Skip to Accessibility Tools Skip to Content Skip to Footer

Heart / Cardiovascular Disease

Cardiovascular complications: an introduction

If you’ve been diagnosed with type 2 diabetes, there are a number of things that you can do to make sure you stay healthy. At the top of your list should be controlling your blood sugar, losing excess weight, and making sure that both your blood pressure and lipids are under control. All of these factors contribute to the development of type 2 diabetes and the most common complication of diabetes, cardiovascular disease. As a person with type 2 diabetes, even though you are at high risk for cardiovascular disease, you can do a lot to decrease that risk and live a healthier and happier life.

Why it’s important to make healthy life changes

It is especially important to take care of the ABCs of diabetes (hemoglobin A1C, blood pressure, and cholesterol), because people with diabetes face significantly increased risk for a range of cardiovascular complications. In fact, having diabetes itself is a risk factor for development of cardiovascular disease and cardiovascular disease tends to develop much earlier in a person with diabetes.

Among people in the US who have diabetes, the risk of death due to cardiovascular events (including heart attack, stroke, and other events) is 2 to 4 greater than for people without diabetes.1 This statistic alone should be a wake-up call for any person with diabetes, especially since your risk for cardiovascular complications can be decreased by controlling your blood sugar, reducing your weight, controlling your blood pressure and lipids, and making other healthy lifestyle changes.

Risk of death from cardiovascular disease
among people with diabetes in US*



Men 1.7 times greater
Women 2.2 times greater

*Data from Framingham Heart Study.

Atherosclerosis and cardiovascular risk

Most cardiovascular complications involve underlying atherosclerosis, which is characterized by build up of fatty material (called plaques) on the inner walls of arteries.

High cholesterol, elevated levels of a waxy substance in the blood that derives from animal fats in the diet and is manufactured by the liver, is a major cause of atherosclerosis. People with diabetes whose blood sugar is not controlled are at increased risk for the development of atherosclerosis. Insulin resistance, uncontrolled blood glucose, and high blood pressure contribute to the development of atherosclerosis. So, if you have diabetes, keeping your blood sugar under control can reduce your risk for atherosclerosis and dangerous cardiovascular complications.2

What are the cardiovascular complications of diabetes?

Cardiovascular complications associated with diabetes include heart disease, cerebrovascular disease, and peripheral vascular disease (diseases affecting the arteries outside of the chest and abdomen, such as those in the legs).

In heart disease, a key risk is heart attack, in which a plaque breaks away from vessel wall and causes a blockage in a coronary artery, impeding the flow of blood that the heart muscle needs to work properly. Other risks include congestive heart failure. People with diabetes face a three-fold greater risk of dying from heart disease than those without diabetes.3

In cerebrovascular disease, the key risk is stroke, in which a plaque breaks away from vessel wall and causes a blockage in a part of the brain, impeding the flow of blood to the brain. People with diabetes have a two- to three-fold increased risk of having an ischemic stroke (the most common type of stroke, in which the blood flow to the brain is interrupted).3

Cardiovascular complications of diabetes also include high blood pressure, which is often present in addition to atherosclerosis, and which increases the risk for disruption of plaque on vessel walls, which can result in heart attack or stroke.

Reducing your risk for cardiovascular complications. The good news about diabetes and cardiovascular complications is that you can take charge and lower your risk for such complications, both by making healthy lifestyle changes and by taking medications, such as blood pressure medications (antihypertensives) and medications called statins that control high LDL cholesterol. Key things that you can do to lower your risk for cardiovascular complications include4-6:

  • Quit smoking
  • Get regular exercise
  • Achieve and maintain lipid goals
  • Use a healthy eat plan and/or a statin to keep your cholesterol and triglyceride levels under control—according to the American Diabetes Association, persons with diabetes should have LDL cholesterol level less than 100 mg/dL and
  • Talk to your healthcare provider about whether you should take low-dose aspirin—aspirin (75-162 mg per day) has been shown to be an effective strategy for preventing cardiovascular disease in people who are at risk
Written by: Jonathan Simmons | Last reviewed: May 2014.
1. National diabetes fact sheet: national estimates and general information on diabetes and prediabetes in the United States, 2011. Atlanta, GA: US DHHS, CDC; 2011. 2. Dods RF. Understanding Diabetes: A Biochemical Perspective. Hoboken, NJ: Wiley; 2013. -- 3. Levin ME, Pfeifer MA, eds. The Uncomplicated Guide to Diabetes Complications. 3rd ed. Alexandria, VA: American Diabetes Association; 2009. -- 4. McCulloch DK, Robertson RP. Prevention of type 2 diabetes mellitus. Nathan DM, Mulder JE, eds. UptoDate. Wolters Kluwer Health. Accessed at: 2013. -- 5. Bakris GL. Treatment of hypertension in patients with diabetes mellitus. Kaplan NM, Nathan DM, Forman JP, eds. UptoDate. Wolters Kluwer Health. Accessed at: 2013. 6. American Diabetes Association. Standards of Medical Care in Diabetes—2014. Diabetes Care 2014;37:S14-S80.