Cardiovascular Disease, TBL, & Diabetes, Oh My!

 

    In preparing for what is usually the bane of most MSBS students existence, TBL, I was tasked with dissecting our physiology paper on cardiovascular disease (CVD) and its associated manifestations. More specifically, Dr. Campisi wrote a phenomenal synopsis (in only 11 pages!) of a brief overview of cardiovascular disease, neurotransmitters/neurotoxins, cardiac muscle/NMJ physiology, and a plethora of other things. Towards the end of the paper, a clinical discussion is had about the comorbidity of CVD and diabetes, as to which I thought BLOG POST! Individuals with Type II diabetes are at increased risk for high blood pressure and high cholesterol, in addition to their abnormally elevated blood glucose levels, this triad can lead to increased risk for heart disease, myocardial infarction, and stroke (National Institute of Diabetes and Digestive and Kidney Diseases, 2021). As we have previously learned, high blood pressure leading to turbulent blood flow, high cholesterol leading to build-up of atherosclerotic plaques, and high blood glucose leading to damage of one’s blood vessels, all possible manifestations of a diabetes diagnosis, can ultimately lead to a CVD diagnosis as well.

            CVD is currently the leading cause of death for men, women, and children in the United States and on average, accounts for 1 in every 4 deaths (Centers for Disease Control and Prevention, 2021). CVD is also the leading cause of death for individuals with type II diabetes. Arterial stiffness due to a conglomeration of the previously mentioned risk factors, hypertension, atherosclerosis, and vascular endothelial damage due to elevated blood glucose levels, is seen in the large elastic arteries surrounding the heart in patients with type II diabetes (Strain & Paldanius, 2018). This strain on the heart due to the symptoms of diabetes is what ultimately can cause a CVD diagnosis, among other things. In further elaborating upon these risk factors, individuals with type II diabetes face the greatest burden when it comes to atherosclerotic plaque buildup due to their bodies resistance to insulin. The insulin resistance seen in patients with type II diabetes helps explain the poor regulation of free fatty acid levels in the bloodstream, which leads to hypertriglyceridemia ( Low Wang, Hess, Hiatt & Goldfine, 2016). Subsequently, there is a decrease in the degradation of apolipoprotein B which causes an overproduction of VLDL-cholesterol that cannot be uptaken by the liver via lipoprotein lipase due to its downregulation via insulin resistance; thus resulting in increased levels of VLDL-cholesterol in the blood stream that can then create atherosclerotic plaques (Low Wang, Hess, Hiatt & Goldfine, 2016).

            As Dr. Campisi has mentioned before, “an ounce of prevention is worth a pound of cure”, management of one’s diabetes symptoms via healthy diet, blood sugar monitoring, frequent doctors visits, exercise, smoking cessation, the list goes on can significantly help reduce the likelihood of a CVD diagnosis. Individuals at high risk for either diabetes or CVD should consult with their healthcare provider(s) as to how they can minimize their risks for either of these ailments, as to which preventative measures implemented by the physician should also be at the forefront of care, in helping reduce the prevalence of such ubiquitous diseases.  

References

Division for Heart Disease and Stroke Prevention, Heart Disease Facts (2021). Centers for Disease Control and Prevention. Retrieved November 14, 2021, from https://www.cdc.gov/heartdisease/facts.htm.

Low Wang, C. C., Hess, C. N., Hiatt, W. R., & Goldfine, A. B. (2016). Clinical Update: Cardiovascular Disease in Diabetes Mellitus: Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus - Mechanisms, Management, and Clinical Considerations. Circulation, 133(24), 2459–2502. https://doi.org/10.1161/CIRCULATIONAHA.116.022194

National Institute of Diabetes and Digestive and Kidney Diseases , & Buse, J. B., Diabetes, Heart Disease, & Stroke (2021). National Institutes of Health. Retrieved November 14, 2021, from https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke.

Strain, W. D., & Paldánius, P. M. (2018). Diabetes, cardiovascular disease and the microcirculation. Cardiovascular diabetology, 17(1), 57. https://doi.org/10.1186/s12933-018-0703-2