Case Study - JD

JD is a 56yr old caucasian male with a 10yr history of hypertension and 5 yr history of NIDDM. He is assymptomatic and had come to see me for a medical checkup. There is no family history of note. He does not smoke and drinks socially (some wine). Physical examination shows a BP of 150/90mmHg and HR 80/min. Precordial examination was unremarkable. He does have a left carotid bruit. His lipid profile is as shown, (F) T.Cholesterol - 6.3 mMols/L, HDL-C 0.9mMols/L, LDL-C 4.0mMols/L and TG 2.7 mMols/L.. (F) Sugar 7.5mMols/L, HbA1C 7.4%.

Q1 : Do you think Mr JD is likely to have CAD?
Q2 : What screening test would you carry out to check him for the presence or absence of CAD?
Q3 : What should his target BP be?
Q4 : How would you manage his dyslipidemia?