Cardiovascular Disease
Approach
Diabetic patients have a fourfold chance of having both macrovascular and microvascular disease. Smoking, dyslipidemia, insulin resistance, homocysteine levels, emotional stress, and lack of general antioxidants due to the oxidation of LDL and low levels of vitamin E all need to be considered when treating diabetic patients with high cardiovascular risk factor.
The clinical signs of ischemic heart disease in diabetic patients are different than in other patients. Diabetic patients often will have a silent ischemia, making it more difficult to diagnose. Patients may have no pain, just nausea or sweating. Thyroid hormone therapy has to be used cautiously with diabetics due to its potential of increasing cardiac blood flow. Hypertension drugs can decrease insulin sensitivity, so whenever possible, natural medicine should be used in place of prescription antihypertensives.
Clinical Nutrition
Inositol Hexanaicinate: Inositol hexanaicinate works well in lowering lipid levels.
B Vitamins: Homocysteine levels also should be checked because high levels can injure the endothelial cells of the vascular system, resulting in increased platelet utilization and the formation of atherosclerotic disturbances, resulting in hypertension. One study found that men with very high levels of homocysteine were three times more likely to have a myocardial infarction, even while taking in consideration lipid levels. Homocysteine can be lowered with the simple addition of vitamins B-12 (1000 mcg), B-6 (50 mg), and folic acid (1 mg).
Vitamin E: Helps prevent protein glycosylation, thereby indirectly decreasing atherosclerotic hypertension.
Alpha-lipoic Acid: Also helps prevent protein glycosylation, thereby indirectly decreasing atherosclerotic hypertension.
Botanical Medicine
Snakeroot (Rauwolfia serpentina): Rauwolfia serpentina is a very reliable herbal treatment to lower severe hypertension. It is also an excellent remedy for anxiety and insomnia that often accompanies a hypertensive patient. However, like most prescription drugs for hypertension, some patients do complain of feeling tired when on Rauwolfia.
Hawthorne Berry (Cratagus oxycanthus): Moderate hypertension can be safely treated with hawthorne berry. It is extremely high in flavonoids that help limit atherosclerosis. It has the ability to help regulate tension, low or high, and is able to strengthen the heart muscle, as evidenced by clinical trials on the analysis in the ejection of the heart.
Traditional Chinese Medicine
Red Yeast: Lipid lowering therapy can be very well treated with the traditional Chinese medicine red yeast that contains at least nine statin compounds. Unlike its pharmaceutical counterpart, it contains only one statin isolate, and has no known history of causing liver disease.
Acupuncture: Acupuncture lowers blood pressure. Studies have shown that its hypotensive effects can last a year after the treatments have been finished, while pharmaceuticals never can be stopped.
Conventional Allopathic Treatment
ACE Inhibitors: ACE inhibitors are the drugs of choice in diabetic hypertension patients. ACE inhibitors have shown to reduce progression to renal failure by 50% in Type I patients in stage 4 diabetic nephropathy. However, diabetics may develop severe complications with the use of antihypertensive drugs, including altered symptoms of hypoglycemia from beta-blockers, intensified fluid retention from sympathetic inhibitors, and worsened hyperglycemia from diuretics.
Lipid-lowering Therapy: Lipid-lowering therapy improves cardiac outcomes in diabetic patients. A study in Scandinavia on the use of statin drugs and diabetic cardiac outcome was assessed. The Scandinavian study was performed on over 4,000 patients. There was a 55% reduction in major cardiovascular events, including myocardial infarction, in patients treated with simvastatin. However, statin drugs have a history of causing liver disease.
