Q: My father had a mild heart attack earlier this year. At present he is quite well and is on Sorbitrate 10 mg 3 times daily; Tonact ASP 75 Bedtime and Amaryl before breakfast 1 daily. I need a second opinion on these. He is a diabetic patient as well.

A:The medicines are fine. They can prevent further blockages but do little for cholesterol blocks that have already formed. What he needs is a stress test (ECG treadmill test or Exercise ECHO test or Stress nuclear test) to quantify the degree and importance of blocks. If there are large areas that are not getting enough blood supply he will need a coronary angiogram followed by revascularisation (angioplasty or CABG). The goals for diabetics are as follows: FBS <110, PPBS <140 to 150, HbA1C <6.7 (it tells you average glucose levels over 3 months), LDL-Cholesterol <70mg/dl, HDL- Cholesterol >45 mg/dl, Triglycerides <150 mg/dl; Urine Albumin- Nil, BP< 130/85, TMT negative at 9+ minutes of exercise, Ideal body weight (wt in kg) / height in meters square <25. He may also benefit from a group of drugs called ACE Inhibitors especially if he has marginally increased BP or albumin in his urine. He may also benefit from higher doses of atorvastatin especially if his LDL cholesterol is higher than 100mg%.