Why is it prone to diabetes, high blood pressure?

 ① The disorder of glucose metabolism could accelerate a small renal artery and systemic atherosclerosis, so that peripheral resistance increase in blood pressure.

 ② High blood sugar can increase blood volume, kidney overload Shuinazhuliu and eventually can cause high blood pressure.

 High blood pressure and cardiac output and peripheral resistance related. An increase in cardiac output is not accompanied by changes in peripheral can cause high blood pressure; increased peripheral resistance is not accompanied by changes in cardiac output or blood volume, but also can increase blood pressure and diabetes are the two changes, so will blood pressure the rapid rise and cause serious complications.

 On the other hand, high blood pressure can also increase the damage caused by diabetes, including its impact of small blood vessels and kidneys to form a vicious circle, in order to break this vicious circle, we must actively control diabetes, as far as possible to improve the body’s tissues to insulin sensitivity, while It should also effectively control blood pressure, so as to achieve within the normal range, but it should avoid the use of antihypertensive drugs affect the metabolism of insulin, such as the diuretic Hydrochlorothiazide and so on. In addition, proper exercise and weight control high blood pressure and diabetes is also a very important measure. The one hand it can improve the body’s tissues to insulin sensitivity, reduce insulin and other hypoglycemic drug doses; the other hand, mild to moderate hypertension has obvious depressor effect, so diabetic patients with hypertension, should insist on appropriate exercises and control of body weight and other non-drug treatment.

 According to the 1999 World Health Organization diagnostic criteria:

 1, impaired fasting glucose defined as fasting blood glucose in the 6.1-7.0mmol / L (mmol / l), more than 7.0mmol / L (mmol / l) compared with diabetes;

 2, impaired glucose tolerance is defined as the 75 g oral glucose tolerance test (OGTT) 2 hour plasma glucose of 7.8-11.1mmol / L, more than 11.1mmol / L, compared with diabetes.

 Can be seen frequently measured physical examination will be missed most of the fasting blood glucose (about 2 / 3) in patients with pre-diabetes. Therefore, in order to be diagnosed with impaired glucose tolerance to OGTT.

 Analysis of knowledge – how to do oral glucose tolerance test

 Treated with oral glucose tolerance test (OGTT) before the 3 days diet is relatively normal, mainly because the other empty. Many people are receiving checks were slightly higher fasting plasma glucose, and then further examine the former are often deliberately dieting, so that could lead to test results are not allowed. The so-called normal diet, generally require a daily staple food to more than 3 2. Subjects fasted the night before to be more than 8 hours. Subjects first morning fasting blood glucose extraction, and then 5 minutes to drink 250-300 ml of syrup (which contains 75 grams anhydrous glucose), water temperature should not be too cold, so as not to affect the sugar dissolves. From time to drink the first one, 2 hours after taking the blood glucose measurements. Test requirements in the near future subjects without infection, surgery and trauma stress situations, testing them not to smoke, drink coffee and vigorous exercise, otherwise they will affect the determination of blood glucose results, delays in diagnosis.

 Who should be screened for pre-diabetes

 At present that:

 * Aged 45 and above;

 * Younger, but accompanied by overweight or obese;

 * Or have family history of diabetes;

 * There is a history of gestational diabetes mellitus

 The above four types of people should be carried out pre-diabetes screening. Fasting blood glucose to determine the fasting glucose to carry out OGTT identified abnormal glucose tolerance. Routine fasting blood glucose and other clinical indicators such as body mass index (BMI), blood pressure and lipid profile such as to determine the individual level of risk of diabetes, fasting blood glucose and OGTT between the two in combination can be more effective and comprehensive screening of patients with pre-diabetes.

 Diagnosed with pre-diabetes have to take medicine to protect the heart after

 Fasting blood sugar is not high, but the increase in glucose after meals, which is a pre-diabetes, this medication should not it? In the past, the doctor will guide the patient lifestyle changes, such as diet, exercise, etc., but now, doctors will tell patients, lifestyle changes should be accompanied by the medication as soon as possible. Held in recent evaluation studies of acarbose (ACE) press conference, People’s Liberation Army General Hospital, said Professor Pan Changyu, abnormal glucose metabolism to early intervention, with the ultimate aim is not only to reduce blood sugar, but in order to reduce cardiovascular events , that is, protect the heart.

 * Injury to the heart of postprandial hyperglycemia

 Many patients, fasting plasma glucose test is normal, but the meal or received oral glucose tolerance test, you will find significantly more than normal blood sugar, which range between normal and diabetes is a state of pre-diabetes, also known as impaired glucose tolerance by the loss. Many people feel that do not is a slightly higher blood glucose and should be no harm. However, Karolinska professor at the University of Dayton Lasry said the heart of Europe investigations and surveys have shown that the heart of China, diabetes and myocardial infarction are a pair of lethal combinations. The coronary heart disease patients, abnormal glucose metabolism (including diabetes and pre-diabetes) than we have imagined universal. “A lot of studies have shown that postprandial hyperglycemia and cardiovascular disease incidence and mortality rates close.” Visible, even if not yet developed to the stage of diabetes, pre-diabetes patient’s heart also faces great risk.

 * There are three major advantages of early administration

 According to the Chinese Medical Association Diabetes credits will be the latest epidemiological survey, prevalence of diabetes in Chinese urban residents was 11%, pre-diabetes prevalence rate was about 15%, that is, the community has a diabetes patient, almost about to have a into the ranks of pre-diabetes in patients with diabetes mellitus. According to experts, without intervention, about 1 / 3 of patients with pre-diabetes will develop diabetes.

 And, if only fasting blood glucose, there is a large part of patients with abnormal glucose metabolism has been missed, especially in patients with pre-diabetes. For this reason, the University of Oxford Diabetes Center Waruiheman professor said that in 2007 the United States and Europe, “diabetes, pre-diabetes and cardiovascular disease guidelines” were recommended oral glucose tolerance test fasting blood glucose and postprandial glucose, with a view to early detection of Asymptomatic hyperglycemia and type 2 diabetes. Moreover, early intervention has become the United States and Europe specialist diabetes medical consensus.

 Professor Pan Changyu pointed out that if able to postprandial blood glucose under control, there are three major advantages: First, effective control of blood glucose and glycated hemoglobin, the second is to reduce pre-diabetes progressed to the risk of type 2 diabetes and the third is to reduce the patient’s cardiovascular risk, which point is the most important.

 * Blood sugar a another job started to take medicine

 Since the pre-diabetes should actively treated, how do drugs? Professor Pan Changyu, said Acarbose is currently the only applied to pre-diabetes drug, has been approved in 27 countries. There are a number of research evidence that the use of acarbose treatment in patients with the risk of diabetes and myocardial infarction were significantly reduced, is the only evidence of cardiovascular benefits of hypoglycemic drugs.

 Pan Chang-yu said that acarbose security is good, the burden of liver and kidney is small, not to increase the weight, does not produce low blood sugar in China has been widely used and accepted by

 1. Calorie intake and consumption balance. Development of a daily intake of total calories should be, scientific computing, so that intake and consumption of heat balance.

 2. Not eat candy. Such patients should not eat sugar, glucose, honey and its products. Eat high starch vegetables such as potatoes, sweet potatoes and yams and so on.

 3. Eat high-cholesterol foods. Eating egg yolk, animal skin and liver of high-cholesterol food.

 4. Select high-quality protein. First, protein intake should be limited to, blood urea nitrogen increased in the more necessary attention; Secondly, the protein source should be based on milk, lean meat, eggs, seafood and other high-quality animal protein-based.

 5. Multi-eat foods rich in fiber. Eat more fiber foods such as kelp, seaweed and so on. Dietary fiber is not digested and absorbed by the small intestine, but can bring a sense of satiation to help reduce food, and can delay the absorption of sugar and fat. Soluble dietary fiber (grains, cereals, pulses in the higher levels) can absorb intestinal cholesterol, help lower blood sugar and cholesterol levels.

 6. Choose low-sugar fruits. If the blood glucose control is not good, water-soluble vitamins and minerals may cause excessive loss, so need to be supplemented with low sugar content of fresh fruits and vegetables, such as strawberries, tomatoes, cucumbers and so on. Usually between meals or eat 1 hour before bedtime, but also optionally in the physical activity during or after the hungry. In order to avoid postprandial hyperglycemia is generally not recommended to eat fruit after dinner.

 7. Eating sunflower seeds and peanuts. Many women like the Chi Guazai, peanuts and other snacks, these foods contain a certain amount of carbohydrates, and high fat content.

 8. Shaoshiduocan. Tonne to eat less, eat a few tons, the total unchanged. Such an approach can ensure that the postprandial blood glucose does not rise too high.

 9. Note that dinner time. If you eat dinner too late, the lack of an appropriate amount of activity after a meal, then the calories in food consumption will be too late to convert stored fat. Therefore, it is best to schedule dinner between 6:30-7:30 in the afternoon, so there is time to conduct appropriate amount of exercise after dinner.

 10. Strict salt restriction. Ordinary daily sodium intake should be controlled in less than 6 grams, while the hypertensive patients with diabetes mellitus and a maximum not more than 3 grams. )

 Diet Care

 Treatment of diabetic patients with dietary control is also an important measure for coronary heart disease. Principle is light, digestible, low-carbohydrate, low fat, low salt, high protein, high vitamins, high-fiber foods; appropriate timing, quantitative, Shaoshiduocan; bogey sweets, eat three square meals, cigarettes, alcohol and irritant food; In addition, the meal time to dovetail with insulin injections. Dietary treatment on the importance of diabetic patients with coronary heart disease, has repeatedly stressed the need to have sufficient knowledge to enable patients, and can make consistent efforts to dine by your doctor and effectively to treatment.

 Myocardial infarction care

 Such patients should pay particular attention to observe whether the secondary low blood sugar, to prevent low blood sugar caused by tachycardia, arrhythmia, cardiac blood flow redistribution, resulting in a greater area of myocardial infarction and increased heart damage. At this point, blood glucose should be maintained at 11.1mmol / L or so, should not drop too low. In addition, patients should be observed at any time whether the stomach discomfort, nausea, vomiting, loss of appetite, difficulty breathing, cold sweat, neck pain, toothache, etc., once the above-mentioned symptoms should promptly check the ECG, if myocardial ischemia, should be addressed urgently in order to avoid delay treatment.

 Prevention of Heart Failure Care

 To control the infusion rate and stringent control input mainly on the types of liquid. Infusion in patients with diabetes choose to use a general multi-bogey sugar, salt solution, but sodium can also increase the heart of the high burden-induced heart failure; infusion too much, too little can lead to renal dysfunction were associated with water and electrolyte disturbance occurred. Infusion in combination with monitoring of blood glucose, electrolytes, urine output, urine specific gravity infusion regulating the speed and adjust the infusion types.

 Merger of arrhythmia care

 For the occurrence of arrhythmia patients in addition to ECG monitoring, the need to Zhu Huanzhe absolute bed rest. At the same time to create a quiet environment for patients, strict control of access. Continuous low flow oxygen. Application of cardiac drugs when the need anti-virus response.

 Psychological Care

 Coronary heart disease is a kind of psychological factors associated with chronic physical diseases, this group of patients with a history of more than 10 years accounted for 84% of up to 25 years, this lifelong disease causes great suffering to patients and mental stress, there is and even despair, loss of confidence in treatment.

 Health Education

 Of health education on diabetes care in patients with coronary heart disease have a particularly important role. The purpose is to help patients develop a healthy behavior, get the best psychosomatic condition. First, let patients have a correct understanding of the illness, sure you can live like ordinary people. Health education, including the occurrence and development of this disease, prognosis, treatment, rest, functional exercise, calculate daily food intake, self-administration of insulin, self-monitoring of blood sugar, urine sugar, prevent complications, knowledge and skills to improve patient’s self-protection consciousness to detect, deal with problems. Health education should be extended to patients after discharge from hospital in order to avoid some of the patients hospitalized between the doctor’s advice, after discharge can not be controlled, contrary to doctor’s orders, resulting in exacerbation was again required hospitalization.

 Classified according to pathogenesis, the most common arrhythmia was premature beat, premature beat, but many people no symptoms, most of them good prognosis, so diabetics do not stress; the second most common is atrial fibrillation, which is a result of arrhythmia in patients with diabetes mellitus to out-patient clinic and hospital up to the start of reasons for that; third of idiopathic ventricular tachycardia, but clinical rare, more common in young people, not very dangerous; the fourth is pathological ventricular tachycardia, diabetic patients with myocardial infarction prone to this disease.

 When should you install defibrillator?

 If you have diabetes pathological malignant ventricular tachycardia, we often syncope, falls, eye black symptoms, if suffering from coronary heart disease, there had been myocardial infarction, it is even more dangerous. Treatment for these patients often had an onset heart rate reached 150 ~ 200 times per minute, if the blood pressure instability and even a faint, you should use cardiac defibrillators (ICD), since the event of ventricular fibrillation, for some patients would be a fatal blow. ICD is an implantable heart defibrillators, doctors in the patient’s right chest or left chest to make a skin incision, buried inside a cardiac defibrillator, the electrode on the heart, there is the problem will look at electric shock, dangerous situation, ie the can be lifted. This diabetes is a life-saving treatment can extend life span. Diabetic patients with coronary heart disease in particular, the merger likely to be such cases, this time should consult a doctor need to consider whether the heart defibrillator installed.

 Treatment of atrial fibrillation in two kinds of programs

 Many patients with diabetes complicated with atrial fibrillation. Is divided into paroxysmal atrial fibrillation and persistent, paroxysmal atrial fibrillation in the beginning when the disease may be 1 to 2 years attack once, and then probably every day, hair, or hair several times a week, every few minutes, a few hours or even days, when patients often find it hard to be, irregular heartbeat; and persistent atrial fibrillation can attack every minute, you may jump a month or several years, a dozen years.

 Diabetic patients with atrial fibrillation is the biggest trouble of stroke. In addition, the heart is also very easy to form thrombosis, life-threatening, the annual mortality rate is about 5%, if it is for patients over 70 years old, then every year up to 5% ~ 10%. In the treatment, if patients with diabetes have high blood pressure, heart failure or more than 70 years old, provided that they meet any one of the three, it must take warfarin and other anticoagulant drugs to treat and the chances of stroke can be reduced by 50 % ~ 60%, but the need can be long-term use of these drugs have a preventive effect.

 In other countries, if the diabetic patients with atrial fibrillation can be taken with warfarin, while the domestic new treatment guidelines is relatively conservative, and would like to add high blood pressure, heart failure, more than 70-year-olds in any one of three conditions. Of course, there are two risk factors for the time must serve warfarin. The role of warfarin to prevent thrombosis good, but easily lead to bleeding, diabetic patients taking warfarin, the greater the risk of bleeding. Relatively speaking, the role of aspirin weaker, but small bleeding side effects. The use of warfarin needed to pay attention, in order to reduce the risk of bleeding and achieve the purpose of prevention of thrombosis must be frequent monitoring of blood coagulation indicators cumbersome. Patients living in large and medium cities to facilitate inspection, you can consider the use of warfarin therapy.

 Another alternative is radiofrequency ablation, its assembly power can reach 80% ~ 90%, and the impact is not diabetes. Atrial fibrillation by radiofrequency ablation will be converted to normal rhythm, can reduce the risk of stroke. At present, radiofrequency ablation is as important as the choice of drug therapy.

 Master Chen has just been hospitalized due to coronary heart disease, doctors gave him check blood sugar, but also in the sugar after the blood, which makes him puzzled, “I came to see heart disease, how can also check blood sugar?” In fact, the above-mentioned Cardiology confused a minority of patients. People’s Liberation Army General Hospital, told the Endocrine Copan, Professor Chang-yu “Life Times” reporter on the etiology of coronary heart disease and diabetes are closely linked, like one of the two melons grown on the dendrites, both suffering from any one of them, and then suffering another The odds will be greatly increased. Therefore, she reminded coronary heart disease patients, must be concerned about their blood sugar.

 ”Diabetes is equivalent coronary heart disease”

 In the American Diabetes Association, there is a saying: diabetes, coronary heart disease equivalent. Seemed sound alarmist, but it is based on a large number of long-term study of the medical profession. Pan Chang-Yu told reporters, according to research, 70% – 80% of people with diabetes eventually die of cardio-cerebral vascular diseases. Finland took a 18-year study results show that diabetes, without coronary heart disease in patients with coronary heart disease, non-diabetic patients the survival rate curves overlap. Based on this, “U.S. National Cholesterol Education Program adult treatment guidelines Ⅲ” (ATPIII) clearly points out that diabetes and coronary heart disease is “and other Dangerous Disease.”

 In turn, the number of people with coronary heart disease patients with blood sugar a problem? 5,000 people took part in the heart of Europe survey results showed that in patients diagnosed with coronary heart disease, if the blood glucose testing, 2 / 3 of people high blood sugar. “In the heart of China recently concluded survey, this proportion is 78%. Both of which the abnormal glucose tolerance, but also mildly elevated fasting glucose, and even some of them have reached the diagnostic criteria for diabetes.” Pan Chang-yu said, .

 Fasting blood glucose to normal is not equal to normal blood glucose

 Coronary heart disease, diabetes and why the shadow each other, go hand in hand? Pan Chang-Yu explained that the current study found that diabetes and coronary heart disease share a common genetic background, another common way of life as the bad soil, close is not difficult to understand. “And our ultimate aim is not only to prevent coronary heart disease patients, but also prevention of diabetes in patients with cardio-cerebral vascular accident onto the road of no return.”

 The chef admitted to hospital, Chen fasting blood glucose checked before the result is normal, but do oral glucose tolerance test, or oral administration of 75 g anhydrous glucose 2 hours after the blood glucose test, it was significantly higher than the reference value of. Pan Chang-yu said, this is called “impaired glucose tolerance”, blood glucose levels between normal and diabetes later, it shows the body deal with sugar in patients with impaired in their ability, “It is noteworthy that the Chinese people are more susceptible than Europe and the United States Sugar damage tolerance. “Therefore, if only to check fasting blood glucose, there will be a large number of missed diagnosis in patients with impaired glucose tolerance, resulting in adversely affected by illness.

 Check blood glucose in patients with coronary heart disease are the

 Coronary heart disease coupled with a high blood sugar, as worse, high blood sugar in patients with coronary heart disease myocardial infarction, stroke, put-stent restenosis, would greatly increase the chances of sudden death, a serious threat to patient survival. She therefore appealed to all patients with coronary heart disease, and the family history of diabetes, age over 40 years of age, smoking, hypertension, hyperlipidemia, diabetes or pregnancy have occurred in patients with birth macrosomia, blood sugar tests every year, if necessary, make candy tolerance test. Once problems are detected, we should as soon as possible interventions, including medication and lifestyle changes to avoid from the “impaired glucose tolerance” to continue development of diabetes, diabetes complications occurred.

 Attention to blood sugar, take the initiative to do inspections to assess their health, is responsible for the performance of themselves and their families.

 Diet Care

 Treatment of diabetic patients with dietary control is also an important measure for coronary heart disease. Principle is that light, digestible, low-carbohydrate, low fat, low salt, high protein, high vitamins, high-fiber foods; appropriate timing, quantitative, Shaoshiduocan; bogey sweets, eat three square meals, smoking, alcohol and to stimulate of food; In addition, the meal time to dovetail with insulin injections. Dietary treatment on the importance of diabetic patients with coronary heart disease, has repeatedly stressed the need to have sufficient knowledge to enable patients, and can make consistent efforts to dine by your doctor and effectively to treatment.

 Myocardial infarction care

 Such patients should pay particular attention to observe whether the secondary low blood sugar, to prevent low blood sugar caused by tachycardia, arrhythmia, cardiac blood flow redistribution, resulting in a greater area of myocardial infarction and increased heart damage. At this point, blood glucose should be maintained at 11.1mmol / L or so, should not drop too low. In addition, patients should be observed at any time whether the stomach discomfort, nausea, vomiting, loss of appetite, difficulty breathing, cold sweat, neck pain, toothache, etc., once the above-mentioned symptoms should promptly check the ECG, if myocardial ischemia, should be addressed urgently in order to avoid delay treatment.

 Prevention of Heart Failure Care

 To control the infusion rate and stringent control input mainly on the types of liquid. Infusion in patients with diabetes choose to use a general multi-bogey sugar, salt solution, but sodium can also increase the heart of the high burden-induced heart failure; infusion too much, too little can lead to renal dysfunction were associated with water and electrolyte disturbance occurred. Infusion in combination with monitoring of blood glucose, electrolytes, urine output, urine specific gravity infusion regulating the speed and adjust the infusion types.

 Merger of arrhythmia care

 For the occurrence of arrhythmia patients in addition to ECG monitoring, the need to Zhu Huanzhe absolute bed rest. At the same time to create a quiet environment for patients, strict control of access. Continuous low flow oxygen. Application of cardiac drugs when the need anti-virus response.

 Psychological Care

 Coronary heart disease is a kind of psychological factors associated with chronic physical diseases, this group of patients with a history of more than 10 years accounted for 84% of up to 25 years, this lifelong disease causes great suffering to patients and mental stress, there is and even despair, loss of confidence in treatment.

 Health Education

 Of health education on diabetes care in patients with coronary heart disease have a particularly important role. The purpose is to help patients develop a healthy behavior, get the best psychosomatic condition. First, let patients have a correct understanding of the illness, sure you can live like ordinary people. Health education, including the occurrence and development of this disease, prognosis, treatment, rest, functional exercise, calculate daily food intake, self-administration of insulin, self-monitoring of blood sugar, urine sugar, prevent complications, knowledge and skills to improve patient’s self-protection consciousness to detect, deal with problems.

 Health education should be extended to patients after discharge from hospital in order to avoid some of the patients hospitalized between the doctor’s advice, after discharge can not be controlled, contrary to doctor’s orders, resulting in exacerbation was again required hospitalization.

 ”Diabetes is a cardiovascular disease,” “Diabetes is a ’sugar, heart disease”‘. More and more scientific studies have been confirmed and public acceptance.

 Why should there be “sugar heart disease”

 Pathological anatomical studies have shown that patients with diabetes in both coronary arteries or cerebral arteries, renal arteries, peripheral arteries. There are more of the same age non-diabetic patients with more severe atherosclerosis.

 After the atherosclerosis. Some or all of the lumen was blocked, leading to target organ ischemia and hypoxia cause a pathological change. If blockage in coronary artery disease, that is caused by coronary atherosclerotic heart disease (CHD). Of coronary heart disease in patients with diabetes and coronary heart disease compared with patients without diabetes. The former general multivessel coronary vessel involvement, and diffuse lesions widespread, more plaque ulceration and thrombosis. Diabetes of any age can accelerate the phase of the progression of atherosclerosis. This is similar to countries in the world.

 Diabetes caused by atherosclerosis of the mechanism are manifold. High blood sugar alone is concerned, both the formation of irreversible lipoprotein glycated protein and glycosylated to increase the extent of oxidative damage may also cause blood vessel wall and endothelial damage. Promote thrombosis.

 Diabetes can also be caused by microvascular disease, there endothelial damage, basement membrane thickening, protein non-enzymatic glycation, free radical activity increased, prostaglandin anomalies and so on.

 ”Sugar Heart Disease,” What are the early signs of

 ”Sugar heart disease”, including the heart and great vessels on the microvascular disease, heart disease, cardiac autonomic neuropathy and coronary heart disease. Especially coronary heart disease is more common. Was diverse clinical manifestations. Resting tachycardia may be an early manifestation of a common. Patients may wake up in the morning when the self-test heart rate. Diabetes, heart involvement in the resting heart rate, often more than 90 times per minute

 This is because the heart have been affected by two kinds of sympathetic and parasympathetic nerves. Sympathetic heart rate accelerated to enable the parasympathetic heart rate, which regulate and coordinate the heart rate, to meet the human needs under different physiological states. Diabetic often the first heart attack early parasympathetic damage, so sympathetic in a relatively excited state. Fast heart rate gradually increased. By the late diabetes. Both sympathetic and parasympathetic damage to the heart is almost completely lost their nerve. Heart rate is relatively fixed.

 Orthostatic hypotension are more common. Normal position changes, the body can increase vascular tone and cardiac output, so that blood pressure remained normal. Diabetes orthostatic hypotension is due to autonomic control of blood vessels, especially the sympathetic nerve damage, can not effectively regulate vascular tone. If you measure a patient from a supine immediate effect of blood pressure, systolic blood pressure drop greater than 30 mm Hg, diastolic blood pressure decreased more than 20 mm Hg when. Can be diagnosed as orthostatic hypotension.

 Atypical angina pectoris caused by coronary artery spasm caused by myocardial ischemia and hypoxia. Diabetic patients often are not typical symptoms of angina, or even without any symptoms, a greater danger.

 Anti-rule as early as early as multiplier

 Diabetes, cardiovascular complications in type 2 diabetes, a major cause of death. Early detection of asymptomatic cardiovascular disease is very important, because early detection of high-risk populations can take effective preventive measures to reduce the incidence of cardiovascular disease and mortality rates. For some there is evidence of cardiovascular disease can begin with the anti-ischemic medication. Early screening can also identify the need revascularization surgery in patients with cardiovascular complications. From a number of secondary prevention study found. Aggressive treatment measures can effectively reduce the incidence of cardiovascular disease and mortality. With type 2 diabetes in the following circumstances should be carefully examined in order to identify whether the coronary artery disease and its severity.

 1. There are typical or atypical symptoms of cardiovascular disease.

 2. The basis of ECG myocardial ischemia or infarction prompted.

 3. There are peripheral vascular or carotid artery occlusive disease.

 4. A long-term sit-in way of life. The age of 35 years of age. Plans to begin intense physical exercise, when.

5. In addition to diabetes, more than two kinds of things have the following risk factors exist in patients with:

 ① total cholesterol ≥ 6.24 mmol, l, low-density lipoprotein (LDL) cholesterol ≥ 4.16 mmol, l, or high-density lipoprotein (HDL) cholesterol,

 ② blood pressure, “a

 40/90 mm Hg.

 ③ smoking.

 ④ a family history of coronary heart disease.

 ⑤ traces of urine albumin, or a large number of persons.

 For type 2 diabetes risk factor for coronary artery disease in patients with early preventive treatment should be to reduce the incidence of coronary heart disease. Lipid-lowering, blood pressure and giving aspirin to be effective means of strict blood glucose control can reduce the incidence of coronary heart disease. For existing coronary heart disease. And impaired left ventricular function. Even in patients with normal blood pressure and urinary albumin excretion, the application of angiotensin-converting enzyme inhibitors are also useful. If the patient is a clear diagnosis of asymptomatic coronary heart disease should be treated as soon as possible. Prevention of myocardial ischemia.

 ”Sugar heart disease,” the general treatment

 1. Smoking Cessation

 2. The appropriate physical activity under the condition permits, preferably three or more times per week lasted 30-60 minutes of moderate activity (such as walking, cycling, etc.).

 3. Control of body weight Body Mass Index (BMI) should be controlled at 25 kg / square meters. Particularly in patients with high blood pressure and blood lipid disorders.

 4. Controlling blood sugar fasting blood glucose should be “6.1 mmol / liter. HBA1C should be ≤ 6%.

 5. Control the primary objective of lipids LDL ≤ 2.6 mmol, l. Fight for HDL> 0.91 mmol, l, triglycerides (TG) <2.2 mmol / liter.

 First, to diet. On blood LDL and cholesterol should be limited to patients with elevated cholesterol and saturated fatty acid content of foods that are high, such as fat and liver, brain, kidneys, lungs and other offal. Bone marrow, egg yolks, rich roe, roe, animal fats and their products, coconut oil, cocoa oil, cuttlefish, eel and so on. Pairs of patients with elevated serum TG while limiting the total calorie intake, eating less sugar and sweets. Recommended to eat garlic, onions, mushrooms, seaweed, vegetables, beans and so on. Such as diet control is invalid, it should use lipid-regulating drugs.

 6. Control of blood pressure blood pressure should be controlled at 120/80 mm Hg or less.

 7. Details of life should not be fullness, reduce the mental burden. Avoid over exertion. Do not drink.

 8. Antiplatelet and anticoagulation can choose aspirin. Day 75-150 mg in patients after myocardial infarction who can not use aspirin. Can be used warfarin.

 9. Application of angiotensin-converting enzyme inhibitor on high-risk patients after myocardial infarction (anterior wall myocardial infarction, recurrent myocardial infarction, cardiac function is poor, there are symptoms of heart failure, arrhythmia) suggested that the application may be used as the treatment of patients with essential hypertension.

 As the occurrence and development of diabetes, heart disease is a very slow and hidden process. Clinical symptoms appear before the damage already have a function. Therefore, once type 2 diabetes was diagnosed. Diabetes, heart disease should be conducted on the prevention and treatment of serious about controlling risk factors such as hypertension, hyperlipidemia, obesity, smoking, high blood sugar, etc., so as to ensure that patients with diabetes to enjoy their later years.

 ”Sugar heart disease,” the clinical features of

 1, resting tachycardia, due to early stage of diabetes involving the cardiac autonomic nerve, heart rate, often tend to increase faster. In general, all resting heart rate greater than 90 times per minute, shall consider possible cardiac autonomic nerve dysfunction.

 2, painless myocardial infarction, diabetes, acute myocardial infarction in patients with far more than non-diabetic patients, case fatality rate as high as 30% a 50%. Because autonomic neuropathy is not sensitive to pain, myocardial infarction was often painless, because the typical symptoms often missed or misdiagnosed easily.

 3, orthostatic hypotension, diabetic cardiac autonomic neuropathy due to regulation of blood pressure, reflex disorders, prone to orthostatic hypotension, the patient from a supine or squatting effect immediately because of the sudden reduction in blood pressure, dizziness and even loss of consciousness, etc. .

 4, sudden death due to cardiac autonomic neuropathy and functional disorders, diabetes, heart disease may be due to a variety of stress, infection, anesthesia, etc. lead to sudden death, manifested as severe arrhythmia or cardiogenic shock, patients feel only a short-lived chest tightness, palpitations After the rapid development of a serious shock or coma and even death.

 Diuretic antihypertensive drugs: the majority of hypertensive patients with diabetes mellitus complicated by fluid retention, so a small amount of diuretic antihypertensive drugs may improve blood pressure. However, diuretic antihypertensive drugs can cause hypoglycemia in patients with non-insulin-dependent diabetes mellitus, and to reduce insulin secretion, sensitivity decreased, so that deterioration of glucose tolerance, there may affect the uric acid and lipid metabolism, and therefore can not serve as the preferred drug, may be short-term use.

 Calcium antagonist: nifedipine GITS, such as the new worship the same, can inhibit the flow of calcium ions to cells, relaxation of vascular smooth muscle, reducing the role of peripheral vascular resistance, which can lower blood pressure, but the brain, coronary and renal blood flow is not reduced. Ischemic heart disease, cerebral vascular dysfunction in diabetic patients with hypertension, but also a better antihypertensive drugs. Calcium antagonist does not affect glucose and lipid metabolism, therefore, it is preferred in patients with diabetes mellitus complicated with hypertension antihypertensive drugs.

 Angiotensin-converting enzyme inhibitors: A dimercaptopropane candied acid can increase insulin sensitivity 11%, for the elderly has a good step-down light effects of high blood pressure, blood pressure, while also improving insulin sensitivity. Of sugar, not only does not adversely affect lipid metabolism can also serve to improve the effect, so for diabetes with hypertension is undoubtedly the first choice antihypertensive drugs, renal dysfunction, but unfit for use.

 Vasodilator: The hydralazine as a vasodilator antihypertensive drugs represented, may have a role in improving insulin sensitivity, but does not affect glucose tolerance, while the role of another vasodilator, increasing blood flow, therefore, patients with diabetes mellitus complicated with hypertension can be use this drug.

 At present, China has reached more than 4000 million diabetes patients control blood sugar at the same time, prevent cardiovascular and cerebrovascular complications is particularly important. Over the years the popularity of diabetes knowledge, many patients with diabetes know that controlling blood sugar in diabetes an important part of the course of treatment. Unfortunately, many patients do not realize that cardiovascular and cerebrovascular diseases are the most serious complication of diabetes, both share a common pathogenesis of “soil.” In fact, as early as in 2001, the U.S. intervention in the National Adult cholesterol guidelines clearly suggested that “diabetes is coronary heart disease risk equivalents.” Numerous studies also confirmed that about 2 / 3 of patients with coronary heart disease combined with hyperglycemia, but up to 3 / 4 of people with diabetes eventually die of thrombotic disease.

 In heart and brain vascular events in the chain, atherosclerosis is buried in the blood vessels inside the “curse”, artery wall plaque rupture, thrombosis is the culprit that triggered the event. Thrombosis occurred in heart, then lead to coronary heart disease, myocardial infarction; occurred in the brain, while leading to stroke, cerebral infarction; occurred in the limbs, peripheral arterial disease is triggered, leading to necrosis of the legs and feet. Professor Jin reminded to reduce cardiovascular and cerebrovascular events in a key step is to prevent platelet aggregation, prevent thrombosis, and prevention and treatment of thrombotic diseases, the most economical and most effective drugs are low-dose aspirin.

 High blood pressure young people approaching

 ”Hypertensive diseases in 50 to 60 years of age the highest incidence rates in this age group, but there has been development trend of younger age, and even some primary and secondary hypertension has become a ‘prisoner’.” Hypertensive patients under the age of 35 accounted for 20% of the more than ten years ago, an increase doubled. Life is not the law, work pressure, high-sugar, high fat diet, lack of exercise, smoking and so on, have become an important reason for hypertension.

  “Most of the cardiovascular disease is preventable.” King said, the prevention of hypertension should start with, pay attention to physical exercise, lose weight, prevent weight gain; to ensure a good night’s sleep, avoid stress; restricting salt, animal oils and high cholesterol foods intake, eat calcium, magnesium and other nutrients in food. High blood pressure occurs, must be under the guidance of a doctor taking blood pressure drugs, to avoid the heart, brain, kidneys and other vital organs are damaged, life-threatening.

  Hypertension is a multi-genetic disease. Professor Jin reminds 40-year-old middle-aged man and father suffering from hyperlipidemia, high blood pressure, should be alert to changes in blood pressure, if the fluctuations in blood lipids, is likely to be an early performance of high blood pressure, when the look at cardiovascular doctor.

  High cholesterol level is too low tend to hinder the health of

  Caused by high cholesterol, heart disease and stroke and other cardiovascular and cerebrovascular diseases, has become China’s first national cause of death. High blood pressure, diabetes, hypercholesterolemia, obesity, smoking and cardiovascular and cerebrovascular diseases are important risk factors. In recent years, hypercholesterolemia caused by the incidence of myocardial infarction increased significantly. At the same time, while it strengthened the prevention and treatment of high blood pressure, cerebral bleeding greatly reduced, but because of the attention and control of cholesterol is not enough, resulting in an increase of ischemic stroke, but also makes the high incidence of stroke.

 But experts also said that cholesterol was not lower the better, cholesterol is too low will be harmful to health. Over the past 10 years, scientists have found that cholesterol in anti-cancer effect that can not be ignored. Low blood cholesterol levels in vivo of people suffering from colon cancer chances are people with higher cholesterol levels of 3 times.