Cardiovascular Disease in Diabetes and Chronic Kidney Disease

People with type 2 diabetes are at a higher risk for developing chronic kidney disease (CKD) and cardiovascular disease. Having both type 2 diabetes and CKD can multiply their risk for developing cardiovascular disease.¹

The umbrella term “cardiovascular disease” includes several diseases that affect the heart or blood vessels. Cardiovascular disease can lead to blocked arteries or other conditions that can damage the heart. Eventually, this can cause a heart attack, stroke, or heart failure.^1,2

Although diabetes alone can increase the risk for cardiovascular disease, research shows that this risk is much higher in people who have both diabetes and CKD. And CKD is common in people with diabetes. About 40 percent of people with diabetes develop CKD.¹

One of the goals of diabetes treatment is to lower a person’s chances of developing CKD. Treatment also lowers their chances of developing cardiovascular disease.¹

How diabetes affects the heart and kidneys

Type 2 diabetes can affect the heart and kidneys in several ways.

High blood sugar

People with type 2 diabetes have a high amount of sugar in their blood. High blood sugar levels can negatively affect many parts of the body, including the heart and kidneys.^2,3

High blood sugar can damage the inner lining of the blood vessels. This inner lining plays an important role in making sure blood can flow to the heart and other organs. When the lining gets damaged, blood vessels can become narrowed or blood clots can form. Eventually, this can block blood flow and lead to serious problems.^2,3

If blood flow to the kidneys gets blocked, the kidneys may be damaged. This can lead to CKD. Similarly, if blood flow to the heart gets blocked, cardiovascular disease and heart failure may occur.^2,3

Finally, insulin and certain other drugs used to treat high blood sugar can increase the risk for cardiovascular disease.^2,3

Fat buildup

Type 2 diabetes can increase the amount of lipids, or fats, in the blood. High lipid levels in the blood make it more likely for fat to build up in the blood vessels. This fat buildup can block blood flow.^2,3

Fat buildup in blood vessels also can lead to atherosclerosis. This term means hardening or stiffening of the arteries. Stiff arteries can lead to high blood pressure, a risk factor for cardiovascular disease.^2,3

How to lower your risk for cardiovascular disease

If you have been diagnosed with type 2 diabetes, visit your healthcare provider regularly to monitor the health of your kidneys and heart. To lower your risk of developing cardiovascular disease, your provider may use different treatments to manage your:⁴

• Blood pressure
• Lipid levels
• Blood sugar levels

Some lifestyle changes may also help. These can include:⁴

• Regular exercise
• Maintaining a healthy weight
• Eating a healthy diet
• Not smoking

Treatments

Your healthcare provider may suggest certain treatments to prevent CKD and cardiovascular disease. Certain types of prescription drugs can help lower the risk of damage to the kidneys or the heart. These drugs include:^1-4

• Glucagon-like peptide-1 (GLP-1) receptor agonists
• Sodium-glucose cotransporter-2 (SGLT2) inhibitors
• Nonsteroidal mineralocorticoid receptor antagonists (MRAs)
• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers (ARBs)
• Beta-blockers
• Calcium channel blockers
• Statins

These drugs each reduce the risk of CKD and cardiovascular disease in a different way. The goal of these treatments is to maintain healthy blood pressure, blood sugar, and lipid levels. Depending on your situation, some of these drugs may work better than others. Also, combining drugs from different classes may increase the benefits. Talk to your doctor about what treatment may be right for you.^3,4