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Diabetes: Lower Your Risk for Heart Attack and Stroke

Topic Overview

It's true—diabetes raises your risk of heart disease. That means your risks of heart attack and stroke are higher when you have diabetes. Diabetes is plenty to keep up with as it is. That explains why dealing with both heart risk and diabetes can seem like too much all at once.

But it's also true that good heart-health care has a lot in common with good diabetes care.

  • Most healthy choices that help control your diabetes also help your heart.
  • Add a few heart-healthy habits, and you'll lower your heart disease risk.

How are heart disease and diabetes connected?

Experts do not fully understand how diabetes affects the heart. Heart disease can be caused by high blood sugar, insulin resistance, high cholesterol, and high blood pressure. But genetics and lifestyle may also affect a person's risk. For example, if you smoke, you are at a higher risk for heart and blood vessel disease than someone who does not smoke.

Your risk of having heart disease is even higher if you have:

  • High blood pressure, which pushes blood through the arteries with too much force. Over time, this damages the walls of the arteries.
  • High cholesterol, which causes the buildup of a kind of fat inside the blood vessel walls. This buildup can lower blood flow to the heart muscle and raise your risk for a heart attack.
  • Kidney damage, which shares many of the risk factors for heart disease (such as high blood sugar, high blood pressure, and high cholesterol).

How can you lower your heart disease risk?

You can lower your heart disease risk by:

  • Keeping your cholesterol numbers at healthy levels.
  • Controlling your blood sugar.
  • Lowering your blood pressure if it's high.
  • Not smoking.

This isn't as hard as it might sound. Many of the same healthy habits help control your blood sugar, blood pressure, cholesterol, and weight.

You're probably already doing more for your heart than you think.

Eat wisely

Plan your foods with diabetes in mind. Then think heart-healthy, and make changes if needed.

  • Start with your carbs.

    • Try to eat about the same amount of carbohydrate throughout the day. This helps keep your blood sugar in a healthy range.
    • Use your favourite way to balance your carbs. Do you prefer carb counting or the plate format?
  • Add a heart-healthy focus.

    • Choose foods that are high in fibre and low in saturated fat, trans fat, and salt. That means fruits, vegetables, whole grains, and low-fat meats and dairy.
    • Cook with oil instead of butter.
    • Limit salty, processed foods such as crackers, chips, cookies, and canned soups.
    • If you need food tips that are healthy for both your heart and your diabetes, work with a registered dietitian.

You can choose from several heart-healthy eating plans to help control your blood pressure and cholesterol.

Be active

Being active is good for your diabetes and for your heart. It helps manage your blood pressure, blood sugar, and cholesterol. And it plays a key part in controlling your weight. In turn, a healthy weight also helps control your diabetes and heart risk.

    • Talk to your doctor before you start an exercise program.
    • Choose a way to be active that you enjoy. Walking is a good choice if you're just starting out or your time is limited. Resistance exercise also helps to improve your fitness level and improve your blood sugar control.
    • Day by day or week by week, add a little more time or effort to your activity. Build up to at least 2½ hours of moderate to vigorous activity per week. Try to include resistance exercises at least 2 times a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.footnote 1

Watch and track your levels

  • Test your blood sugar levels. Know your blood sugar goals. Test your levels at home, and get your diabetes A1c tests on schedule. Every day, do your best to keep your blood sugar about the same, within your target range.
  • Know your blood pressure. Think about taking your blood pressure at home. Keep a record, and share it with your doctor. Your doctor will give you a goal that's right for you. If you have diabetes and your blood pressure is high, your treatment may also include blood pressure medicine.
  • Know your cholesterol. Get your cholesterol tested on schedule. Know your LDL and HDL cholesterol numbers, and ask your doctor what your cholesterol goal is. LDL is the "bad" cholesterol, the kind that can clog your arteries. HDL is the "good" cholesterol. A high level of HDL is linked with a lower risk for having a heart attack.

Keep good health at the top of your list

  • Work closely with your health professionals. Make sure that each doctor you see has all of your medical information, including test results. If you have questions about tests, medicines, exercise, or a healthy diet, talk to your doctor or a registered dietitian.
  • Don't smoke. Smoking raises your risk of a heart attack or stroke. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can make it easier to quit for good.
  • Take your medicine every day, as prescribed. Medicines work only as long as you are taking them. For example, your doctor may recommend you take a statin medicine to lower cholesterol and your risk of heart attack and stroke. Or your doctor may recommend daily aspirin, if you both decide it is right for you.



  1. Canadian Society for Exercise Physiology (2011). Canadian Physical Activity Guidelines For Adults. Available online: Accessed October 28, 2014.
  2. Diabetes Canada Clinical Practice Guidelines Expert Committee, et al. (2018). Physical activity and diabetes. Canadian Journal of Diabetes, 42(Suppl 1): S54–S63. DOI: 10.1016/j.jcjd.2017.10.008. Accessed October 15, 2018.

Other Works Consulted

  • American Diabetes Association (2017). Standards of medical care in diabetes—2017. Diabetes Care, 40(Suppl 1): S1–S135.
  • De Ferranti SD, et al. (2014). Type 1 diabetes mellitus and cardiovascular disease: A scientific statement from the American Heart Association and American Diabetes Association. Diabetes Care, published online August 11, 2014. DOI: 10.2337/dc14-1720. Accessed September 4, 2014.
  • Eckel RH, et al. (2013). 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. Accessed December 5, 2013.
  • Fox CS, et al. (2015). Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: A scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care, 38(9):1777–1803. DOI: 10.2337/dci15-0012. Accessed September 29, 2015.
  • Low Wang CC, et al. (2016). Cardiovascular disease in diabetes mellitus: Atherosclerotic cardiovascular disease and heart failure in type 2 diabetes mellitus—Mechanisms, management, and clinical considerations. Circulation, 133: 2459–2502. DOI:10.1161/CIRCULATIONAHA.116.022194. Accessed November 25, 2016.
  • Skyler JS, et al. (2009). Intensive glycemic control and the prevention of cardiovascular events: Implications of the ACCORD, ADVANCE, and VA Diabetes Trials: A position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association. Diabetes Care, 32(1), 187–192.
  • Smith SC, et al. (2011). AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: A guideline from the American Heart Association and American College of Cardiology Foundation. Circulation, 124(22): 2458–2473. Also available online:


Adaptation Date: 4/28/2022

Adapted By: HealthLink BC

Adaptation Reviewed By: HealthLink BC