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Diabetes - preventing heart attack and stroke

Lower your risks

People with diabetes have a higher risk for heart attacks and strokes. High blood pressure and high cholesterol increase these risks even more. Controlling blood pressure and cholesterol are very important for preventing heart attacks and strokes.

See your doctor who treats your diabetes often. During these visits, health care providers will check your cholesterol, blood sugar, and blood pressure. You may also be instructed to take medicines.

You can lower your risks of heart attack and stroke by exercising every day . For instance, a daily 30-minute walk each day can lower your risk.

Other things you can do to lower your risk are:

  • Follow your meal plan and watch how much you eat.
  • Do not smoke cigarettes. Talk with your doctor if you need help quitting.
  • Take your medicines the way your doctor and nurse instruct you to.
  • Do not miss doctor's appointments.
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Cholesterol

When you have extra cholesterol in your blood, it builds up inside the walls of your heart's arteries (blood vessels). This buildup is called plaque. It narrows your arteries and reduces or stops blood flow. This can lead to heart attack, stroke, or other serious heart disease.

Most people with diabetes are prescribed a medicine to reduce their LDL cholesterol levels. A group of medicines called statins are almost always used. You should learn how to take your statin medicine and how to watch for side effects.

Doctors used to set a target LDL cholesterol level of between 70 and 100 mg/dL for people with diabetes. Now, there is no specific target number.

If you have other risk factors for heart disease or stroke, your provider may prescribe higher doses of a statin drug.

Your doctor should check your cholesterol levels at least once a year.

Eat foods that are low in fat and learn how to shop for and cook foods that are healthy for your heart .

Get plenty of exercise, as well. Talk with your doctor about what kinds of exercises are right for you.

Blood pressure

Have your blood pressure checked often. You can have it checked at a fire station or a drugstore. Your doctor or nurse should check your blood pressure at every visit. For most people with diabetes, a good blood pressure goal is less than 130 to 140 over 80 mm Hg. Ask your doctor what is best for you.

Exercising, eating low-salt foods, and losing weight (if you are overweight) can lower your blood pressure. If your blood pressure is too high, your doctor will prescribe drugs to lower it.

Before you exercise

Getting exercise will help you control your diabetes and make your heart stronger. Always talk with your doctor before you start an exercise program or before you increase the amount of exercise you are doing. Some people with diabetes may have heart problems and not know it because they do not have symptoms.

Taking aspirin may help

Taking aspirin every day lowers your risk for heart attacks. The recommended dose is 81 mg a day. Do not take aspirin without talking to your doctor first. Ask your doctor about taking an aspirin every day if:

  • You are over 50 years old (men) or 60 years old (women).
  • You have had heart problems.
  • People in your family have had heart problems.
  • You have high blood pressure or high cholesterol levels.
  • You are a smoker.

References

American Diabetes Association. Standards of medical care in diabetes -- 2014. Diabetes Care. 2014; 37 Suppl 1:S14-S80.

Stone NJ, Robinson J, Lichtenstein AH, Bairey Merz N, Lloyd-Jones DM, et al. 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults. JACC. In press.

Stone NJ, Robinson JG, Lichtenstein AH, Goff DC Jr, Lloyd-Jones DM, Smith SC Jr, et al. Treatment of blood cholesterol to reduce atherosclerotic cardiovascular disease risk in adults: synopsis of the 2013 American College of Cardiology/American Heart Association cholesterol guideline. Ann Intern Med. 2014 Mar 4;160(5):339-343.

Pencina MJ, Navar-Boggan AM, D'Agostino RB Sr, Williams K, Neely B, Sniderman AD, Peterson ED. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014 Apr 10;370(15):1422-1431. Epub 2014 Mar 19.

Updated: 9/4/2012

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. A.D.A.M. Editorial Update: 05/14/2014


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