Toshihiko Natsume writes:

        1) What would be the most effective ways to inform Mr. O of his current health ?

        He has some risk factors for heat disease: hypertension, high-LDL and low-HDL cholesterol, and overweight. Also I think he has stress, that is one of the risk factors, because he is a busy business men. To have understand him of his health situation, it is necessary to explain why these factors are called "risk factors".

        Why is "high-LDL and low-HDL cholesterol" called a risk factor?

        Extra cholesterol may be stored in arteries and cause them to become narrow. The function of LDL is carrying cholesterol to blood vessels and cholesterol is stored, and the function of HDL is, contrary to the LDL, removing stored cholesterol from blood vessels. So in his case, may be his blood vessels, specially in the heart, have excessive cholesterol and are becoming blocked.

        Why is "hypertension" called a risk factor?

        It is not clear what the cause of hypertension is but it is known that continuing state of high blood pressure causes arteriosclerosis and this decreases starchiness of blood vessels. So the resistance of blood flow increases and blood flow decreases.

        Why is "overweight" called a risk factor?

        Overweight is a evidence of taking excess calories and lack of suitable exercise. Excess calories change in to fatty acid and the level of cholesterol in the blood increases.

        He also has chest pain. This suggests that his blood vessels are becoming closed so his health situation is serious.

        His elder brother died of heart disease so it is possible that he has a genetic factor for heart disease.

        He works very hard so he has no time to take a rest and may be he is exposed to stress. The stress also effects hypertension and high cholesterol in blood.

        2) He should understand it is possible to have another heart attack in a few weeks because his state is pathologically not changed, if he takes medicine, it effects only for a short time. So he should not manipulate dangerous machines like a car, motorbike, etc., and should carry medicine for a heart attack. Also it is recommended he have a card on which is written his health stats in case of an emergency.

        3) What should Mr. O do within the next few weeks to improve his health outlook?

        He should have rest and stay calm because working activity stimulates metabolism rising the demand for oxygen and stress causes contraction of blood vessels. His blood vessels in heart are weekend so they will not be able to respond to all the demands of metabolism. And he has to quit smoking, because smoke contains many alkaloids and gasses that have a bad effect on blood vessel contraction.

        I want to recommend that he take off for a few weeks to rest physically and mentally also to have medical examinations to determine his health condition clearly.

        4) What should he do in the longer term to help prevent the occurrence of another heat attack?

        He should go on a diet to control his weight and to regulate the ratio of HDL and LDL.

        First, he should reduce his calorie intake avoiding fatty foods like hamburgers, fried potatoes, fatty meat, and so on for reducing his weight, because fat has more than twice as much calories as carbohydrates. And to regulate the ratio of HDL and LDL, he needs to avoid animal fat that increases LDL, and if he needs to use oil, it is recommended he use vegetable oil, especially olive oil, which increases HDL. Also he should have more vegetables, because vegetables are rich in dietary fiber witch prevents absorption of fat and they are rich in vitamins witch regulate the body's metabolism. And as vegetables are low in calories, you can feel satisfaction eating a quantity reducing total calories you take. If his diet is successful, his weight will become normal and the ratio of HDL and LDL will be suitable and also his blood pressure will reduce.

        He should do light exercise like walking, paying attention not to give excess stress to the heart. It is enough if he sweats a little. Then little by little, he can increase his exercise. Exercise is good not only for consuming excess energy to reduce weight and fatty acid in the blood but also it is good for relaxing physically and mentally.

        He also needs to consult a doctor periodically to check his health condition and to evaluate diet and exercise therapy.

         

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