Nothing causes more deaths in the United States each year than heart disease — not even cancer. According to the Centers for Disease Control and Prevention, a person dies from heart disease every 36 seconds. And if you have diabetes, you’re twice as likely to suffer from cardiovascular disease than a person without diabetes. In this article, we are going to arm you with everything you regarding cardiovascular disease prevention — from understanding the jargon to identifying risk factors and providing simple lifestyle suggestions you can implement right now. 

What is cardiovascular disease?

People often use different cardiovascular disease-related terms interchangeably, which can be confusing. For example, maybe you’ve wondered what the difference between heart disease, coronary heart disease, and cardiovascular disease is. Don’t they all describe the same thing? Not exactly. There are some small but important differences.

Cardiovascular disease (CVD) is an umbrella term used to describe any disease affecting the heart (cardio) or blood vessels (vascular), including coronary heart disease and others. A good rule of thumb is this: all heart diseases are cardiovascular diseases, but not all cardiovascular diseases are heart diseases.

• Coronary heart disease: Also known as coronary artery disease, this disease occurs when plaque builds up in your arteries, reducing the flow of blood to your heart. Plaque is a combination of fat, cholesterol, calcium, and other substances. This buildup is often referred to as atherosclerosis. Plaque can also lead to blood clots, which are the most common cause of heart attacks.

• Heart attack: Also known as myocardial infarction, a heart attack occurs when blood flow to part of the heart is blocked by a blood clot. If blood flow is cut off completely, the affected part of the heart can begin to die.

• Stroke: Although they impact the brain, strokes are also considered a cardiovascular disease because they are caused by blocked vessels that supply blood to the brain. Like heart attacks, the blockages causing strokes are often caused by blood clots. Strokes can also occur when a blood vessel inside the brain bursts. These types of strokes are usually caused by high blood pressure.

• Heart failure: Contrary to common belief, heart failure does not mean the heart stops beating. Instead, the heart no longer works as efficiently as it used to and the body no longer gets enough blood and oxygen.

• Arrhythmia: Arrhythmia is an abnormal heart rhythm; either the heart beats too fast, too slow, or irregularly. Arrhythmia can affect how well your heart delivers blood and oxygen to the rest of the body.

There are additional cardiovascular diseases that are also caused by infections (such as rheumatic heart disease) or that are defects present at birth (congenital heart disease). Because these conditions are not preventable by lifestyle choices, they won’t be discussed in this article.

Symptoms of cardiovascular disease

According to the American Diabetes Association, there are several symptoms of cardiovascular disease that people with diabetes should watch out for. If you experience any of the following, be sure to go to the emergency room right away:

• Shortness of breath
• Fatigue
• Weakness or numbness in your arms or legs
• Pain in your chest, throat, back, legs, neck, jaw, upper abdomen and/or arms

Additionally, you should go to the hospital if you experience any of the following symptoms of heart attack:

• Pain, discomfort, and tightness in your chest
• A feeling similar to indigestion or heartburn
• Discomfort in one or both of your arms, back, jaw, neck, or upper abdomen
• Shortness of breath
• Sweating
• Indigestion, nausea, or vomiting 
• Tiredness, fainting, or light-headedness

Or, you should go to the hospital if you experience any of the symptoms of heart failure:

• Shortness of breath
• Weakness
• Nausea
• Quick/irregular heartbeat
• Coughing with pink-tinged mucus
• Fatigue
• Fluid retention in your feet/ankles

Conditions that put you at risk for CVD

There are several important medical conditions that increase a person’s risk for developing a serious cardiovascular disease:

• Hypertension, or high blood pressure (see note below):^: When your blood pressure is too high, your arteries experience an abnormally high level of force from the blood being pumped through them. A blood pressure of 140/90 mm Hg is usually considered hypertension; a blood pressure of 180/20 mm Hg  is considered severe hypertension. Note that these limits are based on general guidelines and you should consult with your physician to determine if your blood pressure is nearing or at an unhealthy level.

• High blood cholesterol (see note below): Cholesterol, which is a waxy, fat-like substance, isn’t bad in and of itself; in fact, your body couldn’t function without it. But too much of a good thing can be a bad thing. There are two types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). When there is too much LDL — also known as “bad cholesterol” in your blood, plaque can build up in your blood vessels. HDL, on the other hand, carries away the LDL and plaque from your arteries to your liver, which flushes the bad cholesterol out of your body.

• Overweight and obesity: Overweight and obesity are serious medical conditions that are characterized by an excessive amount of body fat. There are a number of factors that can lead to obesity; most often, it is caused by some combination of hereditary, physiological, environmental and lifestyle factors. A measurement known as Body Mass Index (BMI) has historically been used to diagnose obesity; however, certain factors — such as muscle mass — can skew a person’s BMI and physicians are increasingly moving away from relying just on this one diagnostic tool. 

Note: Both hypertension and high blood cholesterol are asymptomatic, meaning you won't know that you have these conditions until it’s too late. The best way to stay on top of your health is to regularly visit your doctor, who can take your blood pressure with a cuff and determine your cholesterol levels with a simple blood test. You might also consider monitoring your blood pressure daily at home if your doctor determines you are at risk for high blood pressure.

In addition to these medical conditions that increase a person’s risk for CVD, there are several lifestyle factors that can also increase CVD risk (as well as the precursor conditions just outlined above):

• Not getting enough exercise
• Smoking
• Poor diet
• Overconsumption of alcohol

Cardiovascular disease and diabetes

As mentioned above, people with diabetes are at a much higher risk for cardiovascular disease than people without diabetes. However, the relationship between the two conditions is complex: diabetes can lead to cardiovascular disease and its precursor conditions, but some of the cardiovascular disease precursor conditions discussed above, such as hypertension, can also lead to diabetes. This complex, two-way relationship is difficult to unravel because many studies only look at one direction: diabetes causing CVD/CVD precursor conditions or vice versa.

A large cross-sectional study (over 400,000 participants) published in the American Journal of Preventive Medicine took a deep dive into the relationship between diabetes and hypertension. Generally, people with diabetes also had higher rates of several hypertension risk factors: high blood pressure, hyperlipidemia, hypertension, frequent alcohol consumption, abnormal sleep and less exercise. But correcting for these factors revealed something important: diabetes alone, absent any other factor, increased the risk for hypertension. But, perhaps even more importantly, the risk of hypertension was lower in the diabetic individuals that led healthier lifestyles: adequate exercise, normal weight, regular activity, and little alcohol consumption.

Researchers recently used genetic mapping to define genetic risk scores for adverse cardiovascular events (heart attack, stroke, and death of cardiovascular tissue) in diabetic patients, reporting a higher risk of adverse events in individuals with higher genetic risk scores. Furthermore, the risk of adverse events in patients with higher genetic risk scores couldn’t be alleviated by intensive glycemic therapy (i.e., with drugs), leading the authors to encourage a very early focus on lifestyle factors such as diet and exercise to prevent CVD in at-risk individuals.

Clearly, the relationship between diabetes and CVD is complex and can be impacted by a number of different factors. Nevertheless, one thing is certain: regardless of whether diabetes is the cause of CVD or CVD the cause of diabetes, both cause-effect relationships can be prevented by the same thing: a healthy lifestyle.

How to prevent cardiovascular disease

So, what exactly is a healthy lifestyle? When it comes to preventing cardiovascular disease, CVD precursor conditions and even diabetes, most health organizations (including the American Diabetes Association) suggest the same set of recommendations:

• Exercise at least 150 minutes per week. Choose exercises you enjoy! The best exercise plan is one you can stick to.

• Sit less. If you work in an office, take breaks to walk around every 30 minutes, or work at a stand-up desk.

• Maintain a healthy weight. Talk with your doctor to identify your healthy weight and devise a diet and exercise plan to help you reach it.

• Eat a healthy diet. Emphasize fruits, vegetables, and whole, unrefined grains (i.e., get a lot of fiber). Avoid saturated and trans fats and refined, processed foods. 

• Manage stress. Stress can have a negative impact on your health in many ways, including increasing the risk of high blood pressure. So if you feel stressed often, and deeply, consider adopting some new strategies — such as meditation, yoga, cognitive behavioral therapy, relaxation and breathing techniques, or simply upping your engagement with your supportive social network.

• Get a good night's sleep. Most adults need between 7-9 hours of sleep per night. Sticking to a bedtime routine and going to bed at the same time every night are some of the best ways to support healthy sleep. 

• If you smoke, quit.

• Limit alcohol intake. Some studies have shown that even one drink a day can increase the risk of high blood pressure in people with diabetes.

Additionally, if your doctor has prescribed any medications for controlling blood pressure, cholesterol or any other conditions, make sure you take those medications as directed. You should also frequently check your blood pressure, blood cholesterol levels and A1c levels, and talk with your doctor about any concerning trends.

Key takeaways

When it comes to cardiovascular disease prevention, CVD is one of the most serious diseases affecting Americans, but it is also one of the most preventable. If you have diabetes, your disorder will be better managed if you optimize your heart health. While the relationship between cardiovascular disease and diabetes is complex, both conditions can be prevented and/or better controlled by adhering to the same lifestyle habits: getting enough sleep and exercise, eating a healthy diet, and managing stress. Talk to your doctor today to come up with a diet and exercise plan you can stick to and be on your way to better heart health.