PRE-DIABETES AND HEART HEALTH
How the Cardiovascular System Works and What Can Go Wrong
Heart 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
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
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
Explaining the Terminology
Acute Myocardial Infarction
A heart attack.
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
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.
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
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.
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.
A generic term for several diseases in which the arterial wall
becomes thickened and loses elasticity.
Aspirin and Heart Health
The 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.
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.
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
Heart 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
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
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.
A 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).
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.
A disorder whereby the body is unable to process blood sugar and
insulin correctly. See Insulin Resistance, Diabetes and Heart
Also 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.
Flutter and Fibrillation
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
In second-degree heart block, some signals from the atria don't
reach the ventricles. This causes "dropped beats." There are two
- 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
- 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
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).
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.)
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.
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.
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
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.
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
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
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
Transient Ischemic Attacks (TIA)
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
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.
Over 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.
Recommendations 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
Insulin 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
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
The 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
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
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:
- 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
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
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
Read about the Insulite Excess Weight & Obesity System that can help
reverse the symptoms of Insulin Resistance
Combating Heart Disease
Nearly 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.
Stopping 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.
"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
Insulite Weekly Health Support Message
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
Hypertension, or high blood pressure, is a silent killer which
can be caused by Insulin Resistance-related weight gain and
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
|American Heart Association-recommended blood pressure levels
|Blood Pressure Category
||Systolic (mm Hg)
||Diastolic (mm Hg)
||less than 120
||less than 80
||160 or higher
||100 or higher
| Source: American Heart Association -
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.
These 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
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
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
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.)
In 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
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
Heart disease risk and death rates are high among Mexican
Americans partly because of increased rates of obesity and
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
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
Read about the Insulite System that can help
reverse the symptoms of Insulin Resistance
How the Sexes Deal Differently with the Risks of Heart Disease
There 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.
Recent 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
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
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
How Parents Can Promote their Children's Heart Health
Being 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.
Minor 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
- 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
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
The 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.
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Read about Diabetes Myths