Heart conditions are the most lethal complications associated with diabetes, but their risk can often be reduced. Diabetes is one of the four major risk factors – along with high blood pressure, smoking and abnormal cholesterol levels – for heart attack.

A heart attack can occur when the coronary arteries become blocked because of the buildup of plaque (atherosclerosis), restricting blood to the heart. This condition is called coronary artery disease (CAD). When blood flow to the heart stops, heart tissue begins to die. This event is called a heart attack.

Diabetes increases the risk of developing CAD in part because high levels of glucose (blood sugar) cause blood vessels to thicken and to lose their elasticity. People with diabetes tend to have CAD that occurs earlier in life and is more likely to be fatal.

People with diabetes are also at increased risk of many other cardiovascular diseases. These include peripheral arterial disease, cerebrovascular disease, stroke  and heart failure. Although the majority of people with diabetes die of cardiovascular causes, many are unaware of the risks. This may be due to the nature of these diseases. The symptoms of uncontrolled diabetes are often apparent (e.g., fatigue, excessive thirst, frequent urination), whereas symptoms of cardiovascular conditions may not be as obvious.

High blood pressure and high cholesterol, for instance, are both major risk factors for heart attack. But blood pressure and cholesterol often increase without any obvious symptoms, sometimes until a heart attack (or stroke) occurs. Because patients with diabetes are more likely than nondiabetics to die from either of these events, it is vital to control blood pressure and cholesterol.

Eating a healthy diet, getting enough exercise and not smoking are also important, both to help control glucose levels and to reduce the risk of heart conditions. Even small improvements in glucose, blood pressure and cholesterol readings can have a dramatic effect on the long-term health of people with diabetes.