Matters of the Heart

By Steven Baldridge

Preparing for this article, I came across a few sobering statistics. Ask any five people with diabetes if they have an increases their risk of heart disease or stroke. Three of those five people will say “no” and one of the other two will say “probably not.” Those four people are dead wrong. In fact, three of those five people will eventually die from some form of heart disease. And one of the remaining two will die from blood vessel problems in another body part (stroke, kidney disease, poor circulation in the legs leading to complications, etc.).

 Simply stated, diabetes kills. It most often kills by damaging blood vessels in a variety of different ways. Here we will talk about the blood vessels that supply the heart, but please take note – anything that damages any blood vessels almost always damages all blood vessels in all body parts. Some are just less likely to kill us.

 This is a bit complicated and I only have a few hundred words, but let’s give it a try. Ready?

The blood that my heart pumps does not feed my heart until a little of it is routed through the vessels on the surface of my heart. All blood vessels are smooth on the inside so that none of the great things in my blood – like red blood cells, proteins, platelets and such – get snagged on any rough edges. Any damage to this smooth lining causes that spot to be rough. When a rough spot is detected my body sends the chemical equivalent of a repair crew filling a pothole. Unlike the road, the lining of my blood vessel can heal and the patch will then dissolve. The patching material my body uses to smooth over these rough places until they can heal is a mixture that includes a lot of fat – specifically, cholesterol.

 Relax. This is a very good process when it runs as designed. If the rough spot snags a platelet, the platelet rips open and the insides begin a long chain reaction that makes a blood clot. This also is very good if the roughness was due to sudden holes in my body. The leak is plugged. When the area heals, the clot dissolves and I go on my merry way. Both of these processes happen day in and day out in all of us.

 However, if the damage never heals the plaques never dissolve. To avoid blood clots in all the wrong places the “road crew” gets carried away and lays down layer upon layer of patching material because the signal to do so is “this area is still damaged.” Since the damage is general, the repair happens over huge sections of blood vessels, not only small areas. Eventually the “patch” (plaque) is so big it actually stiffens the blood vessel and narrows the opening so much the blood cannot get through that vessel in the amounts the heart muscle needs. This sets up ongoing distress in the heart muscle, and it fails to work properly. It gets still more complicated but the end result is some form of heart disease.

 For two or three of those five people we talked about earlier in this article, it gets worse. One of the plaques cracks and breaks, creating a sudden huge rough spot in an already too narrow blood vessel. Now a clot forms there, possibly blocking that spot completely. All the heart muscle that was supposed to get that blood now starts to die. This is a heart attack.

 What does all this have to do with diabetes? Uncontrolled blood sugar levels can cause ongoing damage to the blood vessel lining (never heals). Even if my blood sugar is controlled, abnormal insulin levels do the same thing. Diabetes also alters cholesterol amounts and types. The altered cholesterol damages blood vessel linings, makes more plaque, and makes my blood clot faster.

 If I were you, I’d want to find out more about both diabetes and heart disease. Fortunately UH Samaritan Nurse Practitioner and Diabetes Care and Education Specialist, Sarah Beattie will present “Sweet Heart, the link between diabetes and heart disease” Thursday, February 6 at 5:30 p.m. in the UH Administrative Services Building, 663 East Main Street in Ashland Ohio. Join us as Sarah helps us understand what we can do to thwart this dangerous duo. For those who come between 4:30 and 5:00 we will do a free check of your blood sugar and cholesterol levels. To register for this free event please call 419-207-2563.

 

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