Need for more resources to treat cardiovascular complications – consultant
Consultant Cardiologist at the Heart Foundation of Jamaica, Dr. Handel Emery, has highlighted the need for more resources to address cardiovascular complications, which account for the majority of diabetes-related deaths.
Dr. Emery was speaking against the background of the observation of Heart Month, under the theme ‘The Diabetic Heart: Are you at Risk?’
“I think it is of paramount importance that we recognise this connection, and direct a lot of our attention to identifying, preventing and treating the cardiovascular complications associated with diabetes,” he emphasised.
Dr. Emery said it is important to note that diabetes is extremely common, pointing out that the current data suggest that about 12 per cent of the population over the age of 15 in Jamaica is diabetic.
“When you look at the international data, it’s even more alarming,” he noted. The Consultant said that about 400 million persons worldwide are diabetic at present, and the number is expected to grow to about half a billion by 2030.
“It is a significant global problem, and whilst there has been a lot of focus given to some of the other complications of diabetes, we tend not to really focus a great deal of effort, energy and resources on the cardiovascular complications associated with it,” Dr. Emery said.
RELATIONSHIP BETWEEN DIABETES AND HYPERTENSION
He noted that the relationship between diabetes and hypertension is not new, and although the initial accounts were largely anecdotal, “we began to have epidemiologic data which support this association in the form of a very large and important trial called the Framingham Heart Study, which began in 1948”.
The Consultant explained that subjects were assessed over a 30-year period, which led to the establishment of associations between particular disease entities.
“One of the associations made from the study was that persons who were diabetic were about 200-500 per cent more likely to develop cardiovascular disease than persons who were not diabetic,” he informed.
Dr. Emery noted that diabetic persons have a more rapid rate at which fat and cholesterol are deposited in the arterial system, leading to a narrowing of the blood vessels, which limits the flow of blood. This results in the heart muscle being starved of blood, which can lead to angina.
He also explained that one may have complete blockage of the vessel, which is a heart attack.
“Another way in which diabetes leads to heart failure is that the elevated blood sugars which we see in diabetes can also be directly toxic to heart cells. The heart tissue is not meant to function in an environment where blood sugars are elevated, so if they are chronically exposed to those levels of blood sugar, then there are biochemical consequences such as weakness of the heart muscle, and many patients go on to develop heart failure,” he said.