Diabetics Are At Higher Risk for Cardiovascular Disease? Understanding the Increased Risk of Those With Diabetes for Cardiovascular Disease

By: John Sawdon Director of Education & Special Projects, Cardiac Health Foundation of Canada

This article was written to celebrate Heart Month and was initally published in the National Aboriginal Diabetes Association newsletter. In understanding this risk our first task is to help create awareness about the necessary lifestyle changes that address the Risk Factors for Cardiovascular Disease (CVD). This article discuss the link between Diabetes and Cardiovascular Disease, the Risk Factors for Cardiovascular Disease and the lifestyle changes we can make that helps us to reduce the risk while managing this double jeopardy.


  • People with Diabetes are 2-4x more likely to develop CVD compared to people without diabetes
  • People with Type 2 Diabetes have the same risk of heart attack as people without diabetes who have already had a heart attack
  • People with Diabetes can have a Heart attack without ever realizing it
  • Stroke occurs 2x as often in people with diabetes and high blood pressure as in those with high blood pressure alone
  • Mini-strokes (also known as Transient Ischemic Attacks) occur between 2-6x more in people with diabetes
  • For each risk factor present, the risk of CVD is about 3x greater in people with diabetes as compared to people without diabetes

All types of diabetes can lead to diseases within the heart and circulatory system. There are 3 types of CVD: those affecting heart and coronary circulation (Coronary Heart Disease); those affecting the brain and cerebral circulation (Cerebrovascular Disease); and those affecting the lower limbs (Peripheral Vascular Disease). The most common cause are diseases which start with damage to the blood vessels, such as atherosclerosis (hardening/narrowing of the arteries and formation of plaque) and hypertension (high blood pressure) are two of the major processes as follows:

What are the Risk Factors for Cardiovascular Disease?

  • Advancing Age- risk grows with age; men over 45 and women over 55
  • Diabetes
  • High Cholesterol (Dyslipidaemia) – high levels of LDL or low density lipoprotein (Bad) cholesterol as well as low levels of HDL high-density lipoprotein (Good) cholesterol. Also, high levels of triglycerides (type of fat in blood) is a risk factor by itself.
  • Genetic Background- if parents or siblings have CVD at a premature age (men before 55 and women before 65 years)
  • High Blood Pressure (Hypertension) - above 140/89, very high blood pressure raises risk for stroke
  • High Alcohol Consumption- excess alcohol heightens hypertension
  • Insulin Resistance- people with greater resistance to the action of insulin at the cellular level have greater risk for CVD
  • Male gender-have a higher risk
  • Menopause- Risk for women increases after menopause
  • Obesity- excess body fat especially around the waist sedentary
  • Lifestyle- lack of physical activity
  • Smoking- a major risk factor for hypertension and CVD

Major Lifestyle Changes to manage both diabetes & CVD

The following are lifestyle changes that we can undertake in both managing diabetes and cardiovascular disease. Initially know your ABCDE’s:

  • A-A1c- Monitor and keep your Glucose control target on track, it is usually 7% or less
  • B-Blood Pressure (BP) - Control your blood pressure aim for 130/80 mmHg
  • C-Cholesterol (Dyslipidaemia) Try to keep your LDL lipoprotein level to less than 2.0 mmol/L or less and raise your HDL to over 40
  • D-Drugs to protect your heart, follow instructions from your doctor
  • E-Exercise- Regular exercise recommended at 150 minutes per week at a moderate or vigorous level has been associated with better health. This should include both aerobic exercises and resistance training.
  • Smoking - Stop smoking. Smoking is directly related to blood pressure and atherosclerosis.
  • Stress: and manage stress effectively Yoga and Mindfulness have been associated with stress reduction which reduces inflammation. Developing meaning in one’s life through spiritual connections and mindful meditation can settle you and help you reduce stress in your life while gaining meaning and purpose. Cultural Rituals strengthen personal motivation and commitment including providing the strength of community to help facilitate the change that you are pursuing. By reducing stress you reduce inflammation which is directly associated with both diabetes and CVD.

We know that a buddy system helps with the motivation to undertake aerobic exercises that might include walking, jogging, urban poling and potentially snowshoeing. By contacting a neighbour or announcing on the radio station you may be able to motivate others in your community to start a walking, urban poling or snowshoeing club. This will move you towards your goal of becoming physically active. It also addresses one of the strongest research findings on motivation for physical activity which includes having a support system and an accountability framework for your program.

This change could include increasing physical activity amongst the entire community beginning in the school, at the Community Centre and Health or Healing Centre and among the seniors of the community. We encourage you to celebrate Heart Month by initially making a small commitment by setting and accomplishing your goal. For those of you who have greater visions and want to do more, Become the catalyst for change in your community.

John Sawdon Director Of Education & Special Projects
Cardiac Health Foundation of Canada

The articles, on the Cardiac Health Foundation of Canada website, are presented with the understanding that the Foundation is providing information only and not rendering medical advice. Please check with your family physician, specialist or health care professional before implementing any of the ideas expressed in these articles.