People who have heart disease have a much greater chance of having a heart attack than those who don't. In fact, more than twenty out of every one hundred people with heart disease will have recurrent heart disease within ten years. Heart disease, for the purpose of estimating this risk, is broadly defined and includes coronary artery disease as well as diseases of the arteries outside of the heart. Atherosclerosis in the arteries outside of the heart is generally called peripheral artery disease and can include blockages or enlargements (aneurysms) that affect the neck (carotid), abdominal (aortic), or leg arteries. Symptoms of peripheral arterial disease depend on the site of the blockage, but they can include sudden loss of vision; pain in the calf, thigh, or buttocks when walking; or impotence. 195
We now know that diabetes carries similar risks for heart health. So if you have any of the previously mentioned heart conditions, especially in combination with diabetes, you'll probably be in the most aggressive treatment group (very high risk), so you can skip over the next few steps that help determine that category and go to Step 6. If you have diabetes but are very young and free from heart disease or other risk factors, you might not need such aggressive treatment. If you fall into that category, you will most likely be in the high-risk category; skip to Step 6.
If you don't have a heart problem or diabetes, go to Step 3.
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