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The globe artichoke is one of the oldest known cultivated vegetables, originating from Ethiopia, with Italy currently being the world’s largest producer.

It was valued in ancient Greece and Rome as a digestive aid, available only to the wealthy due to its scarcity.

It was the French and Spanish explorers who fist brought artichokes to the shores of the United States, and today virtually all of the globe artichokes grown in the US are produced in Castroville, California.

Health Benefits of Artichokes

* Nutrients
Globe artichokes are an excellent source of dietary fiber, magnesium, and the trace mineral chromium. They are a very good source of vitamin C, folic acid, biotin, and the trace mineral manganese. They are a good source of niacin, riboflavin, thiamin, vitamin A, and potassium.

* Cholesterol
There have been numerous studies on artichoke extract ever since European scientists first discovered cynarin’s ability to lower cholesterol in the 1970’s. Caffeoylquinic acids, such as cynarin are the active ingredients in artichokes that lower cholesterol, with higher concentrations in the leaves. A 6 week double blind, placebo controlled clinical trial of 143 patients has demonstrated without a doubt to the effectiveness of artichoke leaf extract for lowering cholesterol. The decrease of total cholesterol in the group that received the extract was 18.5% compared to 8.6% in for the placebo group. LDL-cholesterol decrease in the AE group was 22.9% and 6.3% for placebo. LDL/HDL ratio showed a decrease of 20.2% in the AE group and 7.2% in the placebo group.. A compound found in artichoke called luteolinis is also believed to assist with reducing cholesterol.

* Irritable bowel syndrome
In a trial involving 208 adults, results provide support for the notion that artichoke leaf extract has potential value in relieving IBS symptoms.

* Indigestion
In a double-blind trial, 247 patients with dyspepsia (digestive problems) were treated with artichoke leaf extract, and the results demonstrated an improvement in their dyspeptic symptoms. Dyspepsia is often attributed to insufficient flow of bile from the gallbladder, and there is evidence that artichoke leaf has the ability to stimulate this flow.

* Diabetes
The carbohydrate in artichokes is in the form of inulin, which has been shown to stabilize blood sugar levels in diabetics. The artichokes must be fresh, as the inulin will eventually convert to other sugars as the artichoke ages.

* Hangovers
Contrary to what some would like to believe, a study demonstrated the ineffectiveness of artichoke extract in the cure of alcohol-induced hangovers.

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Triglyceride is a fat-like substance produced in your body. High triglyceride level can occure due to obesity, cigarette smoking, alcohol drinking, lack of physical activity and a diet very high in carbohydrates. High triglyceride level usually leads to high total level of cholesterol with high bad cholesterol level and low good cholesterol level. High triglyceride level in blood can also be a sign of diabetes mellitus and/or heart disease.

Blood triglyceride level depend on age and sex. Women tend to have higher triglyceride levels than men do, and as they get older, their cholesterol and triglyceride levels tend to rise.

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Cholesterol is a lipid, a type of fat found in the body. Having high “bad” cholesterol means you have too much LDL in your blood. LDL is low-density lipoprotein, or “bad” cholesterol.

Too much cholesterol in the blood, or high cholesterol, can be serious. People with high cholesterol are at risk of getting heart disease. This can lead to a heart attack or stroke.

Only about 20% of cholesterol comes from the foods you eat. The other 80% is made by your body. Things such as age and family health history affect how much cholesterol your body makes.

Cholesterol levels tend to rise as you get older. Unfortunately, there are usually no signs that you have high cholesterol. But it can be detected with a blood test. These tests can also help your doctor predict what your risk for heart disease may be.

Total Cholesterol

Your blood test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). The total number is based on:

* LDL (”bad” cholesterol)
* HDL (”good” cholesterol)
* Triglyceride (a type of fat found in your blood) levels

Total Cholesterol Levels / What It Means

Less than 200 mg/dL / Desirable
200-239 mg/dL / Borderline high risk for heart disease
240 mg/dL and above / High risk for heart disease

The 2 Types of Cholesterol: LDL and HDL

Bad cholesterol: Low-density lipoprotein (LDL)

Too much LDL in your blood can clog arteries. This can increase the risk of heart attack and stroke.

Good cholesterol: High-density lipoprotein (HDL)

High levels of HDL can help protect you from a heart attack or stroke. HDL carries cholesterol from the body’s tissues to the liver. So, low levels of HDL can increase the risk of heart disease.

If you’re worried about high cholesterol and heart disease, make an appointment to speak with your doctor. LIPITOR is clinically proven to lower bad cholesterol 39-60%, when diet and exercise are not enough (average effect depending on dose).

LIPITOR is a prescription drug. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (”good” cholesterol) or smoking to reduce the risk of heart attack and stroke. When diet and exercise alone are not enough, LIPITOR is used along with a low-fat diet and exercise to lower cholesterol.

LIPITOR is also used in patients with type 2 diabetes and at least one other risk factor for heart disease such as high blood pressure, smoking or complications of diabetes, including eye disease and protein in urine, to reduce the risk of heart attack and stroke.

LIPITOR is not for everyone. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

If you take LIPITOR, tell your doctor if you feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Tell your doctor about all medications you take. This may help avoid serious drug interactions. Your doctor should do blood tests to check your liver function before and during treatment and may adjust your dose. The most common side effects are gas, constipation, stomach pain and heartburn. They tend to be mild and often go away.

When diet and exercise alone are not enough, adding LIPITOR can help. LIPITOR is one of many cholesterol-lowering treatment options that you and your doctor can consider.

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Pfizer Inc announced today that Lipitor® (atorvastatin calcium) 80 mg reduced the risk of heart attack and stroke by 32 percent in patients who have heart disease and chronic kidney disease compared with patients taking the 10 mg dose of Lipitor. This analysis, designed and completed following the closure of the five-year Treating to New Targets (TNT) study, was published in the “Journal of the American College of Cardiology.”

“People with chronic kidney disease are more likely to die from heart disease than to develop kidney failure,” said Dr. James Shepherd, a member of the TNT steering committee and clinical academic consultant, department of pathological biochemistry, University of Glasgow Medical School. “It is critical for us to find new ways to reduce cardiovascular burden in these patients. Intensive statin therapy seems to be at least part of the solution.”

The primary endpoint of the TNT study was the reduction of major cardiovascular events, including death from heart disease, non-fatal heart attacks, resuscitated cardiac arrest, and fatal or non-fatal strokes. This sub-analysis studied 3,107 patients with moderate to severe chronic kidney disease, as defined using a standard measure of kidney function. The efficacy results in this analysis were primarily driven by reductions in heart attack and stroke. Both doses of Lipitor (80 mg and 10 mg) were well tolerated. Lipitor 80 mg is not a starting dose. The safety of Lipitor 80 mg in patients with chronic kidney disease was similar to that reported for the overall TNT population, with no unexpected safety concerns identified.

“The results of this analysis complement the large body of evidence from multiple clinical trials demonstrating the cardiovascular benefits of Lipitor,” said Halit Bander, Ph.D. senior director of Pfizer’s global cardiovascular metabolic medical team.

About Chronic Kidney Disease

An estimated 26 million Americans and 50 million people worldwide have chronic kidney disease, or permanent kidney damage due to injury or disease. Patients with chronic kidney disease do not effectively filter toxins from the blood. When chronic kidney disease progresses to kidney failure, either dialysis or a kidney transplant is needed. Chronic kidney disease recently has been recognized as an important risk factor for cardiovascular disease, the leading cause of death and illness in patients with kidney disease.

About the TNT Study

The TNT study was a landmark investigator-led trial coordinated by an independent steering committee and funded by Pfizer. It was the largest study to date evaluating the efficacy and safety of Lipitor 80 mg. The study enrolled 10,001 men and women with coronary heart disease aged 35 years to 75 years in 14 countries and followed them for an average of five years. The safety of Lipitor 80 mg in patients with chronic kidney disease was similar to that reported for the overall TNT population, with no unexpected safety concerns identified.

About Lipitor

Lipitor is the only statin proven to provide a combination of impressive average LDL (“bad” cholesterol) lowering of 39 percent to 60 percent, significant and proven cardiovascular event reductions, and a well-established safety profile across a broad range of patients.

It is the most prescribed cholesterol-lowering therapy in the world, with nearly 151 million patient-years of experience. Lipitor is supported by an extensive clinical trial program involving more than 400 ongoing and completed trials with more than 80,000 patients.

Important U.S. Prescribing Information

Lipitor is a prescription medication. It is used in patients with multiple risk factors for heart disease such as family history, high blood pressure, age, low HDL (“good” cholesterol) or smoking to reduce the risk of a heart attack, stroke, certain types of heart surgery and chest pain.

Lipitor is also used in patients with type 2 diabetes and at least one other risk factor for heart disease such as high blood pressure, smoking or complications of diabetes, including eye disease and protein in urine, to reduce the risk of heart attack and stroke.

Lipitor is used in patients with existing coronary heart disease to reduce the risk of heart attack, stroke, certain kinds of heart surgery, hospitalization for heart failure, and chest pain.

When diet and exercise alone are not enough, Lipitor is used along with a low-fat diet and exercise to lower cholesterol.

Lipitor is not for everyone. It is not for those with liver problems. And it is not for women who are nursing, pregnant or may become pregnant.

Patients taking Lipitor should tell their doctors if they feel any new muscle pain or weakness. This could be a sign of rare but serious muscle side effects. Patients should tell their doctors about all medications they take. This may help avoid serious drug interactions. Doctors should do blood tests to check liver function before and during treatment and may adjust the dose. The most common side effects are gas, constipation, stomach pain and heartburn. They tend to be mild and often go away.

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LIPITOR is indicated as an adjunct to diet for reduction of elevated total-cholesterol, LDL-cholesterol, apolipoprotein-B, and triglyceride levels in patients with primary hypercholesterolaemia; mixed dyslipidaemia; and heterozygous familial hypercholesterolaemia.

LIPITOR is also indicated to reduce total-C and LDL-C in patients with homozygous familial hypercholesterolaemia as an adjunct to other lipid-lowering treatments (e.g. LDL apheresis) or if such treatments are unavailable.

Therapy with lipid-lowering agents should be a component of multiple-risk-factor intervention in individuals at increased risk of atherosclerotic vascular disease due to hypercholesterolaemia. Lipid-altering agents should be used in addition to a diet restricted in saturated fat and cholesterol only when the response to diet and other non-pharmacological measures has been inadequate.

Prior to initiating therapy with LIPITOR, secondary causes for hypercholesterolaemia (e.g. poorly controlled diabetes mellitus, hypothyroidism, nephrotic syndrome, dysproteinaemias, obstructive liver disease, other drug therapy, and alcoholism) should be excluded, and a lipid profile performed to measure total-C, LDL-C, HDL-C, and TG.

Are there other drugs for lowering cholesterol?

Yes, the most common are the other statins besides atorvastatin. Statins are also referred to as HMG CoA reductase inhibitors and include: simvastatin, rosuvastatin, atorvastatin (Lipitor), fluvastatin, lovastatin, and pravastatin, all of which are sold under their respective brandnames. There are also generic versions of the following statins available: simvastatin, pravastatin and lovastatin.

Another class of drugs that lower cholesterol is the bile acid sequestrants which include: colesevelam, cholestyramine, colestipol, and nicotinic acid (niacin).

Other cholesterol lowering drugs include gemfibrozil, and two drugs discontinued in the US, probucol and clofibrate (Atromid-S).

Rhabdomyolysis with or without renal impairment has been reported with the use of HMG-CoA reductase inhibitors.

Myalgia has been reported in patients treated with LIPITOR. Myopathy, defined as muscle aching or muscle weakness in conjunction with increases in creatine phosphokinase (CPK) values greater than 10 times the upper limit of normal, should be considered in any patient with diffuse myalgias, muscle tenderness or weakness, and/or marked elevation of CPK. Patients should be advised to report promptly any unexplained muscle pain, tenderness or weakness, particularly if accompanied by malaise or fever. LIPITOR therapy should be discontinued if markedly elevated CPK levels occur or myopathy is diagnosed or suspected.

As with other HMG-CoA reductase inhibitors, the risk of myopathy during treatment with LIPITOR is increased with concurrent administration of immunosuppressive drugs, including cyclosporine, fibric acid derivatives, nicotinic acid, azole antifungals or erythromycin.

LIPITOR therapy should be withdrawn in any patient with an acute, serious condition suggestive of a myopathy or having a risk factor predisposing to the development of renal failure secondary to rhabdomyolysis, (eg, severe acute infection, hypotension, major surgery, trauma, severe metabolic, endocrine and electrolyte disorders, and uncontrolled seizures).

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Nearly all people with diabetes have abnormal cholesterol levels, which contribute to their increased risk for heart attack and stroke.

With diabetes, heart attacks occur earlier in life and often result in death. To lower your risk, you need to take action today and lower your cholesterol levels.

What is cholesterol?

Cholesterol is a waxy, fat-like substance that is in all the body’s cells, including the blood. It is critical in building cells and in creating certain hormones.

Your body makes all of the cholesterol it needs. Cholesterol is also found in some food you eat. Cholesterol can’t dissolve in the blood. It needs to be carried from cell to cell by carriers called lipoproteins. There are two types of lipoproteins.

Low-density lipoprotein (LDL) is known as “bad” cholesterol. High-density lipoprotein (HDL) is known as “good” cholesterol.

These two, along with triglycerides, make up your total cholesterol count, which can be determined through a blood test ordered by your doctor.

How does cholesterol work?

LDL cholesterol circulates in the blood and slowly builds up in the inner walls of the arteries. High levels of LDL can stick to the lining of the arteries (blood vessels), leading to atherosclerosis or hardening of the arteries. Atherosclerosis “plaque” is a thick, hard deposit that can narrow the arteries and make them less flexible. If the arteries that supply the heart and brain with blood become blocked with plaque a heart attack or stroke can occur.

HDL cholesterol also circulates in the blood, but its job is to protect against heart attack.

Medical experts think that HDL helps the body by carrying LDL away from the arteries and back to the liver, where it’s passed from the body. Some experts also believe that HDL removes excess cholesterol from arterial plaque, therefore slowing its buildup.

Desirable lab values for LDL is less than 100mg/dl and HDL should be more than 50mg/dl.

What are triglycerides?

Triglyceride is a form of fat in the body. It provides much of the energy needed for cells to function. Calories eaten in a meal and not used immediately by your body are converted to triglycerides and transported to fat cells to be stored. High levels of triglyceride can be due to obesity, inactivity, cigarette smoking, excess alcohol consumption and a diet very high in carbohydrates (60 percent of total calories or more).

Desirable lab values for triglycerides should be lower than 150mg/dl.

Where do they come from?

Dietary cholesterol and triglycerides mainly come from eating animal products and saturated fat.

Foods such as egg yolks, meat, poultry, shellfish and whole and reduced-fat milk and dairy products contain cholesterol and triglycerides. Trans fats can also raise blood cholesterol.

Lowering LDL; raising HDL

According to the American Heart Association, the recommendation is to limit your average daily cholesterol to less than 300 milligrams a day.

If you have heart disease, they recommend limiting the daily intake to less than 200 milligrams. To lower your daily cholesterol intake, you must read the nutritional facts on the food items. By eating lean meat, fish, poultry and fat-free and low-fat dairy products, you can lower your risk of heart disease. Foods from plants (fruits, vegetables, grains, nuts and seeds) don’t contain cholesterol.

If your HDL levels are low, you are at risk for heart disease.

To raise your HDL levels, you should stay physically active, maintain a healthy weight, avoid smoking, cut trans fats and increase monounsaturated fats in your meal plan.

Monounsaturated fats include canola oil, avocado oil or olive oil. You can also add soluble fiber such as oats, fruits, vegetables and legumes.

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Two out of three people with diabetes will die from heart disease or stroke. But those who are proactive with controlling cholesterol and blood pressure stand a much better chance of avoiding trouble.

In this week’s Dealing with Diabetes report, a local heart specialist considers diabetes to be more than just a risk factor.

As a diabetic, Las Vegas resident Irma Park knows the importance of controlling her cholesterol. And it’s a constant challenge. Park was able to quit smoking, but adjusting her diet is proving harder than she thought.

“I can’t pass up anything that looks good to me,” said Park.

Las Vegas cardiologist, James Mock says diabetics can do themselves a favor by trying their best to lead a healthy lifestyle. “One of the things that we’re going to really focus on with that diabetic patient is lifestyle modification. Lose weight as a beginning. Exercise, lose weight, attempt to lower the carbohydrate intake in your diet,” he said.

Poor circulation increases the prevalence of heart disease among diabetics to the point where some doctors automatically assume it’s going to be a problem.

“We treat the diabetic patient as we would treat a patient who’s already had a heart attack,” said Dr. Mock. And that means following strict guidelines for blood pressure and cholesterol.

“People with diabetes, our goals are changed. In terms of blood pressure lowering, we want them to have a much lower blood pressure than the non-diabetic patient. We want them to have a much lower bad cholesterol, or LDL cholesterol as compared to the non-diabetic patient. Why — because we assume they already have blocked arteries,” said Dr. Mock.

Dr. Mock says high blood pressure can also result in kidney failure and the need for dialysis — another reason to be compliant with doctor’s orders.

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A couple of weeks ago Dr. Alicia Fernandez, an associate professor of clinical medicine at UC San Francisco, received a very unusual letter from The International Association of EMTS and Paramedics, an affiliate of The National Association of Government Employees (IAEP/SEIU).

The letter began by noting that Fernandez is part of the union’s approved physician network, and then launched into what can only be described as a shameless sales pitch for Lipitor, Pfizer’s blockbuster cholesterol-lowering drug.

First, the alarming statistics presented in the letter:

* 1 in 3 adults has some form of CVD (cardio-vascular disease)
* About every 26 seconds, an American will suffer a coronary event
* Stroke is a leading cause of serious, long-term disability in the United States
* Every 45 seconds, someone will suffer a stroke.

Then, the endorsement: “Lipitor is available to our members through their prescription plan. IAEP leadership stands behind LIPITOR as the lipid-lowering agent of choice when it is prescribed by a physician. This confidence in LIPITOR is based on its proven efficacy and is supported by its vast clinical experience of more than 15 years…”

The letter went on, at length, to praise Lipitor’s benefits and to downplay the drug’s risks. In clinical trials, the letter states, “the most common adverse events were constipation, flatulence, dyspepsia and abdominal pain.” But while other risks may not be as “common” they are certainly worth mentioning. They include memory loss which can look like Alzheimer’s and severe muscle pain.

A few days ago, Fernandez received a second, identical letter. Never before in her professional experience had she received a drug ad from a union.

“I’ve never seen anything like this. I’ve never seen Labor endorse a drug product,” she told me. “This is incredible.” Unfortunately, Fernandez adds, this is not the first time that she has seen a drug company use a progressive organization to promote its product. …

Why would Pfizer need the union’s help in peddling its drug? Lipitor, after all, is the best-selling drug in the world, with sales of almost $13 billion in 2006.

But recently, Lipitor has been attracting some decidedly negative publicity.

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Lipoproteins are molecules that consists proteins and fat. Lipoprotein can transport cholesterol through the blood. Lipoproteins circulate in the blood and contain cholesterol, fat and protein in varying levels according to the need of your body.

How can you classify lipoproteins?

There are five classifications of lipoproteins. The good lipoprotein refers to High Density Lipoproteins (HDL) and bad lipoprotein refers to Low Density Lipoproteins, called as LDL. Lipoproteins differ in their level of proteins and lipids. High Density Lipoproteins, Very Low Density Lipoproteins (VLDL), Intermediate Density Lipoproteins (IDL), Chylomicrons, Low Density Lipoproteins and Lipoprotein (a) are the main kind of the lipoproteins.

What are the risk factors of lipoprotein?

Atherosclerosis, heart attack, angina, stroke, aneurysm are some of the risk factors. Abnormalities in the levels of lipoproteins can cause the risk of atherosclerosis. Atherosclerosis is hardening of the arteries which can lead to heart attack, angina and stroke. Lipoprotein (a) is similar to low density lipoprotein cholesterol. Both are rich in cholesterol and their higher level can cause atherosclerosis. A blood test can help to find out lipoprotein-a, and its risks for heart problems.

Blood accumulating under the skin (hematoma), fainting and excessive bleeding are some of the other risk factors apart from heart disorders. Atherosclerosis can harden the arteries; make cholesterol deposition and blockage in the arteries. Smoking, diabetes and high blood pressure can also be risk factors of the atherosclerosis.

What are the recommended levels of lipoproteins in blood?

The desirable total cholesterol level is- minimum 200 mg/dl and the maximum should be 240 mg/dl. But the patients with atherosclerotic disease should maintain around 200 mg/dl. A minimum level of triglecerides is 200 mg/dl and the maximum level is 400 mg/dl. Minimum level of Low density lipoproteins (LDL) is 130 mg/dl and the maximum level is 160 mg/dl. But for the atherosclerotic patients 100 mg/dl is recommended. Less than 35 mg/dl of HDL cholesterol level is considered to be low. The average level of HDL cholesterol is 45 mg/dl to 55 mg/dl. The higher level of HDL cholesterol can cause atherosclerotic disease. However, low cholesterol levels of triglycerides, LDL and HDL will increase the risk of atherosclerotic disease.

How are lipoproteins levels managed?

Low density lipoproteins

If the LDL cholesterol is higher than desirable level, that can be reduced by eating low fat diet. Weight loss and the intake of soluble fiber such as oatmeal, beans and psyllium products can also help. Drug treatment is needed if you have very high LDL cholesterol levels with risk factors of atherosclerotic disorder.

High density lipoproteins (HDL)

Low HDL cholesterol should be raised by exercise. If you are having the habit of smoking, then by quitting your smoking, you can improve HDL level. Medications are rarely used in the treatment of low HDL.

Triglyceride

High triglyceride levels can be controlled by weight loss, reducing alcohol intake and minimizing estrogen-containing pills. If you are a diabetic patient, control of diabetes can help. You can use medications for very high triglyceride levels.

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If you have diabetes, your risk of having a heart attack is the same as a non-diabetic who has had a heart attack. So make heart health a priority.

What things can and should you do? First, make sure you have a doctor. People who have no physician are likely to have more advanced health problems than those who see the doctor regularly. This should seem like common sense, but too many people avoid seeing a doctor. Many lack health insurance. Others may see the doctor but may not follow the doctor’s recommendations.

Prevention is far better than having to treat heart disease. Maintaining a healthy blood pressure is one way to reduce your risk. Millions of Americans suffer from untreated high blood pressure, which accelerates heart damage.

Millions also smoke, which competes with high blood pressure as being the single greatest accelerant to heart disease.

So if you want to lower your risk profile for heart disease if you have diabetes, stop smoking and treat your high blood pressure.

Yes, stopping smoking is easier said than done. Most adult smokers started their habit during their teen years, when they were most susceptible to the addictive properties of nicotine. But most smokers need more than just doctor’s orders to kick the habit. Smoking cessation programs are available. If you have diabetes, no other single behavior does more harm than smoking. Make smoking a priority to stop — by whatever means possible.

Reducing risks

Diet has much to do with health. Getting a proper balance of fruits and vegetables can reduce heart disease risks, as can regular physical activity. A daily walk can do more to reduce your risk of heart disease than many prescription medications. But make sure you have proper medical clearance before embarking on an exercise program for your diabetes and heart.

Daily aspirin therapy has been shown to reduce risks to the heart in people with and without diabetes. The common dose prescribed for non-diabetic patients is 81 milligrams per day. Medical evidence shows that diabetics are resistant to that dose. Some researchers recommend that 162 milligrams would be better. But discuss this with your doctor.

By age 35, all diabetics should have yearly electrocardiograms. This painless test can reveal possible problems and may prevent a more serious one. An exercise stress test also can reveal problems within the heart. Diabetics are more likely to have silent heart disease, which further delays getting a proper diagnosis.

Controlling blood pressure is a must for diabetics. Not only is high blood pressure more common in diabetes, but its presence acts as an accelerant to coronary artery disease. Many medicines are effective for high blood pressure. Lowering salt intake also should not be ignored. We all have too much salt in our diets.

One class of blood pressure medicines is especially helpful for diabetics. These are called ACE inhibitors, short for angiotensin converting enzyme inhibitors. They are characterized by the word “pril” attached to the end of the name of the drug’s generic form.

Examples include enalapril, lisinopril and captopril. Not only do these drugs effectively lower blood pressure in diabetics, but they also lower the risk of kidney damage. This is a great bargain, given the high risk of kidney failure in persons with diabetes.

Cholesterol levels down

High cholesterol is a widespread problem. Diabetics are more prone to having high cholesterol and triglyceride levels, collectively known as lipids.

Keeping blood lipid levels as low as possible is key to preventing and even reversing cholesterol plaques within the coronary arteries, which give rise to heart attacks and strokes. While changes in diet are part of the management, it may require a combination of medications to keep the “bad” cholesterol levels (known as LDL) low. Medications known as fibrates are helpful in controlling triglyceride levels. Statins such as atorvastatin (Lipitor) help to reduce “bad” LDL cholesterol.

Good diabetes control helps to lower both triglycerides and LDL.

Conclusion

Keeping heart disease in check (or preventing it altogether) in diabetics starts with keeping your diabetes in the best possible control, as reflected in your hemoglobin A1C test (which is best kept below 7 percent).

Blood pressure and cholesterol levels must be kept in normal ranges by changes in diet and lifestyle, with perhaps some help from prescription medicines. Finally, getting regular heart checkups by your doctor after age 35 will do the most to prevent a cardiac “surprise” one day.

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