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PRE-DIABETES AND HEART HEALTH


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How the Cardiovascular System Works and What Can Go Wrong

Heart Health and Pre-diabetesHeart disease is one of the biggest killers in the U.S. But do you know if you're at risk? And do you know what steps to take if you're vulnerable?

Even though most of the risk factors can be controlled, too many adults of both sexes still pursue a lifestyle of poor diet and lack of exercise that leads to weight gain. This, in turn, causes damage to the cardiovascular system.

"Heart trouble" is a commonly used phrase. But many people don't realize that it refers to a number of different problems, depending on which part of the cardiovascular system is affected. Although the heart is a single organ, it is made up of several different parts:

Coronary arteries deliver blood to the heart muscle.

The heart muscle pumps oxygenated blood out of the heart via the aorta artery to nourish every other organ of the body. The pulmonary artery carries blood to the lungs.

Valves, two on each side, direct blood flow in and out of the heart and among its four chambers, called the atria (upper) and ventricles (lower). The left atrium receives oxygenated blood from the lungs, while the right atrium receives blood from the body and contains the heart's "natural pacemaker" called the sinoatrial node or sinus node, which keeps the heart beating regularly. The left ventricle pumps oxygenated blood around the body, while the right ventricle pumps blood to the lungs for fresh oxygen.

The septum is a muscle down the center of the heart. It separates the right side - where blood returns from the body on its way to the lungs to be replenished with oxygen - from the left side, where oxygen-enriched blood is pumped out to the rest of the body.

The pericardium is an outside sheath that covers and protects the heart muscle.

The electrical system consists of neural pathways that deliver signals to keep the heart beating.

The heart is such a complex mechanism that numerous things can go wrong:

Coronary artery disease refers to the build up of plaque, or fatty material, in the arteries on the heart's surface, either narrowing them, in a condition called angina pectoris, or blocking them completely and causing a heart attack.

Heart muscle weakness can be caused by a number of factors. Long-standing and untreated high blood pressure (hypertension) can strain the heart muscle, forcing it to work harder to get blood into the arteries; a previous heart attack can reduce the amount of healthy heart tissue, interfering with the way the heart contracts; valve disease can affect blood flow, enlarging and weakening the various heart chambers; or a virus or other infection can affect the smooth running of the heart.

A septum thickened by disease also interferes with blood flow within the heart, while the electrical system can go awry, with blocked or erratic signals interrupting normal muscle contraction and causing the heart muscle to beat too quickly or irregularly. These problems can lead to possible heart block, cardiac arrest, bradycardia, ventricular fibrillation or chronic valvular disease.

Explaining the Terminology

Pre-Diabetes Heart Health TerminologyAcute Myocardial Infarction

A heart attack.

Angina

Chest pain or discomfort that occurs when your heart muscle does not get enough blood. Angina may feel like pressure or a squeezing pain in your chest. The pain may also occur in your shoulders, arms, neck, jaw or back. It may also feel like indigestion. Angina is a symptom of coronary artery disease (CAD) the most common type of heart disease.

There are three types of angina: stable, unstable and variant (Prinzmetal's). It is very important to understand the differences between the types.

Stable angina is the most common type. It occurs when the heart is working harder than usual. It is not a heart attack but makes it more likely that you will have a heart attack in the future.

Unstable angina is a very dangerous condition that requires emergency treatment. It is a sign that a heart attack could occur soon. Unlike stable angina, it does not follow a pattern. It can occur without physical exertion and is not relieved by rest or medicine.

Variant angina (Prinzmetal's) is rare and usually occurs at rest. The pain can be severe and usually strikes between midnight and early morning. It can be relieved by medication.

Not all chest pain or discomfort is angina. Chest pain or discomfort can be caused by a heart attack, lung problems (such as an infection or a blood clot), heartburn or a panic attack. However, all chest pain should be checked by a doctor.

Angioplasty

A medical procedure in which a balloon is used to open narrowed or blocked blood vessels (coronary arteries) of the heart caused by atherosclerosis. If the blockage is not too severe, a balloon catheter may be used to open the heart artery as an alternative to open heart surgery. The catheter, a small, hollow, flexible tube that has a balloon near the end of it, is then inserted in or near the blockage and inflated, thus widening or opening the blocked vessel and restoring adequate blood flow to the heart muscle.

Occasionally, blood thinning medicines are also given to prevent formation of a blood clot. In almost all cases, a device called a stent is also placed at the site of narrowing or blockage in order to keep the artery open. A common type of stent is made of self-expanding, stainless steel.

Arrhythmia

Disruptions in the natural rhythm of the heartbeat, normally caused by improper functioning of the electrical system cells in the heart. There are different kinds. Palpitations give the sensation of a pounding heartbeat. Tachycardia is an abnormal increase in the resting heartbeat. Bradycardia is the opposite of an abnormally slow heart rate. Ectopic beats are premature beats often felt as "skipped beats". Flutter and fibrillation are situations in which normal steady beating becomes rapid twitching of the heart.

Arteriosclerosis

A generic term for several diseases in which the arterial wall becomes thickened and loses elasticity.

Aspirin and Heart Health

Reverse Heart HealthThe American Heart Association recommends aspirin use for patients who've had a myocardial infarction (heart attack), unstable angina, ischemic stroke (caused by blood clot) or transient ischemic attacks (TIAs) or "little strokes," if not contra-indicated. This recommendation is based on sound evidence from clinical trials showing that aspirin can have a blood-thinning effect and helps prevent the recurrence of such events as heart attack, hospitalization for recurrent angina and second strokes. Studies show aspirin also helps prevent these events from occurring in people at high risk.

You should not start aspirin therapy without first consulting your physician. The risks and benefits of aspirin therapy vary for each person. If you're taking aspirin and have to undergo even a simple surgical procedure or dental extraction, you must tell the surgeon or dentist about your aspirin dosage.

Atherosclerosis

A type of hardening of the arteries in which cholesterol, fat and other blood components build up in artery walls. As the condition worsens, the arteries become narrower, reducing the flow of oxygen-rich blood and nutrients to the heart.

Bradycardia

A condition in which the heart beats too slowly - usually less than 60 beats per minute. As a result, the body does not get enough oxygen and nutrients to function properly. The normal heart typically beats 60-80 times a minute and pumps about 5 liters of blood through the body per minute. However, if the signal rate is too slow, the chambers of the heart do not contract often enough to supply the proper amount of blood and oxygen to the body. Bradycardia can affect the very young to the very old, though it is most commonly diagnosed among the elderly.

By-Pass Surgery

Avoid Surgery Increase Heart HealthHeart surgery that re-routes, or by-passes, blood around clogged arteries to improve blood flow and oxygen to the heart. The coronary arteries that bring blood to the heart muscle can become clogged by plaque, which is a build-up of fat, cholesterol and other substances. This can slow or stop blood flow through the heart's blood vessels, leading to chest pain or a heart attack. Increasing blood flow to the heart muscle can relieve chest pain and reduce the risk of heart attack.

Surgeons take a segment of a healthy blood vessel from another part of the body and make a detour around the blocked part of the coronary artery.

  • An artery may be detached from the chest wall and the open end attached to the coronary artery below the blocked area.
  • A piece of a long vein in your leg may be taken. One end is sewn onto the aorta, the large artery leaving your heart. The other end of the vein is attached or "grafted" to the coronary artery below the blocked area.
  • Either way, blood can use this new path to flow freely to the heart muscle.

Cardiac Arrest

This condition is the sudden, abrupt loss of heart function. The victim may or may not have previously diagnosed heart disease. It's also called sudden cardiac arrest or unexpected cardiac arrest. Sudden death (also called sudden cardiac death) occurs within minutes after symptoms appear.

The most common underlying reason for patients to die suddenly from cardiac arrest is coronary heart disease. Most cardiac arrests that lead to sudden death occur when the electrical impulses in the diseased heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation) or both. This irregular heart rhythm (arrhythmia) causes the heart to suddenly stop beating. Some cardiac arrests are due to extreme slowing of the heart, called bradycardia.

Other factors besides heart disease and heart attack can cause cardiac arrest. They include respiratory arrest, electrocution, drowning, choking and trauma. Cardiac arrest can also occur without any known cause.

Brain death and permanent death start to occur in just 4- 6 minutes after someone experiences cardiac arrest, which can be reversed if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7-10% with every minute that passes without defibrillation. Few attempts at resuscitation succeed after 10 minutes.

No statistics are available for the exact number of cardiac arrests that occur each year. It's estimated that more than 95% of cardiac arrest victims die before reaching the hospital. In cities where defibrillation is provided within 5-7 minutes, the survival rate from sudden cardiac arrest is as high as 49%.

Early CPR and rapid defibrillation combined with early advanced care can result in high long term survival rates for witnessed cardiac arrest. For instance, in June 1999, automated external defibrillators (AEDs) were mounted 1 minute apart in plain view at Chicago's O'Hare and Midway Airports. In the first 10 months, 14 cardiac arrests occurred, with 12 of the 14 victims in ventricular fibrillation. Nine of the 14 victims (64%) were revived with an AED and had no brain damage.

Cholesterol

Cholesterol and Pre-DiabeteseA white, odorless, powdery substance which the body needs in some measure to function normally. There are several varieties. HDL "good" cholesterol, or high-density lipoprotein cholesterol, helps carry LDL "bad" cholesterol away from the walls of arteries and returns it to the blood stream. Elevated levels of LDL cholesterol, or low density lipoprotein cholesterol, are linked to increased risk of heart attack or stroke. VLDL cholesterol, or very low density cholesterol, carries cholesterol and triglycerides from the liver. After shedding the triglycerides, it becomes LDL cholesterol, which damages the cardiovascular system if allowed to reach excessive levels. Doctors and nutritionists recommend a low cholesterol diet if levels are too high.

Coronary Artery Disease (CAD)

The most common type of heart disease, CAD occurs when plaque builds up in the coronary arteries. This build-up of plaque is called atherosclerosis and results in the coronary arteries becoming narrow and stiff. Blood flow to the heart is reduced. This decreases the oxygen supply to the heart muscle.

Coronary Heart Disease (CHD)

A broad term that describes any disorder that can impact the functioning of the heart muscle itself or the cardiovascular system. Conditions that contribute to heart disease include Hypertension (high blood pressure), Cardiovascular Disease and atherosclerosis (hardening of the arteries).

CPR

Cardiopulmonary Resuscitation.

C-Reactive Protein (CRP)

Inflammation is the process by which the body responds to injury, and inflammation of the arteries is a key factor in the development of atherosclerosis, the build-up of fatty deposits in the lining of arteries. C-Reactive Protein (CRP) is one of the acute phase proteins that increase during systemic inflammation. It's been suggested that testing CRP levels in the blood may be a new way to assess Cardiovascular Disease risk. A high sensitivity CRP test (hs-CRP) is now widely available.

High levels of hs-CRP consistently predict new coronary events in patients with unstable angina and acute myocardial infarction (heart attack). Higher hs-CRP levels also are associated with lower survival rate of these people. Recent studies also suggest that higher levels of hs-CRP may increase the risk that an artery will re-close after it's been opened by balloon angioplasty.

Diabetes

A disorder whereby the body is unable to process blood sugar and insulin correctly. See Insulin Resistance, Diabetes and Heart Disease.

Digitalis

Digitalis and Pre-DiabetesAlso known as digoxin and digitoxin, this drug strengthens the contraction of the heart muscle, slows the heart rate and helps eliminate fluid from body tissues. It's often used to treat congestive heart failure and certain arrhythmias. Digitalis has been described in medical literature for over 200 years and is derived from the foxglove plant.

Ectopic Beats

See Arrhythmia.

Flutter and Fibrillation

See Arrhythmia.

Heart Block

Sometimes the signal from the heart's upper to lower chambers is impaired or doesn't transmit. This is called "heart block" or "AV block." It does NOT mean that the blood flow or blood vessels are blocked.

Heart block is classified according to the level of impairment -- first-degree, second-degree or third-degree (complete) heart block. First-degree heart block, or first-degree AV block, occurs when electrical impulses move through the AV node more slowly than normal. The time it takes for the impulse to get from the atria to the ventricles (the PR interval) should be less than about 0.2 seconds. If it takes longer than this, it's called first-degree heart block. Heart rate and rhythm are normal, and there may be nothing wrong with the heart. Generally, no treatment is necessary for first-degree heart block.

Heart Blocks and Pre-diabetesIn second-degree heart block, some signals from the atria don't reach the ventricles. This causes "dropped beats." There are two types:

  • Type I second-degree heart block, or Mobitz Type I, or Wenckebach's AV block. Electrical impulses are delayed more and more with each heartbeat until a beat is skipped. This condition is not too serious but sometimes causes dizziness and/or other symptoms.
  • Type II second-degree heart block, or Mobitz Type II. This is less common than Type I but generally more serious. Because electrical impulses can't reach the ventricles, an abnormally slow heartbeat may result. In some cases, a pacemaker is needed.

Third-degree or complete heart block (complete AV block) means that the heart's electrical signal doesn't pass from the upper to the lower chambers. When this occurs, an independent pacemaker device inserted in the lower chambers takes over. The ventricles can contract and pump blood, but at a slower rate than that of the natural atrial pacemaker.

These impulses are called functional or ventricular scope beats. They're usually very slow and can't generate the signals needed to maintain full functioning of the heart muscle.

Complete heart block is most often caused in adults by Cardiovascular Disease or as a side effect of drug toxicity. Heart block also can be present at - or even before - birth. (This is called congenital heart block.) It may also result from an injury to the electrical conduction system during heart surgery. Complete heart block may be a medical emergency with potentially severe symptoms and a serious risk of cardiac arrest. If a pacemaker can't be implanted immediately, a temporary device may be used to keep the heart pumping until surgery can be performed.

Insulin Resistance

A condition which prevents the efficient conversion of food into energy because of a vastly reduced number of insulin receptor site on the cell walls. Insulin acts as "a key in a lock," allowing glucose to pass through the cell wall and be converted to energy. If you have too few receptor sites, glucose bounces of the cell wall instead of passing through the insulin "door."

Glucose remains in the blood stream, causing elevated levels of blood sugar, which are sent to the liver. Once there, the sugar is converted into fat and stored via the blood stream throughout the body in a process that can lead to weight gain and obesity. Free-floating insulin may damage the lining of the arteries and contribute to atherosclerosis, which is characterized by a dangerous build-up of plaque on the artery walls.

Insulin Resistance can be an underlying cause of Metabolic Syndrome (Syndrome X), Polycystic Ovarian Syndrome (PCOS) and Pre- and Type 2 Diabetes (see sections on these conditions).

Ischemic Stroke

Major stroke caused by a blood clot.

Metabolic Syndrome (Syndrome X)

A cluster of cardiovascular diseases characterized by the following symptoms: excessive fat tissue in and around the abdominal area, blood fat disorders high levels of fat-storing substances called triglycerides, increased LDL "bad" cholesterol, lowered "good" HDL cholesterol, high blood pressure, Insulin Resistance and Pro-thrombotic or Pro-inflammatory States. Obesity is a major underlying cause of Metabolic Syndrome. (See also Insulin Resistance, Metabolic Syndrome and Heart Disease.)

Obesity

The state of being 20% over one's ideal weight. Or defined by the National Institutes of Health (NIH) as having a BMI (Body Mass Index) of approximately 30 lbs overweight. The BMI is a key for relating body weight to height and is based on an individual's weight in kilograms divided by their height in meters squared. Obesity is frequently based on both behavior and genetics, increasing significantly the risk of health problems such as Metabolic Syndrome (Syndrome X), Polycystic Ovarian Syndrome (PCOS), Type 2 Diabetes, hypertension, heart attack, stroke and certain types of cancer.

Pacemaker

A battery-powered implantable device that electrically stimulates the heart to contract and thus to pump blood throughout the body. Pacemakers consist of a pager-sized housing device which contains a battery and electronic circuitry, plus one or two long thin wires that travel through a vein in the chest to the heart. They are usually implanted in patients in whom the heart's own "spark plug" or electrical system is no longer functioning normally.

Palpitations

See Arrhythmia.

Plaque

A combination of fat and cholesterol which attaches to the interior walls of arteries and narrows them in a process called atherosclerosis. As the condition worsens, there is an increased risk of a heart attack or stroke.

Polycystic Ovarian Syndrome (PCOS)

A hormonal disorder linked to Insulin Resistance and obesity and the leading cause of female infertility. The excess insulin levels associated with PCOS can stimulate the ovaries to secrete abnormally high levels of testosterone. This male hormone may prevent the ovaries from releasing an egg each month, thus causing infertility. PCOS is often linked to Diabetes and the cluster of cardiovascular diseases known as Metabolic Syndrome or Syndrome X, as well as causing skin conditions, excess body hair, male pattern baldness and irregular menses. (See also Insulin Resistance, Polycystic Ovarian Syndrome (PCOS) and Heart Disease.)

Pro-thrombotic or Pro-inflammatory States

A Pro-thrombotic state promotes the formation of thrombin, a major contributing factor in clot formation, which can result in a heart attack and stroke. A Pro-inflammatory state creates inflammation inside cardiovascular vessels, which may lead to heart disease, arthritis, cancer and premature ageing. Omega-3 fatty acids can reduce inflammation and reverse its effect.

Sleep Apnea

The name of this condition means "cessation of breath while asleep."  It is characterized by repetitive episodes of upper airway obstruction that occur during sleep, usually associated with a reduction in blood oxygen. In other words, the airway becomes obstructed at several possible sites. It is a potentially life-threatening condition that requires immediate medical attention. The risks of undiagnosed obstructive sleep apnea include heart attacks, stroke, impotence, irregular heartbeat, high blood pressure and heart disease. In addition, sleep apnea causes daytime sleepiness that can result in accidents.

Statins

Statins are a class of drugs used to lower blood cholesterol. They work in your liver to block a substance needed to make cholesterol. They may also help your body re-absorb cholesterol that has accumulated in plaque on your artery walls. This helps prevent further blockage in your blood vessels. Long term use of statins may even reduce existing blockage in narrowed blood vessels.

Stent

A stent is a wire mesh tube used to prop open an artery during angioplasty. The stent is collapsed to a small diameter and put over a balloon catheter. It's then moved into the area of the blockage. When the balloon is inflated, the stent expands, locks in place and forms a scaffold which holds the artery open. The stent stays in the artery permanently, holds it open, improves blood flow to the heart muscle and relieves symptoms (usually chest pain).

Tachycardia and Pre-diabetesTachycardia

See Arrhythmia.

Transient Ischemic Attacks (TIA)

"Small" strokes.

Triglycerides

Fat-like substances that are carried through the blood stream to the tissues. Much of the body's fat is stored in the form of triglycerides for later use as energy. Excessive levels can cause damage to the cardiovascular system.

Ventricular Defibrillation (Pulseless Ventricular Tachycardia)/Pulseless Electrical Activity (Electromechanical Dissociation) /Asystole

When the heart stops pumping blood to the body in cardiac arrest, it is due to three main reasons. The first is ventricular fibrillation or pulseless ventricular tachycardia. In the case of the former, the heart shakes rapidly but does not pump blood (ventricular fibrillation). In the latter, the heart tries to pump so rapidly that it does not allow blood to flow in or out effectively.

The second cause is pulseless electrical activity (also known as electromechanical dissociation) in which there is normal electromechanical conduction in the heart but the heart does not contract. Thirdly, there is asystole, which occurs when there is no electrical or muscle activity of the heart.

Insulin Resistance, Metabolic Syndrome and Heart Disease

Insulin Resistance has many factors that contribute to its presence in the body. In essence, our environment and lifestyles have evolved too rapidly for our bodies to keep pace. We are still genetically "wired" to thrive on the entrenched habits of our ancestors who consumed different, nutrient-rich foods and a diet low in carbohydrates, as well as sustaining greater levels of movement and exercise.

Some people may also have a genetic predisposition to Insulin Resistance. Others develop Insulin Resistance through unhealthy lifestyles involving poor diet and lack of regular exercise.

Heart Disease and Pre-diabetesOver time, the above factors have damaged the complex ability of our bodies' cells to properly utilize insulin to convert glucose to energy. Unhealthy, high-carbohydrate diets cause the pancreas to overproduce insulin that overwhelms the cells. These, in turn, protect themselves by reducing the number of receptor sites on their surface, which can have devastating results.

Insulin, which acts like a "key in a lock", becomes less effective in opening up the cell and allowing glucose to pass through and be converted to energy. Without enough receptor sites, insulin bounces off the cell and enters the blood stream. Unable to enter the cell, glucose is converted to fat, leading to weight gain and obesity.

Another of Insulin Resistance's negative aspects is free-floating insulin, which can damage the lining of the arteries and contribute to atherosclerosis. This condition is characterized by a dangerous build-up of plaque on the artery walls and may lead to a heart attack or stroke.

Insulin Resistance and obesity are underlying causes of the cluster of cardiovascular disorders called Metabolic Syndrome (also known as Syndrome X).

Metabolic Syndrome is characterized by the following symptoms: excessive fat tissue in and around the abdominal area, blood fat disorders  high levels of fat-storing substances called triglycerides, increased LDL "bad" cholesterol, lowered HDL "good" cholesterol , high blood pressure, Insulin Resistance and Pro-thrombotic or Pro-inflammatory States. As your weight increases, stressors build up on the entire cardiovascular system, with the lungs and heart, for example, having to work harder to distribute an adequate amount of freshly-oxygenated blood throughout the body.

Up to 25% of the adult population of the United States is thought to suffer from Metabolic Syndrome. That means 58-73 million American men and women are at risk from the condition, which substantially increases the chances of damaging the cardiovascular system. Metabolic Syndrome has also been linked to an increased risk of developing Pre-and Type 2 Diabetes. (See Insulin Resistance, Diabetes and Heart Disease.)

A Leading Cause of Infertility

In addition to all the other risks, women with Metabolic Syndrome also have higher occurrences of Polycystic Ovarian Syndrome (PCOS), a leading cause of infertility, which also puts sufferers at greater risk of developing various forms of Diabetes, as well as liver, breast and colon cancer. The condition can also cause excessive hair growth in women, as well as male pattern baldness and skin conditions like acne and brown patches. (See also Insulin Resistance, Polycystic Ovarian Syndrome (PCOS) and Heart Disease.)

Increased levels of insulin and glucose in the blood stream of people with Metabolic Syndrome have been proven to inflict damage to the lining of the arteries, as well as affecting changes in the kidneys' ability to remove salt and causing a greater risk of blood clot formation.

Research by Louisiana State University published in the Journal of the American Medical Association in December 2003 found that those suffering from Metabolic Syndrome were at significantly greater risk of dying from a heart attack than those without the condition. The study, conducted over a 15-year period, concluded that men with Metabolic Syndrome were from 2.9 to 4.2 times more likely to die of a heart attack.

Growing scientific evidence demonstrates additional risk factors. A study by Philadelphia's Thomas Jefferson University found that men with Metabolic Syndrome had a 78% greater risk of having a stroke than those free of the condition. Women had a 50% greater risk. Stroke is the third leading cause of death in the United States.

Metabolic Syndrome and Heart DiseaseRecommendations for reducing heart disease risk are the same as those for reducing Insulin Resistance and the symptoms of Metabolic Syndrome: balancing glucose and insulin levels in the blood stream, losing weight, regulating cholesterol and triglyceride levels and lowering blood pressure to normal levels to prevent damage to the cardiovascular system. This can be achieved through careful meal choices, including low cholesterol food, together with regular exercise and weight loss in overweight individuals.

Insulin Resistance, Polycystic Ovarian Syndrome (PCOS) and Heart Disease

PCOS and Heart DiseaseInsulin Resistance, Polycystic Ovarian Syndrome (PCOS) and Heart Disease Polycystic Ovarian Syndrome (PCOS) is one of the most insidious of hormonal disorders that a women can face. It wreaks havoc in a number of areas, ranging from infertility and skin conditions to Diabetes and the cluster of cardiovascular diseases known as Metabolic Syndrome or Syndrome X. (See also Insulin Resistance, Metabolic Syndrome and Heart Disease.)

PCOS is characterized by high levels of excess insulin caused by Insulin Resistance, a condition which prevents the efficient conversion of food into energy because of a vastly reduced number of insulin receptor sites on the cell walls. Insulin acts as "a key in a lock," allowing glucose, or blood sugar, to pass through the cell wall and be converted to energy. If you have too few receptor sites, glucose bounces of the cell wall instead of passing through the insulin "door."

When this happens, glucose remains in the blood stream, causing elevated levels which are sent to the liver. Once there, the sugar is converted into fat and stored via the blood stream throughout the body in a process that can lead to weight gain and obesity. Free-floating insulin can damage the lining of the arteries. This process contributes to atherosclerosis, a condition characterized by a dangerous build-up of plaque on the artery walls and a factor that sharply increases the risk of damage to the cardiovascular system, leading to heart disease and stroke.

The excess insulin levels associated with PCOS can also stimulate the ovaries to secrete abnormally high levels of testosterone. This male hormone may prevent the ovaries from releasing an egg each month, thus causing infertility.

PCOS sufferers are also at greater risk of developing Pre- and Type 2 Diabetes, which in turn, increase their chances of developing heart disease. Previous research has estimated that these factors can cause up to a seven-fold increase in risk for heart attack for women with PCOS, compared to those without it. (See also Insulin Resistance, Diabetes and Heart Disease.)

Obesity and PCOS

Metabolic Syndrome,PCOS and Heart DiseaseThe high testosterone levels that come with this condition can also contribute to excessive hair growth in women, as well as male pattern baldness and skin conditions like acne and brown patches. Plus, PCOS sufferers are also at greater risk of developing Gestational Diabetes during pregnancy, as well as liver, breast and colon cancer.

In a study by the Royal Free and University Medical School in London, there was no significant difference in age or in total cholesterol, HDL ("good") or LDL ("bad") cholesterol among the groups taking part. However, compared to women with normal ovaries, those with PCOS had significantly higher blood pressure and insulin levels, as well as more weight.

Obesity is a major underlying cause of PCOS. As your weight increases, stressors build up on your entire cardiovascular system, with the lungs and heart, for example, having to work harder to distribute an adequate amount of freshly-oxygenated blood throughout the body. In addition to the increase in triglycerides and LDL "bad" cholesterol, there is a lowering of HDL "good" cholesterol, which, in combination, increases the risk of stroke and heart attack.

Ways to reduce heart disease risk include balancing glucose and insulin levels in the blood stream, losing weight, regulating cholesterol and triglyceride levels and lowering blood pressure to normal levels. To lose weight, eat a balanced nutritional diet, which includes low cholesterol food and exercise regularly.

Read about the Insulite PCOS System that can help
to reverse the symptoms of Insulin Resistance and PCOS

Insulin Resistance, Diabetes and Heart Disease

Upwards of 60 million Americans have some form of Diabetes, with hundred of thousands more due to be diagnosed each year with a disorder that is closely related to Insulin Resistance and Metabolic Syndrome. Diabetics are up to four times more likely to die of heart disease than non-Diabetics. (See Insulin Resistance, Metabolic Syndrome and Heart Disease.)

Diabetes is also strongly linked to Polycystic Ovarian Syndrome (PCOS). (See Insulin Resistance, Polycystic Ovarian Syndrome (PCOS) and Heart Disease.) Before people develop the full-blown variety, called Type 2 Diabetes, most initially have a condition called Pre-Diabetes, which is characterized by blood glucose levels that are higher than normal, though not enough to trigger a diagnosis of Type 2.

It is crucial to address Pre-Diabetes because a growing body of scientific research suggests long term damage to the cardiovascular system may be occurring among people with this condition. The good news is that Type 2 Diabetes can be avoided with relatively minor lifestyle changes like eating a balanced, nutritious diet and regular exercise to lose weight.

Unfortunately, most Americans who are diagnosed with a form of Diabetes have Type 2 Diabetes. This condition can be related to Insulin Resistance, which occurs when the body fails to properly use insulin, combined with insufficient production of insulin by the pancreas. Obesity may be the result.

Long term Damage

Insulin is vital for the process whereby blood sugar or glucose passes through the cell wall via insulin receptor sites to be converted into energy. The number of these sites is vastly reduced by Insulin Resistance and, as a result, levels of glucose and insulin in the blood stream become severely unbalanced. Two serious conditions can develop because of this imbalance. The first is that your cells may be starved of energy. The second is that, over time, high blood glucose levels may cause long term damage to your heart, eyes, kidneys or nerves.

While different forms of Diabetes occur in people of all ages and races, research has shown that some racial groups have a higher risk of developing Type 2 Diabetes. This condition is more common in African Americans, Latinos and Native Americans, as well as Asian Americans and Pacific Islanders. (See Minorities and Heart Disease.) The elderly are also at greater risk. If present, the most common Type 2 Diabetes symptoms are:Long Term Damage from Pre-diabetes

  • increased production of urine - the body is trying to get rid of excess glucose
  • unusual thirst
  • fatigue because the glucose is "going to waste" and not being converted into energy
  • weight loss
  • increased appetite
  • feeling ill
  • blurred vision
  • infections such as thrush or irritation of the genitals

Some people simply feel a bit unwell or assume they are just aging.

Although Type 2 Diabetes can only be managed, people with the disorder often lead long lives. But it is obviously vital to avoid developing this condition by reversing Pre-Diabetes whenever possible.

Recommendations for reducing heart disease risk are the same as those for reducing Insulin Resistance and the symptoms of Pre-Diabetes: balancing glucose and insulin levels in the blood stream, losing weight, regulating cholesterol and triglyceride levels and lowering blood pressure.

This can be done through careful meal choices, including low cholesterol food, together with exercise and weight loss in overweight individuals.

Read about the Insulite Excess Weight & Obesity System that can help
to reverse the symptoms of Insulin Resistance

Combating Heart Disease

combating heart disease and pre-diabetesNearly all of us are born with immaculate arteries. But as soon as we learn how to feed ourselves, our arteries begin to go from clean to clogged. Taking better care of our cardiovascular system by watching our weight via a balanced diet and regular exercise goes a long way towards countering this effect. Adopting a healthier lifestyle will add years to your life as well as improving its quality.

If you pass this information on to your children, they, too, can take steps to avoid premature heart disease.

It isn't just adult men who are especially prone to heart disease. Even pre-menopausal women, who were long considered resistant to "heart trouble", should learn to reduce the risk factors that may cause damage to their cardiovascular systems later in life.

When it comes to heart disease, there are factors that you can't influence, like genetic vulnerability - we can't choose our ancestors or alter our genes - and the aging process. But there are plenty more areas where the effectiveness of taking preventable action is documented by facts and figures.

Stop SmokingStopping smoking is a prime example. More than 400,000 Americans die each year from smoking-related diseases, according to the Centers for Disease Control and Prevention. Cigarette smokers are four times more likely to have heart attacks and develop cardiovascular diseases than non-smokers. Men have a slightly higher risk than women. On average, lifetime smokers have a 50% chance of dying from a smoking-related disease. But quitting can quickly begin to nullify the risks - it's never too late to stop. One year after quitting, your risk of heart disease drops by 50%, according to the World Health Organization (WHO). Within 15 years, a former smoker's risk of dying from heart disease approaches that of a lifetime non-smoker.

Lowering your LDL "bad" cholesterol has enormous benefits. Doctors and nutritionists have a wealth of information about low cholesterol diets. Almost everyone who has a heart attack or undergoes by-pass surgery is now given a statin, a type of cholesterol-lowering agent, regardless of his or her cholesterol level. The statin drugs that reduce cholesterol also reduce the level of C-Reactive Protein, a marker for inflammation of the arteries, which can lead to a heart attack or stroke. Switching to low cholesterol food is highly advisable.

Controlling Your Blood Pressure and getting it to normal levels greatly reduces the risk of both stroke and heart attack by slowing down the formation of arterial plaque that narrows the blood vessels everywhere in the body - especially in the heart, brain, kidneys, eyes and legs.

Managing Your Blood Sugar is vital to avoiding Pre-Diabetes, which can lead to Type 2 Diabetes. (See Insulin Resistance, Diabetes and Heart Disease.) Although Type 2 Diabetes can be managed over a long life, almost 80% of Diabetics eventually die from some form of heart or blood vessel disease.

Heart Disease
"Metabolic Syndrome declined by 41% among a group of 104 adults aged 55 to 75 after the participants added 20 minutes of gentle weightlifting to their aerobic routine over a period of six months."
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Pre-Diabetes is a disorder in which blood sugar is only slightly elevated. An underlying cause is often Insulin Resistance and its related condition, Metabolic Syndrome (See Insulin Resistance, Metabolic Syndrome and Heart Disease.) Millions of Americans have Pre-Diabetes, which, if left unchecked, can develop into the full-blown Type II variety. However, one doesn't automatically lead to the other. Type 2 Diabetes and its life-threatening complications can be prevented by losing weight via a balanced diet and regular exercise.

Losing weight is crucial for heart health. Yet the vast diet industry in America is testament to how difficult some people find it is to achieve. A balanced, nutritional diet, that drastically lowers carbohydrate intake and ideally includes low cholesterol food, combined with regular exercise, are key factors that will help you lose weight and improve the health of your heart. Exercise has to be on a regular basis, not just when you feel like it. So choose a method you enjoy, whether it's walking, swimming, cycling, aerobics etc. and set aside a minimum of 30 minutes most days of the week to do it.

Read about the Insulite Excess Weight & Obesity System that can help to reverse the symptoms of Insulin Resistance

Managing Hypertension/High Blood Pressure

Manage High BPHypertension, or high blood pressure, is a silent killer which can be caused by Insulin Resistance-related weight gain and obesity.

When The National Heart, Lung and Blood Institute revised its blood pressure guidelines, almost 23 million American men who thought they were in the clear suddenly found themselves in a new danger zone called "Pre-Hypertensive."

You are included in this category if your systolic pressure is between 120 and 139 or your diastolic pressure is between 80 and 89. Regard it as a wake-up call to take steps to avoid a stroke further down the road.

What exactly are systolic and diastolic pressures? Blood pressure is commonly measured by wrapping an inflatable cuff around the upper arm. Air is pumped into the cuff until circulation is cut off. When a stethoscope is placed over the cuff, there is silence. Then, as the air is slowly let out of the cuff, blood begins to flow again and can be heard through the stethoscope. This is the point of greatest pressure, called systolic, and is usually expressed as how high it forces a column of mercury to rise in a tube.

At its highest normal pressure, the heart would send a column of mercury to a height of about 120 millimeters. At some point, as more and more air is let out of the cuff, the pressure exerted by the cuff is so little that the sound of the blood pulsing against the artery walls subsides and there is silence again. This is the point of lowest pressure called diastolic, which normally raises the mercury to about 80 millimeters.

It is crucial to "know your numbers" with respect to normal and high blood pressure levels. Life-threatening complications to your cardiovascular system can develop over a period of years when Hypertension exists. Increased pressure on the inner walls of blood vessels make the vessels less flexible over time and more vulnerable to the build-up of fatty deposits in a process known as atherosclerosis, a key risk factor in heart disease. (See Insulin Resistance, Metabolic Syndrome and Heart Disease.)

Hypertension also forces the heart to work harder to pump adequate blood throughout the body. This extra work causes the muscles of the heart to enlarge. Eventually, the enlarged heart becomes inefficient in pumping blood and may lead to heart failure, when the heart cannot pump enough blood to meet the body's needs.

American Heart Association-recommended blood pressure levels
Blood Pressure Category Systolic (mm Hg)   Diastolic (mm Hg)
Normal less than 120 and less than 80
Prehypertension 120-139 or 80-89
High
Stage 1 140-159 or 90-99
Stage 2 160 or higher or 100 or higher
Source: American Heart Association - www.americaheart.org

High blood pressure is common. However, only about half of people with high blood pressure know they have it because of its silent build-up. Blood pressure is controlled in just 1 out of every 8 people who have the condition.

The importance of hypertension is that it is a powerful risk factor for some very serious diseases such as angina, heart attack, stroke, atherosclerosis, kidney failure and circulatory problems in the legs, as well as erectile dysfunction.

In 95% of cases, there is no specific cause for high blood pressure. A diagnosis of the condition is more common in African Americans than in whites, and becomes more likely with advancing age. People who are obese or Diabetic are more likely to have, or to develop, the disorder.

While high blood pressure can occur in slender, active people, it is much more common in the obese. An important step in avoiding high blood pressure is maintaining an ideal body weight by eating appropriately, including low cholesterol food, and getting sufficient regular exercise.

For many people, slender or obese, high blood pressure is a fact of life. What then should you do? The first step is have your blood pressure checked regularly, so that the diagnosis of hypertension is made early. Adults should have their blood pressure checked at least once every year or two.

Once the diagnosis is made, you should reduce the amount of salt and fat in your diet. If you are overweight, losing 10% of your body weight can make a difference. The majority of people with high blood pressure, however, will need medication.

High Blood PressureThese medications are proven to save lives, reducing the rate of heart attack, stroke and all of the other serious complications of high blood pressure. Generally, these medications are safe, with few serious side effects. Most can be taken just once a day.

Don't be surprised if, after treating your high blood pressure for a few months, your doctor says that you need a second or third medication. Most people with controlled high blood pressure (consistently under 140/90 mm Hg) require two or three or four different medications, working together, to control their condition.

By following your doctor's recommendations about medication, you give yourself the best chance possible of avoiding the complications of high blood pressure.

Read about the Insulite MetaX System that can help to reverse the symptoms of Insulin Resistance and Metabolic Syndrome

Minorities and Heart Disease

Heart disease is a killer regardless of racial origin. The underlying causes tend to be the same for everyone: damage to the cardiovascular system, with a key underlying cause being Insulin Resistance-connected obesity. This condition can, in turn, lead to Metabolic Syndrome (Syndrome X), Polycystic Ovarian Syndrome (PCOS) and Pre- and Type 2 Diabetes, all major risk factors in heart-related disorders. (See also sections on Insulin Resistance, Metabolic Syndrome, Polycystic Ovarian Syndrome (PCOS) and Diabetes and their connection with Heart Disease.)

Minorities and Heart DiseaseIn 1999, 78,574 African-Americans died from heart disease, the leading cause of death for all racial and ethnic groups. African-Americans were 30% more likely to die of heart disease than whites when differences in age distributions were taken into account.

African American women are more likely to die from heart disease than other groups of women. Diabetes, high blood pressure, high cholesterol, lack of exercise and smoking all put black women at high risk for heart disease. In addition, studies have shown that African Americans don't receive the same care for heart disease as whites because they don't receive the same procedures and treatments.

Heart disease risk and death rates are high among Mexican Americans partly because of increased rates of obesity and Diabetes.

Overall, Asian/Pacific Islander and Native Hawaiian women have much lower rates of heart disease than women of other minorities. But it is still the leading cause of death within their own grouping. Heart disease risk and death rates are higher among Native Hawaiians and some Asian Americans (especially Asian Indians) partly because of higher rates of obesity, Diabetes and high blood pressure.

Heart disease is the leading cause of death for American Indians and Alaska Natives.

The risk of heart disease can be reduced in the same way as decreasing the chances of developing Insulin Resistance and its attendant conditions, Metabolic Syndrome, Polycystic Ovarian Syndrome (PCOS) and Pre-Diabetes. Doctors recommend balancing glucose and insulin levels in the blood stream, losing weight, regulating cholesterol and triglyceride levels and lowering blood pressure.

The best way to achieve this reduction in risk is to stick to a balanced, nutritional diet, including low cholesterol food, combined with regular exercise and weight loss in overweight individuals.

Read about the Insulite System that can help
to reverse the symptoms of Insulin Resistance

How the Sexes Deal Differently with the Risks of Heart Disease

Heart Disease and Pre DiabetesThere was a time when U.S. doctors seemed to regard damage to the cardiovascular system resulting in heart disease as almost the exclusive preserve of American men. But when research finally showed that coronary artery disease, which can lead to a heart attack, was the primary cause of death among American women, the medical community began to place greater emphasis on female heart health.

The fact remains, however, that considerably more men than women die of heart attacks each year in the U.S., with the average lifespan of an American white male about 5 years less than a woman's. Among African-Americans, the gap is seven years.

Both sexes are at risk from factors such as Insulin Resistance leading to obesity, high cholesterol levels, smoking and high blood pressure, as well as Diabetes, lack of exercise and genetic predisposition. But women reduce their risks in a number of ways because they're more willing than men to discuss their health with a friend as well as consulting a doctor.

Heart Disease and PREDRecent research suggests men are less likely than women to check their cholesterol and blood pressure levels and have them treated if they're abnormal.

Women generally smoke and drink less than men. The death rate among men from alcohol-related diseases, including high blood pressure, is 3.5 times higher than women, who also tend to be more concerned about their weight and eat healthier diets. Men consume too much saturated fat, cholesterol and salt, while eating too few fruits and vegetables. Men are also less likely than women to have a good breakfast (or any breakfast at all), which is a dietary habit associated with a higher death rate from all causes.

Men often opt for the wrong kind of exercise. While women tend to choose healthier forms of working out like aerobics, which lowers blood pressure and cholesterol levels, men often exercise everything BUT their hearts by choosing anaerobic or strengthening activities such as lifting weights. Bulking up with anabolic steroids - again much more widely used by men - can cause several disorders that damage the cardiovascular system and contribute to a greater vulnerability to heart attacks.

Chronic stress and depression can also raise the risk of heart disease, yet many men are reluctant to deal with their emotional problems. Women seem to cope with adversity more effectively than men. They are also more likely to seek help and resort less to denial.

Another risk for single men is the lack of social support from friends and activity groups. In one study, married men who received support from their spouses were shown to be at less risk from heart disease.

Doctors advise that men need to learn that feelings matter, as well as getting to know their bodies' signals and not denying signs that suggest the possibility of a heart attack. They should get help for chronic stress, share feelings of anxiety and follow medical advice about physical activity, diet, weight and medications.

How Parents Can Promote their Children's Heart Health

Parents and Children and Pre DiabetesBeing a good role model is the best way to steer your children onto the right path. Physically active parents who encourage nutritionally balanced meals at the dinner table can instill lifelong good habits in their children.

Childhood obesity has tripled in the last 15 years in the U.S. Youngsters are being increasingly diverted from exercise by an ever-growing choice of computer games, videos and DVDs, plus hundreds of TV channels. Inactivity and obesity-related illnesses now threaten to shorten the lifespan of today's kids: 4 million have above-normal blood pressure, 27 million have high cholesterol and more than a third get no exercise.

Parents and Children and Pre-diabetesMinor shifts in behavior can, however, reverse this trend. Try rewarding kids for not watching so much television and being more physically active, instead. Organize regular family activity with the emphasis on fun. Cut back drastically on their sugar-laden sodas and junk food and set a good example by not consuming them yourself. You'll feel the benefits, too.

Finally, Should You See a Doctor?

Don't diagnose yourself or take any symptoms for granted. Whatever your age or physical condition, be sure to report any chest pain, pressure, discomfort, shortness of breath or palpitations to your doctor. Call Emergency Services if these feelings persist for more than five minutes.

Heart disease can remain silent for years. But its presence may often be identified in numerous ways:

  • A thorough assessment of family and personal history.
  • A careful physical examination. After the age of 20, certain measures should be checked during a routine examination, such as the Body Mass Index (the ratio of your height to your weight), blood pressure and blood analyses that include sugar and cholesterol values.
  • A stress test. Normal results from an electrocardiogram (ECG) don't always mean a healthy heart. If a doctor suspects significant blockages in your coronary arteries, he or she will usually order a stress test, which involves challenging your heart by performing some physical activity, such as walking on a treadmill at a brisk pace either on a level surface or an incline. An ECG taken during and/or after such exercise can reveal abnormalities that confirm the arteries are unable to deliver the extra blood required by that exertion.

If the answer is still not clear, you may have to undergo one of several other procedures:

  • An echocardiogram uses sound waves reflected from the heart to produce images that show how the heart is contracting. When coronary arteries are blocked and cannot deliver the extra blood needed, abnormal heart contraction is visible.

If the result is inconclusive, the next step is a radionuclide stress test, which is more expensive but also more accurate. The image is examined for "cold spots" - scarring that indicates old damage caused to the heart muscle. The appearance of a new "cold spot" (or any change in an existing one) after exercise on a treadmill may mean there is a blockage in one or more of your coronary arteries.

If a patient is unable to walk on a treadmill, due to an orthopedic condition for example or a stroke, that person can be injected with substances that make the heart work harder without actual exercise. If this test shows abnormalities, an angiogram may be required. This step requires dye to be injected into the cardiac blood vessels through a catheter, revealing any blockages.

Never too late or early to prevent DiabetesThe subject of damage to the cardiovascular system leading to heart disease can be unsettling. But the good news is that any obstructed coronary arteries, which cause heart attacks, can be diagnosed very accurately and treated.

Always remember: it's never too late or too early to start taking care of your heart.

Click here to learn about the unique new Insulite Pre-Diabetes System, a scientific breakthrough which can halt Pre-Diabetes before it becomes the irreversible Type 2 variety - a severely increased risk factor for heart disease. The system's formulations include GlucX, which contains ingredients like cholesterol-lowering fenugreek.

Read about Diabetes Myths

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"Nearly 21 million Americans are believed to be diabetic, according to the Centers for Disease Control, and 41 million more are Pre-Diabetic; their blood sugar is high, and could reach the diabetic level if they do not alter their living habits."
Diabetes and Its Awful Toll Quietly Emerge as a Crisis"
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Diabetes or Pre-Diabetes Now Strikes One in Four Americans:
The number of Americans with diabetes has grown to about 24 million people, or roughly 8 percent of the U.S. population. Read more...
7/25/2008, Mercola.com
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"Simply losing 5-7% of your body fat (typically 10-15 pounds) and increasing your physical activity by taking a brisk walk 4-5 times a week can reduce your risk of developing Type II Diabetes by almost 60%."
Diabetes Prevention Program study 2001, study funded by the National Institute of Child Health and Human Development, et al.
Pre-diabetes Newsletter Archive
"I wanted to let you know how much I appreciate your caring advice and guiding me towards taking control of my health. It's hard to express in words how long I have been trying to find the answers you have so easily provided for me.

I am so excited about the positive changes in my health and I can't wait to see where I am six months from now, yet alone the year. Thank you again!"
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"...approximately 90% of overweight Hispanic children with a family history for type 2 diabetes have at least one feature of the metabolic syndrome and 30% possess the metabolic syndrome.

Our results support the view that improving insulin resistance may be crucial in the prevention of both type 2 diabetes and premature cardiovascular disease in this at-risk subpopulation of Hispanic youth."
Cruz ML, Weigensberg MJ, Huang TT, Ball G, Shaibi GQ, Goran MI.,J Clin Endocrinol Metab. 2004 Jan;89(1):108-13.
Article by Dr. Sheri Colberg, Phd, FACSM
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