• high blood pressure
• lipid disorders
• high LDL (bad) cholesterol
• high triglycerides
• low HDL (good) cholesterol
• smoking
• obesity
• lack of physical activity
• poorly controlled blood sugars (too high) or out of normal range

Another emerging risk factor is insulin resistance, a core metabolic dysfunction of type 2 diabetes.

Understanding insulin resistance

Insulin resistance is a condition in which the body doesn't respond efficiently to the insulin it makes. According to Gene Therapy Weekly, it affects about 60 million people in the United States. One in four of them will develop type 2 diabetes when their body becomes unable to maintain normal insulin and glucose levels.

Here’s a list of conditions typically found in people with type 2 diabetes, and an explanation of how they contribute to a patient's risk for developing cardiovascular disease:

• Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin resistance. Insulin resistance may be a mechanism by which obesity leads to cardiovascular disease.
  
  Weight loss can improve cardiovascular risk, decrease insulin concentration and increase insulin sensitivity. Obesity and insulin resistance also has been associated with other risk factors, such as high blood pressure. Learn how to manage your weight.
  
  
• Physical Inactivity is another modifiable major risk factor for insulin resistance and cardiovascular disease. Exercising and losing weight can prevent or delay the onset of type 2 diabetes, reduce blood pressure and help reduce the risk for heart attack and stroke.
  
  It's likely that any type of physical activity — whether sports, household work, gardening or work-related physical activity — is similarly beneficial. 
  
• Hypertension (high blood pressure) has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When a person has both hypertension and diabetes, a common combination, their risk for cardiovascular disease doubles. Learn more.
  
  
• Dyslipidemia  Atherogenic dyslipidemia, often called diabetic dyslipidemia in people with diabetes, is a condition associated with insulin resistance. This type of dyslipidemia is characterized by high levels of triglycerides (hypertriglyceridemia), high levels of small LDL particles and low levels of HDL. This lipid triad often occurs in patients with premature coronary heart disease.
  
  Growing evidence suggests that all of the components of the lipid triad can contribute to the development of atherosclerosis (fatty buildups in artery walls) and can be considered a risk factor. Even though most patients with diabetes don't have marked elevations of LDL cholesterol, their levels are high enough to support the development of atherosclerosis. Learn more about diabetes and cholesterol. 

This content is reviewed regularly. Last updated 03/06/09.