Diabetes - preventing heart attack and stroke

Alternate Names

Lower Your Risk

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

See the health care providers who treat your diabetes often. Your doctor will check your cholesterol, blood sugar, and blood pressure. You may be asked to take medicines.

See also: Diabetes - tests and checkups

A healthy lifestyle, especially watching how much you eat and exercising every day, can help prevent heart attack and stroke. A daily 30-minute walk will lower your risk.

Other things you can do to lower your risk are:

• Follow your meal plan.
• Exercise if you can. See also: Diabetes and exercise
• Do not smoke cigarettes. Talk with your doctor or nurse if you need help quitting.
• Take your medicines the way your doctor and nurse ask you to.
• Do not miss appoints.

See also: Managing your blood sugar

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 even stops, blood flow. This can cause a heart attack, stroke, or other serious heart disease.

Your doctor should check your cholesterol level at least once a year. Cholesterol target goals (in mg/dL) for adults are:

• Total cholesterol should be less than 200
• HDL ("good") cholesterol should be greater than 40 for men, and greater than 50 for women.
• LDL("bad") cholesterol should be less than 100 for men and women.

If you already have heart problems, your doctor may tell you that having an LDL level below 70 is better.

Your doctor may ask you to take medicines to lower your cholesterol. There are several kinds of drugs to help lower blood cholesterol levels. They work in different ways.

See also: Cholesterol - drug treatment

If you change your lifestyle and lose a lot of weight (and keep it off), you can stop taking cholesterol medicine:

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

Getting plenty of exercise will also help. Talk with your doctor about what kind of exercise is 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 and nurse should check your blood pressure at every visit. Your blood pressure should be less than 130/80 mm/Hg.

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.

Signs of Heart Attack and Stroke

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References

American Diabetes Association. Standards of medical care in diabetes -- 2010. Diabetes Care. 2010 Jan;33 Suppl 1:S11-61.

Inzucchi SE, Sherwin RS. Type 2 diabetes mellitus. In: Goldman L and Ausiello D, eds. Cecil Medicine. 23rd ed. Saunders; 2007: chap 248.

In the clinic. Type 2 diabetes. Ann Intern Med. 2010 Mar 2;152(5):ITC1-16.