You know that you must keep your blood glucose levels under control in order to minimize the complications of diabetes. But are you doing everything you can to further reduce your risk of cardiovascular disease?

• Coronary artery disease -- People with type 2 diabetes are 2 to 4 times more likely to develop coronary artery disease than others. The statins have been found effective in lowering high LDL cholesterol and blood triglycerides in people with type 2 diabetes.

• Hypertension -- About 40% of middle-aged people with type 2 diabetes have high blood pressure, a figure that rises to 60% in those over the age of 75. ACE-inhibitors are the preferred medications for treating hypertension, because in addition to lowering blood pressure, they also improve the body's response to insulin and slow the progression of diabetic kidney disease. Target blood pressure in people with diabetes is 130/80 mmHg. Based on the results of a major research study (HOPE trial), experts believe that everyone with diabetes - even if blood pressure is normal, should be taking an ACE-inhibitor.

• Clotting abnormalities -- People with diabetes are prone to blood clots, due to the abnormal "stickiness" of their platelets and a lack of certain blood proteins that slow the breakdown of clots. Low-dose aspirin is recommended for its ability to reduce the tendency of the blood to clot, unless you have a bleeding disorder or stomach ulcer. The latest government survey of health and nutrition found that as many as 8 million people with diabetes who might benefit from aspirin therapy are not using it. Only 37% of people with diabetes and cardiovascular disease were taking low-dose aspirin. The percent was even lower - only 13% -- for those with CVD risk factors.

Talk to your doctor about steps you can take to decrease your chances of developing cardiovascular disease or other complications of diabetes.

Sources:

• Diabetes and Heart Health. Johns Hopkins Medical Letter, Health after 50. March 2001.
• Rolka DB, Fagot-Campagna A, Narayan, KMV. Aspirin use among adults with diabetes. Diabetes Care 2001 (Feb);24:197-201.