The Clot Connection: Thrombosis Heart Attack And Stroke
Blood clots play a major role in myocardial infarction , or heart attack. Over time, the coronary arteries can develop plaquesa buildup of cholesterol, fibrous tissue, and inflammatory cellsin a process called atherosclerosis. Smoking, high blood pressure, high cholesterol, and diabetes are risk factors for atherosclerosis over time, they cause injury to the blood vessels and lead to more plaque formation. In some cases, these plaques become unstable and fracture, triggering the body to form a blood clot at that site. The blood clot may block the coronary artery and starve the heart muscle of oxygen and nutrients, resulting in a heart attack.
In deep vein thrombosis , blood clots develop in the leg or pelvis veins. Inflammation and underlying genetic factors likely predispose people to DVT. Other risk factors such as cancer or immobility also increase risk for DVT. If a portion of the DVT dislodges, it can travel through the veins and eventually reach the pulmonary arteries, becoming a pulmonary embolism .
Aaron W. Aday, MD
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Risk Factors For High Blood Pressure With Diabetes
According to the ADA, the combination of high blood pressure and type 2 diabetes is particularly lethal and can significantly raise your risk of having a heart attack or stroke. Having type 2 diabetes and high blood pressure also increases your chances of developing other diabetes-related diseases, such as kidney disease and retinopathy. Diabetic retinopathy may cause blindness.
Theres also significant evidence to show that chronic high blood pressure can speed the arrival of problems with the ability to think that are associated with aging, such as Alzheimers disease and dementia. According to the AHA, blood vessels in the brain are particularly susceptible to damage due to high blood pressure. This makes it a major risk factor for stroke and dementia.
Uncontrolled diabetes isnt the only health factor that increases risk for high blood pressure. Remember, your chances of having a heart attack or stroke increase exponentially if you have more than one of the following risk factors:
- chronic diseases such as kidney disease, diabetes, or sleep apnea
Preventing High Blood Pressure With Diabetes
There are many lifestyle changes that can lower your blood pressure. Nearly all are dietary, but daily exercise is also recommended. Most doctors advise walking briskly for 30 to 40 minutes every day, but any aerobic activity can make your heart healthier.
The recommends a minimum of either:
- 150 minutes per week of moderate-intensity exercise
- 75 minutes per week of vigorous exercise
- a combination of moderate and vigorous activity each week
In addition to lowering blood pressure, physical activity can strengthen the heart muscle. It may also reduce arterial stiffness. This happens as people age, but is often accelerated by type 2 diabetes. Exercise can also help you gain better control of your blood sugar levels.
Work directly with your doctor to develop an exercise plan. This is especially important if you:
- havent exercised before
- are trying to work up to something more strenuous
- are having trouble meeting your goals
Start with five minutes of brisk walking each day and increase it over time. Take the stairs instead of the elevator, or park your car farther from the store entrance.
You may be familiar with the need for improved eating habits, such as limiting sugar in your diet. But heart-healthy eating also means limiting:
- salt
- high-fat meats
- whole-fat dairy products
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Your Blood Pressure Test
Your doctor or nurse uses a blood pressure monitor to check your blood pressure. Theyll put a cuff around your arm and inflate it. This restricts the blood flow for a few seconds. This can feel uncomfortable but isnt painful. The cuff then deflates, the monitor takes a reading and your doctor or nurse will take the cuff off.
You should get this test at least once a year. Its usually part of your annual review and is one of your essential diabetes health checks.
If you want to, you can buy a blood pressure monitor yourself to use at home. You can get this from a chemist or pharmacy, or order one from our shop. You dont have to do this, but some people find it helps them manage their diabetes better. In some areas, diabetes care teams have suggested people buy their own home blood pressure monitoring kit, during the coronavirus pandemic while access to routine care is disrupted. You can find a list of blood pressure monitors to use at home from the British and Irish Hypertension Society website.
We know that wont be possible for everyone, and we dont think people should have to pay for these devices. Were calling on the NHS to find other ways to make these available for free.
Its fine to use a monitor yourself, but speak to your healthcare team first to make sure youre using it right. Make a note of your readings and speak to your doctor or nurse if youre ever worried.
When Is It High Blood Pressure
If you have high blood pressure, it means that your blood is pumping through your heart and blood vessels with too much force. Over time, consistently high blood pressure tires the heart muscle and can enlarge it. In 2008, 67 percent of American adults aged 20 and over with self-reported diabetes had blood pressure rates that were greater than 140/90 millimeters of mercury .
In the general population and in people with diabetes, a blood pressure reading of less than 120/80 mm Hg is considered normal.
What does this mean? The first number is called the systolic pressure. It indicates the highest pressure exerted as blood pushes through your heart. The second number is called the diastolic pressure. This is the pressure maintained by the arteries when the vessels are relaxed between heartbeats.
According to the American Heart Association , healthy people over 20 with a blood pressure lower than 120/80 should get their blood pressure checked once every two years. People with diabetes need to be more vigilant.
If you have diabetes, your doctor may check your blood pressure at least four times each year. If you have diabetes and high blood pressure, the ADA recommends that you self-monitor at home, record the readings, and share them with your doctor.
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Limit Your Alcohol Intake And Ditch The Cigarettes
If youre currently drinking more than one serving of alcohol per day or more than 7 drinks per week for women and 14 drinks per week for a man.
The American Diabetes Association recommends that people living with diabetes follow the general guidelines for alcohol consumption:
- Men: No more than 2 drinks per day on average
- Women: No more than 1 drink per day on average
Ideally, if youre really motivated to improve your overall health, alcohol would be considered a small indulgence on the weekend versus something you consume on a daily basis. Keep in mind that alcohol is technically a poison to the body that your liver has to process to rid from your system. It will wear on every aspect of your health if consumed all too often, even 1 drink per day.
Mental Stress And Sympathetic Nervous System
Stressors are intrinsic or extrinsic stimuli leading to disturbances in physiology and psychology, and may threaten health. Compared with physical stressors, modern stressors arising from psychological threat are more sustained. Chronic mental stress, resulting from the modern lifestyle, is frequently associated with physiologic and psychological disturbances, and may indirectly lead to diabetes and hypertension .
Although epidemiologic investigations have demonstrated that mental stress is associated with hypertension, cardiovascular disease, obesity, and the metabolic syndrome , the effect of mental stress on the whole body is not completely understood. Animal experiments taught us that the mechanisms include renal sympathetic nerve activity and blood pressure control in which baroreflex function is involved.
In the human body, stimulation of the sympathetic nervous system , caused by chronic stress, elevates pulse rate and cardiac minute output and also activates the RAAS, which is another important pressor mechanism . Increased activity of the SNS also plays a part in the development of impaired glucose and lipid metabolism . Studying the SNS and RAAS allows us to understand their roles in the etiology and treatment of hypertension, metabolic syndrome, and diabetes .
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Avoid Stress If Possible
A stressful day here and there isnt likely to contribute to high blood pressure. Chronic stress, however, can absolutely lead to persistently high blood pressure.
Whether its an overly demanding job, an unhealthy relationship, an anxiety disorder, overwhelming parenting responsibilities, and the many other ways life can take on more than we can mentally handle are all reasonable culprits of high blood pressure.
While many sources of stress may not be fully within your control, it may be time to truly consider what you can change in your life for the sake of your immediate and long-term wellbeing.
Should You Take It Daily
Many people have this question that whether they should take aspirin daily or not? Is it safe for them to have it daily or they should avoid it considering some side effects? A doctor can give the right answer to this question as he/she will check you thoroughly, know your problems, and then advise you on the right solution for this.
In most cases, if you have any of the following scenarios then a doctor tells you to take aspirin on a daily basis.
In the above case, a doctor will give the prescription to the patient a daily dose of 81mg for protection. A patient who already had a heart attack is prescribed aspirin then it is called secondary prevention as the event is being prevented from happening the second time.
The risk of internal bleeding has to be checked as it is a serious problem. Many patients have faced the internal bleeding problem due to it, mostly the people having age 65 and above.
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Diabetes And High Blood Pressure Risks
The condition occurs in as many as two-thirds of people with diabetes and places these individuals at twice the risk of heart disease than a person only dealing with high blood pressure.
Theres no doubt that diabetes and high blood pressure are a dangerous duo, said Betul Hatipoglu, MD, an endocrinologist at the Cleveland Clinic in Ohio. Theyre both very common and are linked by obesity, which is also very common. Nearly half of all people diagnosed with type 2 diabetes have high blood pressure at the time of their diagnosis.
Options For People With High Blood Pressure
If you have high blood pressure or heart conditions and would like to take pain control medications, discuss your options with your doctor beforehand. Most experts agree that acetaminophen and aspirin are the safest pain relief choices for people with high blood pressure. However, not everyone should use aspirin. Ask your doctor if aspirin is safe for you if you take medications for high blood pressure. Aspirin may also cause ulcers, heartburn, and upset stomach, and it can be dangerous to take if you have gout, liver disease, rheumatic fever, or if used in children. Pregnant women also should not take aspirin as it can be unsafe for both mother and baby.
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What Can I Do To Prevent Or Manage High Blood Pressure
Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about
- Getting at least 150 minutes of physical activity each week
- Not smoking
- Managing stress
Learn more about ways to manage and prevent high blood pressure.
In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure. Learn more about medicines for high blood pressure.
Talk with your health care team right away if you think you have high blood pressure or if youve been told you have high blood pressure but do not have it under control.
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Why Is High Blood Pressure A Problem
High blood pressure is a risk factor for developing a cardiovascular disease and kidney damage, sometime in the future.
If you have high blood pressure, over the years it may have a damaging effect on blood vessels and put a strain on your heart.
In general, the higher your blood pressure, the greater your health risk. However, high blood pressure is just one of several possible risk factors for developing a cardiovascular disease.
Other risk factors that also increase the risk of developing a cardiovascular disease are:
- Lifestyle risk factors that can be prevented or changed:
- Smoking.
- High fat blood level.
- Diabetes.
- Kidney diseases that affect kidney function.
- A strong family history. This means if you have a father or brother who developed heart disease or a stroke before they were aged 55, or in a mother or sister before they were aged 65.
- Being male.
- An early menopause in women.
- Age. The older you become, the more likely you are to develop furring or ‘hardening’ of the arteries .
- Ethnic group. For example, people who live in the UK, with ancestry from India, Pakistan, Bangladesh or Sri Lanka, have an increased risk.
Diabetes plus high blood pressure is a particularly strong combination of risk factors.In addition, some other complications of diabetes are more common if you have high blood pressure. For example, damage to the back of the eye and kidney damage related to diabetes .
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No Symptoms No Testing Needed
Screening for PAD probably doesnt make sense for a healthy individual without symptoms, who is younger than 60 years old, has never smoked and has no family history of atherosclerosis or heart disease, he adds.
In this case, screening may actually expose a patient to more risk. This is because the tests can occasionally be incorrect and lead to much more invasive testing, which has its own inherent risks.
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How Diabetes Affects Your Heart
Over time, high blood sugar can damage blood vessels and the nerves that control your heart. People with diabetes are also more likely to have other conditions that raise the risk for heart disease:
- High blood pressure increases the force of blood through your arteries and can damage artery walls. Having both high blood pressure and diabetes can greatly increase your risk for heart disease.
- Too much LDL cholesterol in your bloodstream can form plaque on damaged artery walls.
- High triglycerides and low HDL cholesterol or high LDL cholesterol is thought to contribute to hardening of the arteries.
None of these conditions has symptoms. Your doctor can check your blood pressure and do a simple blood test to see if your LDL, HDL, and triglyceride levels are high.
These factors can also raise your risk for heart disease:
- Smoking
- Being overweight or having obesity
- Not getting enough physical activity
- Eating a diet high in saturated fat, trans fat, cholesterol, and sodium
- Drinking too much alcohol
People with diabetes are also more likely to have heart failure. Heart failure is a serious condition, but it doesnt mean the heart has stopped beating it means your heart cant pump blood well. This can lead to swelling in your legs and fluid building up in your lungs, making it hard to breathe. Heart failure tends to get worse over time, but early diagnosis and treatment can help relieve symptoms and stop or delay the condition getting worse.
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What Should Your Blood Pressure Be
Readings vary, but most people with diabetes should have a blood pressure of no more than 130/80.
The first, or top, number is the “systolic pressure,” or the pressure in your arteries when your heart squeezes and fills the vessels with blood. The second, or bottom, number is the “diastolic pressure,” or the pressure in your arteries when your heart rests between beats, filling itself with blood for the next contraction.
When it comes to preventing diabetes complications, normal blood pressure is as important as good control of your blood sugar levels.
How To Avoid Low Blood Sugar
Here are some tips for avoiding low blood sugar:
- Eat regular meals and a balanced diet.
- Carry healthy snacks.
- Learn how to use an at-home glucose-testing device, or ask your healthcare provider for advice.
- Keep a food diary, which can help you identify your triggers and modify your diet accordingly.
Sometimes, low blood sugar occurs even when you try to prevent it. Therefore, it’s a good idea to carry glucose tablets or other fast-acting carbohydrates, such as half a banana or a couple tablespoons of raisins.
The 1515 rule can help you raise your blood sugar slowly. It involves eating 15 grams of fast-acting carbohydrates and checking your blood sugar levels after 15 minutes. If your blood sugar is not responding to the carbohydrates within 15 minutes, repeat the steps until your blood sugar is in your target range. It may be necessary to call your doctor or seek emergency medical help right away if you can’t get your blood sugar under control.
Preventing low blood sugar is an important part of preventing hypertension, but it is not the only way. Talk to your healthcare provider about unique risk factors that may impact how you approach both blood sugar and blood pressure.
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