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Diabetes - preventing heart attack and stroke

Lower your risks

People with diabetes have a higher chance of having heart attacks and strokes. Smoking and having high blood pressure and high cholesterol increase these risks even more. Controlling blood sugar, blood pressure, and cholesterol levels 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 chance of having a heart attack or a stroke by being active or exercising every day. For instance, a daily 30-minute walk each day can help lower your risks.

Other things you can do to lower your risks are:

  • Follow your meal plan and watch how much you eat. This can help you lose weight if you are overweight or obese.
  • Do not smoke cigarettes. Talk with your doctor if you need help quitting.
  • Take your medicines the way your doctor and nurse recommend.
  • Do not miss doctor's appointments.

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. Medicines called statins are almost always used. You should learn how to take your statin medicine and how to watch for side effects. Your doctor will tell you if there is a target LDL level you need to aim for.

If you have other risk factors for heart disease or stroke, your doctor 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 or obese) can lower your blood pressure. If your blood pressure is too high, your doctor will prescribe medicines 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 a new 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 may lower your chance of having a heart attack. 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 a man over 50 or a woman over 60
  • 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.

Aronson D, Edelman ER. Coronary artery disease and diabetes mellitus. Cardiol Clin. 2014;32;439-455.

Semenovich CF, Goldberg AC, Goldberg IJ. Disorders of lipid metabolism. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, PA: Elsevier Saunders; 2011: chap 37.

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. J Am Coll Cardiol. 2014;63(25 Pt B):2889-2934.


Review Date: 8/5/2014
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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