Heart attack and stroke are the most important causes of death in people with diabetes. It is important for people with diabetes to know their risk for heart attacks and stroke and take steps to prevent them.

One way to find out about your risk of heart attack and stroke is to use a computer program. Computer programs use information about things that affect your risk. These things are called “risk factors.” The risk factors include your age, sex, blood pressure, cholesterol level, and whether you smoke. Some of the computer programs also use your blood glucose level. These programs do not include some risk factors, including your weight or family history of heart attack, because those factors, while important, do not improve the accuracy of the programs' risk calculations very much.

One program, Heart to Heart, is available on the Internet at www.med-decisions.com. You will need your most recent blood pressure and cholesterol levels (both the total and HDL [“good”] cholesterol). The program will ask you to enter your information, and then it will show you your risk of having heart attack during the next 10 years. Using the program takes about 5 minutes.

Here is an example. Imagine a 45-year-old woman with diabetes. She does not smoke. She has known that she has diabetes for 5 years. She exercises regularly, walking for 30 minutes three times per week. Her blood pressure is 130/80 mmHg. She recently had a cholesterol test at work. It showed a total cholesterol level of 230 mg/dl and an HDL cholesterol level of 60 mg/dl. She wants to know her risk of heart disease. The computer program estimates the risk of heart attack or heart-related chest pain as being 6% over the next 10 years. That means if there were 100 people just like this patient, about six would be expected to develop heart disease in the next decade.

Once you know your risk, you can consider ways to lower it if it is too high. Most doctors consider a risk of 10% or more over 10 years to be too high. There are several ways to lower risk, including taking aspirin, treating high blood pressure, lowering cholesterol, better controlling your blood glucose, and exercising more. Discuss your options with your doctor, and choose the ones that are best for you. You may want to consider issues such as the possible side effects, costs, and ease or difficulty of the various options to help you decide which are best for you.