Cardiovascular System

Autonomic neuropathy can affect the nerves that control your heart rate and blood pressure. In people who do not have diabetes, heart rate and blood pressure change slightly all throughout the day in response to lying, sitting, standing, stress, exercise, breathing patterns and sleep. If the nerves have been damaged by diabetes, the heart rate and blood pressure may respond more slowly to these factors.

Problems

• Your heart may beat too fast, and the rate won't adjust when you sleep or exercise.
• This nerve damage may also cause low blood pressure when you stand up. You could get dizzy, light headed, or pass out.

People who have autonomic neuropathy are at greater risk for a silent heart attack. This is a heart attack without pain. Since you are unable to feel chest pain, sudden shortness of breath may be your only sign of a heart attack.

This nerve disease also increases the risk of sudden death and sudden, abrupt loss of a heartbeat. Both problems are caused by damage to the nerves that supply the heart and the nerves that control blood pressure.

Prevention of nerve damage.
Remember, with good blood sugar control you can prevent nerve damage. To reduce the risk of nerve damage, strive to:

• Keep your hemoglobin A1c at 7% or less (a 3 month average blood sugar test)
• Control blood pressure
• Don't smoke
• Eat a healthy diet
• Exercise most days
• Avoid or limit alcohol
• Have routine heart exams (EKG, BP, stress test)

Questions?
If you have further questions about treatment for nerve disease of the cardiovascular system, contact your diabetes healthcare team.

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