Prevention methods for heart attacks
Risk factor modification is a major goal of prevention, both for first attacks and repeat heart attacks. Patients are urged to reduce behaviors that are associated with heart attack, such as smoking, and adopt healthy lifestyle habits that have been shown to prevent heart attacks, such as exercising and eating a heart-healthy diet. By altering these risk factors, it may be possible to slow the progression of atherosclerosis, which is the leading cause of heart attacks.
The American Heart Association (AHA) recommends that people have their blood pressure, body mass index (BMI), waist circumference and pulse checked at least every two years, beginning at age 20. Cholesterol tests and glucose tests are to be checked at least every five years. Such risk factors, according to the AHA, can be used to estimate the risk of developing heart disease within a 10-year period.
Specific recommended changes include:
Improving your cholesterol ratio. A person’s total cholesterol level (which includes LDL cholesterol, HDL cholesterol and triglycerides) should be no more than 200 milligrams per deciliter and no more than five times the HDL level. Key strategies for reducing levels of total cholesterol, LDL cholesterol and triglycerides are to eat a heart-healthy diet and to exercise regularly. If these strategies do not reduce total cholesterol levels, a physician may prescribe cholesterol-reducing drugs (e.g., statins). Strategies for increasing levels of HDL cholesterol include eating monounsaturated fats in moderation, decreasing the amount of saturated fat, limiting alcohol use and starting an exercise program.
Exercising regularly. Exercise can be an excellent tool in the both prevention of heart disease and improving quality of life for heart patients. Physically, it can slow or even reverse the process of atherosclerosis, as well as lower blood pressure and reduce cholesterol levels. Emotionally, it can reduce levels of stress and depression.
Achieving and maintaining a healthy weight. Obesity and being overweight are major risk factors for a host of serious health conditions, including coronary artery disease, high blood pressure, diabetes, heart attack and stroke. Some weight control methods include limiting calories, increasing activity, counseling, medication and surgical interventions.
Eating a heart-healthy diet. Modern research has consistently supported the idea that health is largely determined by what people choose to eat. Certain B-vitamins and minerals have been shown to be helpful to heart health. Omega-3 fatty acids found in certain fish (e.g., tuna, salmon and sardines) may keep arteries healthy and elastic. Saturated fats and tropical oils (palm and coconut oil), however, have been shown to be harmful, because they can speed up the development of coronary artery disease, atherosclerosis and obesity. Trans fat, in particular, has been linked to damage to the heart.
Quitting smoking and avoiding all second–hand smoke. Tobacco smoking is a major cause of coronary artery disease and cardiac arrest. According to the United States Centers for Disease Control and Prevention (CDC), from 1995 to 1999, nearly 450,000 people in the United States died prematurely from smoking. Of these, nearly 150,000 deaths were attributed to cardiovascular diseases and nearly 125,000 were attributed to lung cancer. The CDC also estimates that second–hand smoke was responsible for more than 35,000 deaths from ischemic heart disease (and 3,000 deaths from lung cancer) annually during the same five-year period.
Controlling blood pressure. Individuals with high blood pressure (hypertension) are at greater risk of heart attack and other problems resulting from cardiovascular disease. Current research suggests that hypertension can bring on changes in genes involved in heart function. This contributes to a process known as remodeling, where there is enlargement and weakening of the heart’s left ventricle (left ventricular hypertrophy). Cells involved in heart muscle contraction become impaired and eventually self-destruct, leading to heart failure. Hypertension can be controlled through taking blood pressure medications, self-monitoring, eating a heart-healthy, low-salt diet, and engaging in regular exercise. People are also encouraged to have regular check-ups with their physician.
Controlling diabetes. People with diabetes may be more likely to develop heart-related diseases. Good glucose control is essential for all diabetics, as well as weight loss and a healthy diet. All type 1 diabetics will require insulin therapy, while type 2 diabetics can be treated with a number of additional medications that help control glucose levels. Non-insulin drugs used to treat type 2 diabetes include metformin and acarbose.
Learning and practicing stress management techniques. Stress, excessive anger and fatigue can lead to high-risk practices such as overeating, smoking, high blood pressure (hypertension) and a lack of exercise. In addition, chronic stress may be a direct contributor to poor heart health because it produces increases in blood pressure that could become permanent. Anxiety has also been linked to an increased risk for future health problems in men who have suffered a heart attack.
Avoiding high levels of homocysteine by getting enough B-vitamins. There is considerable debate over the role of homocysteine in heart disease. Homocysteine is an amino acid that is produced as a byproduct of other chemical reactions in the body. Numerous studies have shown that people with elevated homocysteine are at greater risk for heart attack, stroke and other cardiovascular problems. However, researchers have been unable to determine if elevated homocysteine levels are caused by heart disease, or if they cause heart disease. Also, two large, well-designed studies have recently shown that moderately lowering homocysteine among people with diabetes and existing heart disease had no effect on lowering risk for cardiovascular events.
At this point, the AHA has not identified elevated homocysteine as a major risk factor for heart disease and does not recommend widespread use of folic acid and vitamin B supplements to lower homocysteine. However, because of the association between homocysteine and heart disease, people are advised to obtain these important nutrients through a healthy diet that includes fruits, vegetables, whole grain and fortified grain products. Additionally, people who have a family history or personal history of heart disease but lack other well-defined risk factors, such as smoking or obesity, should consider monitoring their homocysteine levels. In the event of elevated homocysteine (above 15 mmol/L), supplementation to lower homocysteine should only be done under the supervision of a physician to ensure the patient's safety. Folate supplements, for example, may mask a true vitamin B-12 deficiency. In addition, studies find that these supplements may increase the risk of artery re-narrowing (restenosis) following revascularization procedures such as balloon angioplasty and stenting.
Recognizing and treating chronic depression. Depression has been linked with a higher risk of developing high blood pressure, heart disease and having a heart attack. Depression is associated with heart disease in several ways, including a risk of abnormal heart rhythms (arrhythmias), alteration of the amount of blood flowing to the coronary arteries, increased risk of blood clots (“sticky” platelets), and increased risk of sudden cardiac death. A recent study of the anti-depressant drug sertraline found that it was a safe and effective therapy in patients having a recent heart attack or unstable angina. It has also been shown to have anti-clotting properties.
There is a great deal of information in the media about different vitamins, mineral, nutrients and other substances and their supposed affect on heart health. For instance, there are conflicting reports on whether high doses of vitamin E can protect arteries and prevent heart attacks and strokes, or whether high doses of vitamin E can actually damage the heart. Aspirin therapy, which may be prescribed for a patient after a heart attack, has also been touted as way to prevent a first heart attack. While recent research supports the theory, there are risks to the regular use of aspirin, including gastrointestinal bleeding. Patients with no history or significant risk of heart disease should discuss with their physician if the risks associated with aspirin outweigh the potential benefits.
It is unfortunate that up to two-thirds of post-attack patients do not make lifestyle changes. It is estimated that up to one-third of fatal heart attacks could be prevented with the proper pre-attack medical treatments and lifestyle modifications. Even after one heart attack, the chances of avoiding future attacks can be increased with appropriate preventive care. People who have had a heart attack, or are at risk of having one, are encouraged to remember that their lifestyle choices can have a major impact on their heart health. Patients should always consult their physicians before making any changes to their diet or activity levels.
Much attention has also been given to the possible benefits of moderate alcohol consumption in lowering the risk of heart attacks and heart disease in general At this point, medical experts do not recommend that non-drinkers begin drinking alcohol for better cardiovascular health. Research is still being done to clarify the relationship between alcohol and the heart. However, findings in recent years have suggested that moderate alcohol consumption may offer some people a degree of protection against heart disease. Moderate drinking is defined as no more than one drink per day for women and no more than two drinks per day for men. One drink is equal to the following: 12 ounces of beer or wine cooler, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
Patients should discuss alcohol consumption with their physicians. In general, patients should follow established, proven wellness strategies. The earlier in life a patient modifies his or her habits, the better the chances of lowering or even eliminating certain risk factors for heart attack.
~~~~~~Wish You Good Health~~~~~~
