Shouhei Koyama writes:
Patient O's condition includes the
following risk factors. There is the possibility of another myocardial
infarction, his blood pressure measurements indicate moderate to high hypertension;
the results of cholesterol tests are not positive; he has chest pain (this
is a clear symptom of angina pectoris). In addition, he is overweight,
his brother died of heart disease five years ago, he smokes cigarettes,
and he hardly does exercise. To best help him I would consider some numbers
of factors that influence his case.
Cigarette smoking, high cholesterol, physical inactivity, being overweight are important risk factors of coronary disease, that is, myocardial infarction and angina in his case. And the risk factors of hypertension are these: overweight, excessive salt, inactive lifestyle, and heredity. Taking these things into consideration, he should rethink his lifestyle at first. So, the most effective ways to inform Mr. O of his current health is to change his lifestyle.
Before stating what to change in his lifestyle, there is another important problem, namely, the risk of another heart attack. If he should have another heart attack, what should he do? I would ask him to write down the following ideas. When one or more symptoms of heart attack have happened, act quickly and take the following steps: Sit down or lie down. If symptoms persist for 2 minutes, call your local emergency telephone number and say you may be having a heart attack. Leave the phone off the hook so that medical personnel can locate his address if he should become unconscious. If he have nitroglycerin tablets, take up to three pills, one at a time every 5 minutes. Ambulances are well equipped to provide emergency care for people who are having heart attacks. It is usually better to have medical personnel come to him than for him to start off for the hospital. If he can get to the hospital faster by car than by ambulance, have someone drive him. He should not drive himself--it could be dangerous. He must not delay getting medical treatment, even if he is not sure he is having a heart attack A delay can cause permanent damage to his heart muscle or even death. Let the doctor determine whether or not he is having a heart attack. If his breathing or pulse stops, any person who is trained in cardiopulmonary resuscitation (CPR) should immediately begin the procedure. Call his local emergency telephone number first. When he arrives at the emergency room, he or the person who brought him should announce clearly that he may be having a heart attack. Make sure he is seen at once. In any case, never delay getting medical treatment.
Then I would like to mention what he should do to improve his health outlook. In the next few weeks, he should get medical treatment, that is, medicines. Hypertension, which is one of his bad conditions, can be relieved by some medicine. For example, the medicine called diuretics rids the body of excess fluids and salt which is the risk factor of high blood pressure, so this medicine can lower the high blood pressure. In addition to this, there are several kinds of medicine: beta blockers (which reduce the heart rate and the heart's output of blood); sympathetic nerve inhibitors (which reduce blood pressure by inhibiting sympathetic nerves from constricting blood vessels); vasodilators (which can cause the muscle in the walls of the blood vessels to relax, allowing the artery to dilate); the A.C.E. or angiotensin converting enzyme inhibitors (which interfere with the body's production of angiotensin, a chemical that causes the arteries to constrict); the calcium antagonists (which reduce the heart rate and relax blood vessels).
Dietary and lifestyle changes also may help control high blood pressure. This is what he should do in the longer term. As pointed out in the first paragraph he has four important risk factors of coronary disease: cigarette smoking, high cholesterol, physical inactivity, being overweight. So, I would like to advise him what to do about these four factors.
First, though he cut down his smoking from a pack a day to less than half a pack, he should cut down more or stop smoking. It sounds strict, but CVD is a very serious disease related to his life.
Secondly, I can recommend him to eat dietary fiber. Dietary fiber may help lower his cholesterol. Vegetables provide vitamins, are excellent sources of fiber, and are naturally low in fat, and fruits are also rich sources of vitamin and are low in fat and calories. And he should not eat fatty food like fried meat too much. The reason is that fatty food contains cholesterol and too much cholesterol in his blood can raise his risk of a heart attack . Extra cholesterol may be stored in his arteries and cause them to become narrow. The amount of cholesterol in an artery wall may be so large that the artery becomes blocked and blood can't flow through it. If an artery that supplies blood to his heart becomes blocked, he may have a heart attack.
Third, he had better do much exercise. Doing exercise is good for his health. Because he is a devoted company employee, he may say he has no time to spare, but if he has another heart attack, he can't even work. He should do more exercise not only to prevent the occurrence heart attack but also to do a good job.
Fourth, he should try to lose weight step by step. Eating dietary food and to do exercise are helpful for him with losing his weight.
Finally, maybe, to do as stated above is very hard for him, but if he can do these things, his health will be pretty good. Health is better than wealth. So, this is worth doing for his life.
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