Satoshi Akamaru writes:
      
      
      
1) You suffered a mild heart attack
        two months ago. It was a very dangerous indication of cardiovascular disease
        (CVD), even though you feel fine now. Statistics say that about one-fourth
        of heart attack patients like you will have another heart attack within
        six years after the first trouble. One out of ten patients will experience
        sudden death within the same time.
        
        I think your coronary arteries are under constriction and can not provide
        sufficient fresh blood to cardiac muscles when necessary, such as when
        you go hiking. Oxygen shortage in cardiac muscles occurs as symptomatic
        pain in the chest or upper limb. You have had several acute chest pains
        right after dinner meals, haven't you?
        
        It is probably safe to say that narrowing arteries accompany arteriosclerosis.
        Arteriosclerosis deprives arteries in the whole body of their ductility
        and leads to hypertension. Hypertension accelerates arteriosclerosis. A
        vicious circle is formed in this way. Your blood pressure measurements,
        165/105mmHg, indicate stage 2 of hypertension and need medical treatment.
        
        Complicated factors concern the progress of arteriosclerosis. It is generally
        believed that arteriosclerosis is elevated with high total cholesterol,
        high LDL levels and low HDL levels in the blood. With LDL--173 mg/dl, HDL--26
        mg/dl, you are classified in the high risk group. High levels of total
        cholesterol and LDL are brought by imbalance between energy intake and
        output. Your overweight condition indicates overeating and physical inactivity.
        In fact, your only exercise is walking across the street from your apartment
        to your office and back. Other factors are smoking and stress in life.
        Though you cut down your smoking, progress of arteriosclerosis doesn't
        stop. Even a minor quantity of nicotine in tobacco promotes arteriosclerosis.
        Your stressful life has bad influence on arteriosclerosis too.
        
        Also you have a genetic background of CVD. You lost your brother to CVD.
        
        2) Please prepare sublingual nitroglycerin 0.3 to 0.6mg, which is the most
        effective drug for angina pectoris. When you feel acute chest pain, you
        can take it under your tongue. Dramatic relief is usually within 1.5 to
        3 minutes, and is completed by about 5 minutes.
        
        If initial treatment is incomplete, that is, the pain doesn't disappear,
        there is a possibility of myocardial infarction rising.
        
        Call your local emergency telephone number and leave the phone off the
        hook so that medical personnel can locate your address if you should become
        unconscious. You can ask another person to take you to a hospital by car
        in case you are close to the hospital which has an ER.
        
        3) You need medical treatment. First, it is important for you to expand
        your narrowed coronary arteries, not to obstruct them. For example, you
        can use cutaneous patches containing nitroglycerin in various sizes, which
        provide prolonged therapeutic effect. Second, hypertensive drugs will lower
        your blood pressure. There are diuretics and sympathetic nerve inhibitors
        and so forth. Third, you must solve your hyperlipidemia, lipids excessive
        pathosis in the blood and incidents of arteriosclerosis. Fortunately there
        are anti-hyperlipidemic drugs, invented in recent years.
        
        You should change some behaviors immediately. You must not do hard exercise
        such as hiking, which is a burden on your heart and may cause another heart
        attack. You had better throw your habit of smoking away. Smoking spoils
        some effects of medical treatments.
        
        4) Good diet and proper physical activity will improve your hypertension
        and hyperlipidemia. Please reduce your total calorie intake, especially
        from fatty food. I recommend you take 30 kinds of foods a day in order
        to avoid diet imbalance. The best and safe way to reform your physical
        inactivity is walking. I suggest you have a dog. A lovely partner will
        ask you to walk him every morning and evening. I know a case in which walking
        a dog lowered his master's blood pressure without drugs.
        
        And maybe you don't notice that your stressful business life is affecting
        your heart. Please cut down your overtime work and don't bring your work
        home. You should decrease the number of times you do social drinking. You
        may be afraid of the effect of not drinking, cutting down overtime, etc.,
        on your success in your company. However I don't want to hear the news
        of your sudden death with you sitting in your chair in your company! 
        
        
        
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