Hiroshi Nishiura writes:
According to Mr. Okada's medical history,
he is in bad health but he had the good fortune to be able to be saved
because his attack was mild. As it was found, he had high risk factors
of cardiovascular diseases (CVD for short), on this occasion. Mr. O should
understand his own state of health now in detail and try to improve his
health. In order to get into a good health state, he should maintain a
new lifestyle and be familiar with as much of the following information
on CVD diseases and its risks.
1) Effective ways to inform Mr. O of his current health:
To inform Mr.O of his current health, he should find three major points
below.
First of all, he must comprehend that his physical state is still very
dangerous, though he could be back to normal and his wife was pleased with
his recovery. It is known that sudden death occurs at from four to six
times the rate of the general population among people who've had a heart
attack. And because of the research which indicates 27 percent of men will
die within one year after having a heart attack, he is still in a very
dangerous state.
Second, he should know that his current age puts him in danger of having
heart attacks. Based on the Framingham Heart Study, 45 percent of all heart
attacks occur in people under age 65. He should take action, making allowances
for his age.
The third important point is that his physical state puts him at high risk
for another heart attack. His blood pressure is 165-105 mmHg and it is
in the danger range. And as to cholesterol, the cholesterol tests resulted
in LDL 173 mg/dl and HDL 26 mg/dl, that is to say, high blood cholesterol.
Furthermore, he is 20 kilos overweight and physically inactive, and this
indicates that he has a 30-50% greater risk of developing high blood pressure.
All the facts above can increase his chance to get CVD.
2) Preparing for the right kind of behavior in the event he should have
another heart attack:
As he is in danger of getting another heart attack he should keep two important
things in mind, listed below, to prepare for another heart attack.
First of all, he should sit down or lie down at once and take a rest. If
symptoms persist for 2 minutes, he should call a local emergency telephone
number and say he may be having a heart attack. Then he should leave the
phone off the hook so that medical personnel can locate his address if
he should become unconscious. If he has nitroglycerin tablets, he should
take up to three pills, one at a time every 5 minutes. Nitroglycerin is
helpful because it reduces the pain of angina by widening blood vessels
to allow more blood to reach the heart muscle.
And before real heart attack occurrence, his wife, or other family members
and his colleagues should know that he has a chance of having a sudden
heart attack. Then they can prepare for treating his danger and it is psychologically
effective for them. And this will be helpful for him to get rid of physical
exertion and emotional stress in his life. As a result, the risk of attacks
can be reduced.
3) What should Mr. O do within the next few weeks to improve his health
outlook?:
To make his state stable, he can consider the points below.
He should plan his new diet and lifestyle according to his doctor's advice
and start at once. As to diet, for example, he should plan a high-fiber
diet and reduce his cholesterol. It is helpful to lose weight and reduce
blood pressure. And of course he should start exercise from easy steps
at fisrt. Furthermore he should start to stop smoking because, of course,
smokers are at high risks.
Even more important in the short term would be taking medication at once.
In order to take medication, first, he should consult with his doctor about
his state and new treatment. He should relate his current health and think
of his future, listening to his doctor's advice. And according to his current
state through examination in detail, his doctor may prescribe one of the
suitable medicines from antihypertensives for his disease. If his doctor
feels Mr.O would suffer another heart attack in a few days, he may also
prescribe nitroglycerin and explain directions.
4) What should he do in the longer term to help prevent the occurrence
of another heart attack?:
In the long term, Mr. O can continue his medication treatment, diet and
lifestyle programming. The major important points he should do are below.
First, he should see doctors and take medication. Whatever the medication
is, it is OK if it is makeshift. As he stays on his medications, through
his trial, he would be able to know suitable drugs for him. It is better
if his medication is more effective than any other drugs while causing
the fewest side effects. There are some kinds of drugs which lower high
blood pressure and these mechanisms that lower blood pressure are different
from case to case. He can find the most suitable medication through ongoing
treatment from his regular doctors.
Second, he should continue his mild exercise routine. It is too dangerous
to do intensive or strict action because it may be harmful to his heart.
He should start with easy exercises, such as walking or riding a bicycle.
And as time goes on, he should increase his activity if possible. It is
known that he needs intensive exercise for at least 15 minutes before he
gets any real cardiovascular benefit. But because there is the danger of
arthritic knee joints from jogging after age 40, he is at about the right
age to start taking long, brisk walks instead. Increasing and improving
physical activity can reduce blood pressure and it may be helpful for losing
weight.
Third, he should continue a healthy diet and improve it. For example, he
should plan a high-fiber diet and/or a low cholesterol diet. It is helpful
to lose weight and reduce blood pressure. For example, if he keeps a high-fiber
diet, this could be the beginning of an even stricter diet in the future.
Dietary changes also may help control high blood pressure.
Finally, he must continue to stop smoking. But the trouble is, some people
who quit cigarettes gain weight, because nicotine helps them metabolize
food faster than usual, and suppresses the appetite. So he must be careful
not to eat too much.
The most basic sort of advice can be summarized as follows:
(1) Stay on medication and find suitable drug.
(2) Continue exercise from mild level and improve it according to his health
state.
(3) Continue a healthy diet and improve it.
(4) Stop smoking.
I suppose the best recipe must be a combination of these. If he keeps to
this advice, it will be helpful for him and may keep him from developing
more serious heart problems in the future, so it is most important that
he resolve to go along with these changes in his lifestyle habits.
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