Why Diabetes Boosts the Risk of Heart Attack and Stroke

Heart attacks and strokes are the number one causes of death in people with diabetes. To help prevent heart attack and stroke, you'll need to keep a sharp eye on your cholesterol and blood pressure, in addition to watching your blood glucose levels.

Blood pressure is a biggie—it's also a major factor in the risk of kidney and eye problems.

"Blood pressure control is extremely important, because high blood pressure can lead to the same kinds of complications as high blood sugar," says William Bornstein, MD, an endocrinologist at the Emory Clinic in Atlanta. "And so in people with diabetes it's that much more important to control the blood pressure. Same with high cholesterol."

In a landmark study of more than 5,000 patients with type 2 diabetes, researchers in the United Kingdom found that lowering hemoglobin A1C levels (by controlling blood sugar) to a median of 7% reduced the "microvascular" (small blood vessel) complications that threaten the eyes, kidneys, and nerves.

But it was blood pressure control that reduced heart problems (a "macrovascular," or large blood-vessel complication) in addition to microvascular problems.