10 Tips for Preventing Heart Disease and stroke

If you have diabetes, heart disease can be a serious concern. In fact, cardiovascular disease leading to heart attack or stroke is by far the leading cause of death in both men and women with diabetes, says Dr. Ganda, a board-certified specialist in Internal Medicine, Endocrinology and Metabolism, and Clinical Nutrition, a Senior Physician in the Section on Adult Diabetes at Joslin, and an Associate Clinical Professor of Medicine at Harvard Medical School. "The good news is that there are steps to take to reduce your risk for heart disease if you have diabetes," says Dr. Ganda.

1. Control your weight. One of the most important things you can do if you have diabetes is maintain a healthy weight. If you are overweight, talk to a registered dietitian about healthy ways to lose weight.
   
2. Get regular physical activity. There is a significant body of research that proves the myriad cardiovascular benefits of regular physical activity (that goes beyond weight loss). Start off slowly, and build a plan that works well for you and meets your needs. The Joslin Diabetes Center offers one-on-one consultations with clinical exercise physiologists that are covered by many insurance providers. These sessions are considered diabetes education—not training sessions—and can start you on the path toward physical fitness.
3. Don’t smoke or expose yourself to second-hand smoke. . If you already do, make plans to begin a smoking cessation program. "Nicotine narrows and restricts blood vessels; diabetes will also do the same thing to your blood vessels.. You can't change having diabetes. But you can stop damage caused by nicotine," says Dr. Ganda.
4. Maintain tight control over glucose. Tight control can prevent many complications from diabetes and also protects your heart. Shoot for an A1C reading of less than 7%.
5. Lower your LDL cholesterol (the "bad" type). Both the American Diabetes Association and the American Heart Association recommend an LDL cholesterol goal of less than 100 mg/dl. Dr. Ganda recommends eating fiber-rich foods, such as fruits, vegetables, and whole grains. Also, he recommends asking your healthcare provider about omega-3 fish oil supplements.
6. Control your blood pressure. All people with diabetes should aim for a blood pressure reading of less than 130/80, advises Dr. Ganda.
7. Consider incorporating aspirin into your daily routine. If you are older than thirty  years of age, you may want to speak to your doctor about taking a baby aspirin daily. In addition, taking a multivitamin can be extremely helpful for those with diabetes, says Dr. Ganda.
8.  Know your risks.The most influential risk factor for cardiovascular disease is age – the older you are, the greater your risk. The second is your genetic make-up. Although everyone is excited by the scientific progress in genomics research, conclusive gene tests are still in their infancy. But, as I tell our medical students, “A good family history is a poor man’s gene test.” We have long known that if your parents, grandparents, or other relatives were afflicted with or died of heart disease, diabetes or stroke, your risk is much greater.
9.  Reduce stress.Stress contributes to cardiovascular disease and, if severe, can cause a heart attack or sudden death. There are plenty of options that help reduce stress, such as regular exercise, adequate sleep, striving for a good marriage, laughing, volunteering or attending religious services. Watching TV generally does not relieve, but can aggravate stress. Also, try to avoid situations and people who make you anxious or angry. 
10. Stay informed: Science changes constantly. The only constant is change. This is especially true in medicine as new techniques and new insights develop constantly. Do not believe every piece of “scientific information” you find in the media or advertisements. An overwhelming number of research studies that make it into scientific publications are poorly designed or yield data that are not representative, e.g., due to a lack of a sufficient number of participants. Keep in mind that many studies are financed or sponsored by individuals or companies with a vested interest in gaining favorable results. The situation can be especially confusing when scientific studies yield different or even contradicting results, and this happens quite often