Hirotomo Sasaki writes:
1. Mr. O is a middle aged average
Japanese man. Often these business men do not care about their own health
condition and believe that they are still young and have no problems. At
first, I will tell him about his condition very clearly by using objective
numbers. His blood pressure indicates moderate to high hypertension, 165-105
mm Hg. The results of cholesterol tests are not positive: LDL -- 173 mg/dl;
HDL -- 26 mg/dl. Furthermore, Mr. O now complains of sharp chest pains
that sometimes occur right after his dinner meals, a clear symptom of angina
pectoris. And from causal observation it is clear that Mr. O is almost
20 kilos overweight. His brother died of heart disease. He is heavy smoker
and does few exercise. These above are the main risk factors of myocardinal
infarction. High blood pressure and LDL level and being overweight and
doing no exercise and smoking are usual risk factors for business people
like Mr. O. Heredity is another problem for Mr. O.
2. A heart attack feels different to different people. Even if you have already had a heart attack, a second one may not feel the same. You may feel pain in any of the areas of the body. You may feel pain only in your arms, jaw, or back. Other warning signs of a heart attack include dizziness, fainting, sweating, nausea, or weakness. Not only chest pain but other pains are signs of heart attack. When attack occurs, 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 your address if you should become unconscious. If you 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 you than for you to start off for the hospital. If you can get to the hospital faster by car than by ambulance, have someone drive you. Do not drive yourself--it could be dangerous. Do not delay getting medical treatment, even if you are not sure you are having a heart attack. A delay can cause permanent damage to your heart muscle or even death. Let the doctor determine whether or not you are having a heart attack. If your breathing or pulse stops, any person who is trained in cardiopulmonary resuscitation (CPR) should immediately begin the procedure. Call your local emergency telephone number first.
When you arrive at the emergency room, you or the person who brought you should announce clearly that you may be having a heart attack. Make sure you are seen at once.
3. A quick way of preventing heart attack is to take medicines. To prevent heart attack, Mr. O needs to reduce his blood pressure. He must take medicines, which are effective ways to reduce hypertension. Antihypertensives are available to lower high blood pressure. Some, called diuretics, rid the body of excess fluids and salt (sodium). Others, called beta blockers, reduce the heart rate and the heart's output of blood. Another class of antihypertensives is called sympathetic nerve inhibitors. Sympathetic nerves go from the brain to all parts of the body, including the arteries. They can cause the arteries to constrict or narrow, thereby raising blood pressure. This class of drugs reduces blood pressure by inhibiting these nerves from constricting blood vessels. Yet another group of drugs is the vasodilators. These can cause the muscle in the walls of the blood vessels (especially the arteries) to relax, allowing the artery to dilate (widen). Two other classes of drugs used to treat high blood pressure are the A.C.E. or angiotensin converting enzyme inhibitors and the calcium antagonists (calcium channel blockers). The A.C.E. inhibitors interfere with the body's production of angiotensin, a chemical that causes the arteries to constrict. The calcium antagonists can reduce the heart rate and relax blood vessels.
In most cases these drugs lower blood pressure, but quite often people respond very differently to these medications. Thus most patients must go through a trial period to find out which medications are most effective while causing the fewest side effects.
The most important points for people with high blood pressure to remember are:
Follow your doctor's instructions. Stay on your medication. Dietary and lifestyle changes also may help control high blood pressure. Some people with mild hypertension can lower their blood pressure by reducing sodium in their diet. Excessive alcohol intake (more than two ounces daily) raises blood pressure in some people and should be restricted. Blood pressure also returns to normal in many obese people when they lose weight. Increasing physical activity can reduce blood pressure in some people, too. Before drugs are prescribed, these methods to control blood pressure are often recommended for people with only mildly elevated blood pressure.
4. Health and mental attitude have a deep relation. He works hard, so he has little rest. This means that he has no relaxation, but has stress. First of all Mr. O needs to keep himself relaxed and reduce stress. His chest pain may be related to stress. Health condition does not change within only a few weeks, so do not do heavy work, keep to light work. Change everything slowly but steadily. Life style has deep relation to one's own health, so he must change it. His family history may include myocardial infarction. High cholesterol, especially LDL, is dangerous. It breaks the walls of arteries and accumulates in the arteries. Smoking may make LDL-activity more active. Being overweight also makes cholesterol, so excess body fat needs to be burned by doing exercise.
What he must do: do exercise, keep
weight natural, stop smoking, and most important, Mr. O should change his
life style and take care of himself and have a heart specialist as his
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