Why are coronary artery complications in patients with diabetes?

The article is professionally consulted by Master, Doctor Nguyen Van Phong - Cardiovascular Center - Vinmec Times City International Hospital

Many studies show that coronary artery disease is one of the major vascular complications in patients with diabetes. The risk of coronary complications of diabetes increases 2 to 4 times, causing serious morbidity and increased mortality in people with diabetes.

Diabetes is a chronic metabolic disorder characterized by hyperglycemia. Hyperglycemia affects the vascular system directly and indirectly, and is a source of morbidity and mortality in both type 1 and type 2 diabetic patients.
Specifically, the mechanism of diabetes mellitus causes damage to endothelial cells, disrupting vascular function. The endothelium is the innermost cell of the vessel wall - the place of direct contact between the vessel wall and blood components. When endothelial function is disturbed, cholesterol molecules will easily pass through the endothelium to enter, combined with white blood cells to increase adhesion and penetration into the endothelium. From there, atherosclerotic plaque is formed, or if the plaque is already present, it progresses very quickly, leading to narrowing of the lumen, causing chronic ischemia in organs.
In addition, the damaged vascular endothelium also causes vasoconstriction, which combines with platelets to adhere, forming a blood clot in the blood vessel. Thrombosis causes acute embolism, which is the cause of clinical manifestations such as: unstable angina, myocardial infarction, cerebral infarction... seriously threatening the patient's life.

Depending on the location of the damaged blood vessel, there will be different complications, such as:
Damage to the eye artery causes vision loss, leading to blindness; Damage to the renal artery leads to kidney failure , increased blood pressure; Damage to coronary arteries causing angina, myocardial infarction, sudden death; Injury to cerebral blood vessels leading to stroke; Injury to the arteries of the extremities causes inflammation and blockage, manifesting as claudication, extremity necrosis, etc. Thus, chronic progressive diabetes will lead to dysfunction and impaired function of many organs, especially eyes, brain, kidneys, nerves and heart. Among them, diabetes causing vascular complications is the most common. Diabetes doubles the risk of coronary heart disease, stroke and life-threatening cardiovascular problems. Coronary complications of diabetes can also be seen in young patients with atypical clinical presentations.
Up to two-thirds of diabetics die from cardiovascular disease. Treatment aimed at preventing and controlling hyperglycemia reduces the harmful effects on the body's tissues. It is important to understand why diabetes causes vascular complications. Because as the prevalence of diabetes continues to rise, so does the measure for the primary and secondary prevention of these complications.

Characteristic type 2 diabetes occurs on the basis of metabolic syndrome, including:
Abdominal obesity Hypertension Hypertension Dyslipidemia Hypercoagulable state. All of these factors increase the risk of cardiovascular disease. In contrast, diabetes is also one of many risk factors for increased heart attack, stroke and death.
According to an epidemiological study, the incidence of myocardial infarction or death at 7 years is:
20% in patients with diabetes; 3.5% in non-diabetic patients. For people with a history of myocardial infarction, the rate of recurrence or death from a cardiovascular event is:
45% in patients with diabetes; 18.8% in non-diabetic patients. In other words, people with diabetes without a history of myocardial infarction have the same risk of an acute coronary event as people with a history of myocardial infarction but without diabetes.
Recent literature also shows that the risk of myocardial infarction in people with diabetes is comparable to that in people with a history of myocardial infarction. According to the new recommendations of the ADA and the American Heart Association, diabetes is considered a risk factor for myocardial infarction equivalent to coronary heart disease.

Among patients with type 2 diabetes, women generally have a higher risk of coronary heart disease than men. The rate of female patients over 40 years of age dying from myocardial ischemia is also higher than that of men.
A very important point to always emphasize is that the clinical presentation of coronary heart disease in patients with diabetes is very poor. Many patients have ischemic heart disease, even severe myocardial infarction, but do not know they have the disease, only when they go to the health check to find out. Therefore, patients with diabetes must have regular cardiovascular check-ups to detect early signs of myocardial ischemia. However, many patients have clinical manifestations with angina pectoris, or a feeling of heaviness in the left chest, palpitations, palpitations, shortness of breath... All signs are abnormal, even if very small. All patients with diabetes need to be carefully considered for their cardiovascular health for early detection and timely treatment.

There are a number of factors that, when combined with diabetes, will increase the risk of cardiovascular complications many times over, as well as aggravate the coronary complications of diabetes. Includes:
Over 60 years old (the older you get, the higher the risk) High blood pressure Dyslipidemia (high cholesterol and/or triglycerides). Obesity, especially belly fat Addiction smoker Sedentary Family history of death from a heart attack.

The more factors combined, the greater the rate of diabetes causing vascular complications. Of the above, there are 2 factors that cannot be affected: age and family history, while the rest are modifiable. Therefore, people with diabetes should not ignore the impact of these risk factors, and try to eliminate sedentary habits, smoking and unhealthy eating habits.
Diabetes is a dangerous disease and can leave many complications, of which are typical complications of cardiovascular disease and coronary artery disease. Therefore, health examination, monitoring, blood sugar management and screening for cardiovascular diseases are necessary.
According to statistics, after 10 years, the prevalence of diabetes in the community has doubled, from nearly 3% to 5.4% of the population, especially type 2 diabetes. Diabetic screening will help patients update their health status and have timely intervention methods. Currently, at Vinmec International General Hospital, there are screening programs for Cardiology combined with diabetes. The entire procedure is performed by a team of leading specialists and modern technological equipment, which can diagnose and screen for type 2 diabetes early even when there are no symptoms. Timely identification of cardiovascular complications to timely intervene, ensure the health of the patient.
If you have a need for examination, you can go directly to Vinmec International General Hospital or register for an online examination.