Hello! Thank you for asking on HCM! Regarding yuor concern, I would recommend to make every effort t ocontrol his obvious cardio-vascular risk factors. (1) A fasting blood glucose 198 mg/dl is an indicator of diabetes. I would recommend to perform also a postprandial blood glucose, and HbA1c; and after that to consult wit han endocrinologist for an appropriate antidiabetic therapy, coupled with subsequent medical advices on how to manage his hypercaloric diet (and avoid excess carbohydrates, lipids, spicy foods, etc), and check his blood glucose. (2) Facing your high lipid profile and presence of diabetes, It is recommended to start a therapy in conjunction wit hdiet modulation. A statin preparation (Atorvastatin, Rosuvastatin, etc) would be a useful option. (3) Avoid smoking, and smoking contacts, as it is considered an important coronary risk factors. If smoking cesation is not successful, than the above efforts will be partially beneficial. (4) Reduce body weight and start a schedule physical activity program. This would help cardio-vascular protection and control better diabetes. You need to discuss with the attending doctor about the above issues. Hope to have been helpful! Greetings! Dr. Iliri