis, MO, first learned about her heart issues in 1988 when she experienced a premature birth. While the delivery continued successfully, the medications she needed caused complications, leading to several weeks in intensive care where she was diagnosed with mitral valve prolapse and gestational diabetes. Although Grandison’s blood glucose levels returned to normal after the birth of her first child, her heart palpitations persisted.
Three years later, Grandison visited her doctor thinking she had the flu. It turned out to be a sudden spike in blood glucose levels that led to a diagnosis of type 1 diabetes. Unfortunately, she continued to face medical challenges. After years of searching for answers with multiple doctors due to severe heart palpitations, difficulty breathing, pain in her left arm, and dizziness, Grandison was finally diagnosed with cardiomyopathy and received a pacemaker. She later learned she also had atrial fibrillation, which increases the risk of cardiovascular accidents.
What upsets Grandison, now a volunteer for Go Red For Women, an initiative of the American Heart Association, is that she was never informed about the risk of heart disease when she was first diagnosed with diabetes. “I was informed about complications such as blindness, amputation, and kidney diseases, but that was it,” she said. Nearly half of women in the U.S. are unaware that heart disease is the leading cause of death among women (1 in 5 deaths), and over 60 million have some form of heart disease. These numbers are even higher for women with diabetes.
Women with diabetes have a higher likelihood of experiencing a heart attack at a younger age and are at a greater risk of dying from that heart attack. Diabetes also increases the risk of cardiovascular accidents in women. Higher blood glucose levels can lead to increased fat deposits in the blood vessels, blocking or narrowing them. Elevated blood glucose levels are associated with high triglyceride levels in your blood, which are also linked to heart disease.
So, what is the connection between heart disease, diabetes, and cardiovascular accidents? The answer lies in the risk factors and the damage each of these conditions can cause in your body. In addition to family history, other significant risk factors, known as cardiometabolic risk factors, are common to these three disorders. These include:
– High cholesterol levels
– High triglyceride levels
– Poor diet
– Overweight or obesity
– Lack of physical activity
– Smoking
– Hypertension
Hypertension can also increase your risk of a cardiovascular accident or heart disease. Each condition can elevate the risk of experiencing one of the other two. For instance, having diabetes raises your risk of heart disease. “Having type 2 diabetes is similar to having had a heart attack,” said Icilma Fergus, M.D., a cardiologist and director of cardiovascular disparities at Mount Sinai Medical Center in New York. This means that diabetes causes the same level of damage to your heart as a heart attack.
According to Fergus, there are modifiable risk factors because your lifestyle also plays a significant role in cardiometabolic risk factors. “For example, what you eat, how much you eat, and the composition of what you eat. We are starting to see people aged 17, 18, and 19 developing type 2 diabetes. This is because they consume many calories and many foods made with preservatives.”
It is important to know your numbers. Since some risk factors for heart disease, diabetes, and cardiovascular accidents overlap, you can take steps to reduce your risk. Fergus recommended that once women reach their thirties, especially with a history of heart disease or other risk factors, they should be aware of their blood sugar levels (known as A1C levels), cholesterol levels, blood pressure, weight, and waist circumference. Simply having consultations with your gynecologist, who may be the primary care physician for many women, is a good starting point. They can assess your blood pressure and conduct blood tests to explain your blood pressure and sugar levels. If you don’t have a primary care physician and are concerned, you can visit an urgent care clinic and inform them of your symptoms. In all cases, they will check your blood pressure and conduct blood tests. Urgent care centers can refer you to a specialist if necessary.
Unfortunately, not all risk factors can be easily modified. Your place of residence, level of education, and income can affect your health. “These are known as social determinants of health,” said Fergus. Even your ethnicity and disabilities can play a significant role. Studies show that individuals with lower incomes and education levels have higher rates of heart disease and are less likely to receive timely treatment when symptoms arise. Adopting simple lifestyle changes such as consuming a healthy diet, engaging in physical activity, and quitting smoking can help lower your risk of heart disease, diabetes, and cardiovascular accidents. “There are simple steps you can take to be a healthy woman,” said Fergus.
It may seem daunting to think about the various things you should do to reduce your risk of heart disease, diabetes, and cardiovascular accidents. The National Institute of Diabetes and Digestive and Kidney Diseases recommends starting by controlling the “ABCs”:
– A is to know and understand your A1C levels from the past three months to determine your blood sugar levels and if you have diabetes or are at risk of developing it.
– B is to know your blood pressure. For most people, a healthy blood pressure is below 120/80, but everyone is different, so ask your doctor what your target should be.
– C is cholesterol. Ask your doctor what your LDL cholesterol levels should be. LDL cholesterol is known as the “bad” cholesterol.
Monitoring your triglyceride levels is also crucial in managing your risk of heart disease and cardiovascular accidents. If any of your ABCs or triglyceride levels are high (above 150 mg/dL), you can reduce them through lifestyle changes such as adopting a healthy diet, increasing physical activity, and quitting smoking. If these measures do not lower your levels, your doctor may recommend medications to control your risk of heart disease and diabetes.
There are steps you can take now to reduce your risk. Start by educating yourself about your potential risk factors and take action to protect your heart health.
