118 CHA

1. How common is it to suffer a cardiovascular problem and also have diabetes?

Cardiovascular disease and diabetes are intimately related. The exact percentages may vary slightly according to the population studied and the sources where they look, but it is estimated that around 30-40% of people with cardiovascular disease also have type 2 diabetes. On the other hand, the prevalence of cardiovascular disease in people with diabetes is even greater, since diabetics have a risk of 2 to 4 times greater to develop cardiovascular disease and it is estimated that between 50-80% of the deaths of these deaths of these patients It is for cardiovascular complications.

2. What is it?

It is due to interconnected pathophysiological mechanisms and shared risk factors. Chronic hyperglycemia that diabetic patients have produces damage to the organism that favors atherosclerosis, which is producing obstructions in the arteries, which increases the risk of suffering from stroke, infarctions and heart failure … On the other hand, other risk factors of cardiovascular disease, such as obesity, dyslipsemia or physical inactivity end up developing diabetes.

3. Is it more common to have heart failure and then diabetes or vice versa appears?

It is more common than diabetes preceding the development of heart failure.

4. Why? Can it be avoided?

In both cases there are shared risk mechanisms and factors. On the one hand, there is a generalized damage to the body’s arteries and, on the other hand, there is a state of chronic inflammation and insulin resistance that contributes to the development and progression of both diseases. Regarding prevention, the reality is that the integral and proactive management of one of these conditions is a key strategy to prevent the appearance of the other. This often implies changes in lifestyle through healthy eating and the performance of physical exercise and, in many cases, the use of drugs with dual benefits.

5. You have a worse prognosis with both pathologies, right?

Yes, since these patients have a greater load of comorbidities (obesity, chronic kidney disease …), worse quality of life, greater risk of suffering hospitalization and greater mortality.

6. How should both pathologies be handled?

Its management requires a comprehensive and coordinated approach that implies optimizing the pharmacological treatment of each disease separately. However, non -pharmacological measures such as directed and controlled physical exercise and a healthy diet with specific considerations for each pathology involve a fundamental pillar. In addition, it is important that patients monitor in specialized units where narrow and integral monitoring can be performed, with the possibility of detecting possible decompensations early.

7. Can you give me any specific advice on what to eat? Are green leafy vegetables, for example, good for both pathologies?

In general, the Mediterranean diet has proven to be the healthiest food. It is usually recommended a diet based on the “Harvard dish”, which is a visual guide to create healthy and balanced meals. We must imagine that we divide the plate into sections: half of the dish must contain varied fruit and vegetables; A room must contain integral grains (quinoa, oatmeal, integral rice, comprehensive paste and whole wheat bread) and another room must include healthy protein (fish, birds, legumes, eggs …). Green leafy vegetables are excellent for people with heart failure and diabetes, since they are low in calories, rich in fiber, antioxidants, vitamins and minerals.

8. Any prohibited food?

I would not speak so much of prohibitions, but to leave less recommended foods for specific moments. Patients with heart failure should be special care with salt, avoiding processed, canned foods and fast foods. In addition, they must restrict the amount of liquids to 1.5 – 2 liters per day. For their part, diabetics should avoid foods that produce blood glucose peaks, as is the case with simple carbohydrates by producing rapid sugar absorption: pastries, honey, jam of blood sugar.

9. As for exercise, just walk? How many km?

Although walking is a good starting point, the ideal is to combine different activities. There is no unique figure of kilometers that is “necessary” for all, since it depends on the initial physical condition, the presence of other comorbidities and individual objectives. General recommendations are usually to perform at least 150 minutes of aerobic activity of moderate intensity per week. This could translate into a light walk for about 30 minutes 5 days a week.

10. Do you advise another exercise?

The ideal is to combine the aerobic exercise that includes walking, but also swimming, riding a bike, dancing, climbing stairs, etc., and strength training, incorporating exercises with light weights or body weight itself, to improve muscle mass, which is important for the general force and also for insulin sensitivity.