Lots of people worry about atherosclerosis -- or hardening of the arteries -- as a factor in heart disease and stroke. But did you know that diabetes, high cholesterol, high blood pressure, a sedentary lifestyle, and obesity are all major risk factors for atherosclerosis?
Take the case of Barbie Perkins-Cooper, 57, a writer from Mount Pleasant, S.C. When she discovered that she had type 2 diabetes, she also discovered that she was at risk for atherosclerosis. What's worse: her high cholesterol levels, obesity, and sedentary lifestyle put her at even greater risk.
Perkins-Cooper is hardly alone. Many people who are eventually diagnosed with atherosclerosis have at least one of these other problems. And that's not all. Once you develop atherosclerosis, each of these conditions can worsen the damage to your arteries. Here's how:
Diabetes. People with diabetes tend to develop atherosclerosis earlier and more extensively than those without the disease. In fact, people with diabetes -- especially women -- are two to six times more likely to get atherosclerosis. Patients with type 1 and type 2 diabetes can also develop the disease in small blood vessels, such as those in the eyes and kidneys.
Diabetes is a major predictor of how well patients fare with atherosclerosis and heart disease. "Once you have a heart attack, for example, you're going to do a lot worse than if you don't have diabetes," says Sam Tsimikas, MD, professor of clinical medicine and director of vascular medicine at the University of California, San Diego.
High LDL cholesterol. High levels of LDL, the bad kind of cholesterol, promote plaque formation in artery linings -- the signature symptom of atherosclerosis. Too much LDL can worsen atherosclerosis and increase the chance of heart disease. "It is a major risk factor," Tsimikas says. "The higher the LDL, the more likely you are to get a heart attack. The lower the LDL, the more likely you are not to get one."
High blood pressure. This condition is associated with inflammation and increased damage to the lining of the vessels because they're under higher pressure, Tsimikas says. A vessel is like a garden hose, he says. "If it's always under high pressure, eventually, it's going to get damaged. If there are other risk factors -- diabetes and high cholesterol circulating in that pipe -- eventually, all of that is going to clog it up."
Obesity. Being obese raises the risk of atherosclerosis in the arteries that supply blood to the heart muscle. Abdominal obesity also makes a person more likely to develop high blood pressure, type 2 diabetes, and high cholesterol. Once these various problems come into play, they can further damage the blood vessels and worsen atherosclerosis. Keeping weight under control is crucial, Tsimikas says. "If people can commit to eat less and walk for 20 minutes every day, it will make a big difference."
Smoking. Smoking is linked to progression of atherosclerosis. It harms the inner lining of blood vessels, increases risk of injury to the inner lining of arteries, raises LDL cholesterol, and lowers HDL (good) cholesterol. "If you look at patients under 50 with heart attacks, almost all of them are smokers," Tsimikas says. "Smoking can cause heart disease by damaging your blood vessels and causing more plaque and blood clots to form inside blood vessels." The good news: risk of heart disease decreases quickly after a smoker gives up cigarettes, Tsimikas says.
Keeping blood pressure, cholesterol, weight, and diabetes under control also results in big payoffs, Tsimikas says, even if your atherosclerosis has already led to heart disease. "If you control the risk factors more aggressively, you're more likely to do better in terms of preventing a new heart attack or not needing a bypass or other procedure."
Perkins-Cooper's own doctor calls her a poster child for good health. After that shocking diabetes diagnosis, she dropped 32 pounds -- no more fried Southern food and regular dessert, she says. She lowered her cholesterol from a high of 225. She began exercising, too. "I'm a very stubborn person," she says. "When I put my mind to it, I can get things done. I just revamped my whole lifestyle."