Taking Care of Your Heart

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Maybe your health care provider has told you that you are at high risk for heart disease.  Or, perhaps you already have had a heart attack.  Having diabetes means that you are much more likely to have coronary artery (heart) disease, a heart attack, or a stroke.

The good news is that you can take steps to prevent heart disease or reduce your chances of having another heart attack.  Lifestyle changes, such as choosing foods wisely and being physically active, as well as taking medication can help. 

What is coronary artery disease?

Coronary artery disease is caused by a narrowing or blocking of the blood vessels that go to your heart.  It’s the most common form of heart disease.  Your blood carries oxygen and other needed materials to your heart.  Blood vessels to your heart can become partially or totally blocked by fatty deposits.  A heart attack occurs when the blood supply to your heart is reduced or cut off.

What steps can I take to prevent coronary artery disease?

You can lower your risk by keeping your ABCs of diabetes on target with wise food choices, physical activity, and medication.  Losing weight can also help you manage your ABCs and prevent heart disease.   Every step you take will help.  The closer your numbers are to your targets, the better your chances of preventing heart disease or cutting your risk for another heart attack.  If you smoke, get help to quit.

A is for A-1-C

An A-1-C is the blood glucose (sugar) check “with a memory.”  It tells you your average blood glucose for the past 2 to 3 months.  The American Diabetes Association (ADA) recommends that people aim for an A-1-C below 7.

B is for blood pressure

Your blood pressure numbers tell you the force of blood inside your blood vessels.  When your blood pressure is high, your heart has to work harder than it should.  The ADA recommends that you keep your blood pressure below 130/80 (said as “130 over 80”) mmHg.

C is for cholesterol

Your cholesterol numbers tell you the amount of fat in your blood.  Some kinds, like HDL cholesterol, help protect your heart.  Other kinds, like LDL cholesterol, can clog your blood vessels and lead to heart disease.  Triglycerides are another kind of blood fat that raises your risk for heart disease.  The chart below gives the targets suggested by the ADA. 

Type of Blood Lipid	ADA Targets
LDL cholesterol	Below 100 mg/dl
HDL cholesterol for men for women	Above 40 mg/dl Above 50 mg/dl
Triglycerides	Below 150 mg/dl

What can I do to reach my ABC targets?

Making wise food choices, being physically active, and taking medications can help you reach your targets.

Make wise food choices

Many people find that changing what they eat can make a big difference in their blood glucose, blood pressure, and cholesterol levels.  Below are several strategies for making wise food choices.  Determine which ones you would be willing to try.  For more information about how to make these changes, talk with your health care team.

• I’ll eat less fat, especially saturated fat (found in fatty meats, poultry skin, butter, 2% or whole milk, ice cream, cheese, palm oil, coconut oil, trans fats, hydrogenated oils, lard, and shortening).
  

• I’ll choose lean meats and meat substitutes.
  

• I’ll switch to low-fat or fat-free dairy products.
  

• I’ll eat at least 5 servings of fruits and vegetables each day.
  

• I’ll cut back on foods that are high in cholesterol (such as egg yolks, high-fat meat and poultry, and high-fat dairy products).
  

• I’ll choose the kinds of fat that can help lower my cholesterol, such as olive oil or canola oil.  Nuts also have a healthy type of fat.
  

• I’ll eat fish two or three times a week, choosing kinds that are high in heart-protective fat (such as albacore tuna, herring, mackerel, rainbow trout, sardines, and salmon).
  

• I’ll cook using low-fat methods (such as baking, roasting, or grilling foods or by using nonstick pans and cooking sprays).
  

• I’ll eat more foods that are high in fiber (such as oatmeal, oat bran, dried beans and peas like kidney beans, fruits, and vegetables). 
  

• I’ll eat less salt and sodium.

Lose weight or take steps to prevent weight gain

• I’ll cut down on calories and fat.
  

• I’ll try to be more physically active than I am now.

Be physically active

Before you start a new routine, check with your health care team to find out which activities will be safe for you.  Then think about how you can add more activity to your routine.  If you’re just starting out, begin with 5 minutes a day and gradually add more time.  Then work up to doing a total of about 30 minutes of aerobic exercise, such as brisk walking, most days of the week.

Take medications

Medications are available to help you reach your ABC targets and lower your risk of another heart attack.  You may need several medications to stay on track. 

Some types of blood pressure and cholesterol-lowering medications can protect your heart.  Your health care provider can provide information about which medications are best for you.

Aspirin can also help lower your risk of heart disease.  Ask your provider whether taking a low-dose aspirin every day would be wise.

What can help me quit smoking?

If you’re ready to quit, talk with your health care team.  They can help you find ways to quit.   Joining a support group or smoking-cessation program can also help.