<s>[INST] My father is 58yrs old. His TMT was mildly positive for reversible ischaemia. He exercised for 8 mins 21 sec of the  Bruce protocol and achieved a workload pf 10.1 mets. Peak heart beat of 146 beats/min. Ther was no S3 and S4 gallop in the recovery period. At peak exercise there was 1.4-1.5 mm ST segment depression in keas 2,3aVF. Changes reverse  within one minute post exercise.He is diabetic with fastic sugar 155 and PP 244. He is smoker and with High BP. kindly advise. [/INST] Hi, changes of ischemia present. To prevent further ischemia and heart damage antihypertensive has to be started (enalapril or amlodipine).sugar level should get controlled. For that take low sugar diet. If still not controlled start metformin. Strictly avoid smoke to prevent heart attack. Avoid high lipid diet and fast foods. Take more water. Low salt diet should be taken. Here damage to heart can't be reverted now. But further ischemic attack can be prevented. Take aspirin tablet regularly. If lipid high atorvastatin started </s>