Kenta Yokoi writes:
Mr. Okada has many kinds of CVD risk
(1) He smokes cigarette now even though he reduced the amount of cigarettes he smokes.
(2) He is almost 20 kilos overweight. But he hardly does exercise except going to his office and back.
(3) His cholesterol level is not positive : LDL-173 ; HDL-26 mg/dl.
(4) His blood pressure indicates moderate to high hypertension while he is still relatively young.
(5) He once suffered a mild myocardial infarction, but he didn't see a doctor. And sharp chest pains sometimes occur right after his dinner meals.
Facts (1)-(4) are confirmed as CVD risk factor from the result of examination and statistical figures. So we should tell Mr.O he has many kinds of risk factors, using these data. In addition, we can tell him that from fact (5), he has angina and needs treatment.
I guess the reason Mr.O delayed seeing a doctor is that he didn't believe he had angina. Though the most important thing is to see a doctor as soon as possible, unlike before, he is seeing a doctor. So I will tell him the right kind of behavior in the event of another heart attack.
(1) Sit down or lie down. To rest is important.
(2) When symptoms persist for 2 minutes, call a local emergency telephone number and say he is having a heart attack.
(3) We know Mr.O has angina. So doctor will give him nitroglycerine tablets if it is needful. When he has a heart attack take up to three pills, one at a time every 5 minutes.
(4) When he has heart attack, he should go hospital as soon as possible. So if he can go there faster than calling ambulance, he should do this without driving a car by himself.
Among many kinds of CVD risk factors, the thing we should remark at first about Mr.O's health is his blood pressure. His blood pressure ranks with stage 2 hypertension. Hypertension is listed as a contributing cause on more than 180,000 death certificates of stroke, heart attack, and heart failure victims. So as soon as possible he needs to treat his hypertension. One of the most available ways to treat this is using medications. 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. If these medications are not effective, there are another classes of antihypertensives, sympathetic nerve inhibitors, A.C.E, angiotensin converting enzyme inhibitors and the calcium antagonists (calcium channel blockers). But all medications need a doctor's instruction. If he keeps his promise to his doctor, medications will take effect for a few weeks.
Things Mr. O should do for his health are too many. But I guess he can't solve problems all at once. So I will tell him some of most important things that he should do in the longer term to prevent the occurrence of another heart attack.
(1) He should take care of his diet. Especially, eating meaty meals is not good because they contain too much cholesterol. High cholesterol hardens the blood vessels. If he consults a nutritionist, he would be taught good dietary habits.
(2) Mr.O needs to reduce his overweight for mending and keeping his health. Dietary programs, I said, are one of the good things he should take up. But he needs more, he should do exercise. And he works too hard. I guess he doesn't have any time to rest his spirit. Thinking of his current condition, I feel that walking would be suitable for him at first. I don't know how long he walks everyday, so, for example, he should make some recreation times and walk more than 20 minutes a day. When he can walk easily, we will think about other exercise programs.
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