Did you know that cardiovascular disease (CVD), which includes heart disease, strokes, peripheral vascular disease, hypertension (high blood pressure) and more, was responsible for about 930,000 deaths in the United States last year, or over 38% of all deaths? And people with diabetes have an even greater risk of developing all forms of CVD since elevated blood sugars accelerate the formation of plaque in the coronary arteries that contributes to heart attacks.
Heart disease is the leading cause of death in people with diabetes, and older diabetic adults have two to four times the normal risk of dying from a heart condition. Sadly, adults who develop type 2 diabetes at a younger age (by 18 to 44 years old) are even worse off; they are 14 times more likely to suffer heart attacks and up to 30 times more likely to have a stroke. Many undiagnosed people with type 2 diabetes learn of their condition after having their first heart attack. At that point, they likely have had undetected diabetes for a number of years, long enough for it to cause damage to their cardiovascular system. Coronary artery plaque buildup can actually begin in childhood, and when co-existing health issues like high blood pressure and elevated cholesterol levels (both common in type 2 diabetes) are present, the heart disease process is further accelerated.
By now, you need some good news, right? Let’s talk about what you can do to combat heart disease, even if you have diabetes. To do that we have to discuss my favorite topic: exercise! Where does physical activity come into all of this? Front and center! Physical inactivity alone increases your risk for heart disease, as well as all other forms of CVD, and less fit people have a 30 to 50 percent greater risk of developing high blood pressure and subsequent strokes. A sedentary state, along with cigarette smoking, high blood pressure, and high blood cholesterol, is one of the most modifiable risk factors for a heart attack – studies have shown that regular physical activity dramatically reduces your risk of heart problems. While becoming a regular exerciser does not guarantee that you will not get heart disease, your chances are far less if you exercise, control your blood sugars, and minimize the impact of the other risk factors that you can control.
Do you have to take up jogging – gulp! – to attain a healthier heart? Absolutely not! Doing any physical activity is far better than none, and even low-intensity activities can help heart problems. People who have a low fitness level are much more likely to die early than people who have achieved even a moderate level of fitness. When done for as little as 30 minutes a day, activities such as walking, climbing stairs, gardening, yard work, housework, dancing, and home exercise have been shown to be beneficial to cardiovascular health. Admittedly, more vigorous aerobic activities such as brisk walking, running, swimming, and bicycling – done on most days of the week – will have the greatest benefit. If you want to exceed a moderate level of fitness, you need to exercise a minimum of three to four times a week, for 30 to 60 minutes total, and at 50 to 80 percent of your maximal capacity.
If you’re female, you may have even more reason to get active. Although most pre-menopausal women’s hearts are somewhat protected by the effects of female hormones like estrogen, having diabetes places women on a level playing field with men in terms of their heart disease risk. Sedentary women have twice the chance of dying from heart disease than women who exercise, just as women who smoke cigarettes double their chances of dying from heart disease. Women may live longer than men, but not necessarily better, and elderly women who have not been physically active experience more disability in their activities of daily living than their more active counterparts. But, the few studies on heart health and exercise that have included women show that they may benefit even more than men, that the risk of death from heart disease is reduced even further in women who are physically fit.
If you’ve been inactive, then now is the time to start moving more. More and more seniors are proving every day that they are not too old to exercise, and the older you are, the more you need regular exercise. Most apparently healthy people of any age can safely engage in low to moderate levels of physical activity (e.g., moderate walking, gardening, yard work) without seeing their doctors first. As a precaution, if you are middle-aged or older, currently sedentary, at high risk for heart disease or already have it, or have other health concerns, seek medical advice before you start a more intense physical activity. Also, if you’ve been having any symptoms that may be indicative of heart disease, such as shortness of breath, undiagnosed pain in your chest, jaw, arm, upper back, or lower legs, see your doctor first and have an exercise stress test to be on the safe side.
Finally, don’t try to do too much too fast; start exercising at an intensity that is on the easy side, and increase it gradually, if/when you desire to. Pick activities that are fun, that suit your needs, and that you can do year-round so that you can make them a permanent part of your lifestyle. Wear comfortable clothing and footwear, and choose a well-lighted, safe place with a smooth, soft surface to be active. Take time to warm up and cool down when doing more intense activities. Get up and get moving, and a healthy heart will be your reward!