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Effects of Cardiac disease and diabetes in the pro-
gression of stroke
Although, not directly implicated, the effects of car-
diac disease and diabetes go hand in hand in pro-
mulgating the end point of stroke. Amongst the two
entities , diabetes seems to have a bigger role in
the evolution of either entities and stroke. The main
mechanisms that can be attributed to the develop-
ment of stroke in a patient with both cardiac disease
and diabetes include 1. Increased endothelial damage
and dysfunction which promotes atherosclerosis 2.
Autonomic dysregulation which precipitates arrhyth-
mias in a pre existing cardiac disease and thereby
causing reduced blood flow and increased stasis pro-
moting clot formation 3. Increased systemic inflam-
mation 4. Increased coagulation, reduced fibrinolysis,
increased platelet activation which promotes aggre-
gation and therefore a thrombotic event 5. Increased
stiffness of vessel walls thereby causing increased
systemic resistance in a pre-existing damaged heart
,subsequently worsening the cardiac functions and
beginning a cascade of events that ends in a chain
reaction till the cessation of blood flow occurs to ei-
ther the heart or the brain.
Conclusion
Although significant gains have been undertaken
to reduce the burden of stroke in the community
the recent rise in rates of diabetes and cardiac dis-
ease threatens to reverse these advances. Improving
stroke outcomes in individuals with diabetes and car-
diac disease requires prompt and persistent imple-
mentation of evidence-based medical therapies as
well as adoption of beneficial lifestyle practices.

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