Miyuki Daio writes:
The most important issue for T is
that he has many risk factors for developing coronary heart disease. He
is 39 years old, and is not very young. And he is a Type A personality,
an overworked bureau chief. To make matters worse, he is hypertensive,
has feelings of weakness and mild pain in the neck and upper chest areas.
He has early atherosclerosis. He hasn't exercise recently, and he smokes
very much, 2 packs a day. The worst point is that he doesn't pay attention
to his own health condition at all. He thinks that he is still young and
healthy. It is not good for clinical treatments.
I think that lack of exercise and heavy smoking are the obvious serious problems for his heart condition, but there are other problems. For example, he used to run a marathon, but he doesn't exercise now. I think that physical inactivity is another bad problem. Long-distance runners have a greater capacity to dilate their coronary arteries and thus markedly increase blood flow to their heart muscles. According to this, patient T was not hypertensive before. And his mother died after heart by-pass surgery complicated by hardening of the arteries (atherosclerosis). So I think that this is another indirect concern that he has a family history of heart disease.
I must help him feel better in the short time. I will give him some medicine for taking weakness and pain out, and to reduce his high blood pressure. Then he will feel better soon.
And if he tries to reduce smoking, he will be feeling better, because cigarettes constrict blood vessels. So his blood pressure will become lower, if he can stop smoking gradually. And I must advise him that it is not good to overwork, to think about his business too seriously. I will tell him he needs to enjoy his life, think about his life positively and easily, because his mentality will affect medical treatment.
And I must tell him how to prevent heart disease in the long term. At first, I will tell him how serious his health condition is. He should find he has risks to develop serious atherosclerosis and heart disease. But I must not forget to encourage him. To become pessimistic will obstruct the good effect of medical care.
He should do more regular exercise and reduce and quit smoking. Then his blood pressure will become normal. And he wouldn't get overweight. Because exercises, especially running for him, will help his coronary arteries dilate and help his blood pressure to get lower. It is important that he is careful about his diet and eating habits. Especially, he should pay attention to intake of sugar and fat. He might not get overweight if he does exercise regularly and eats healthy. His HDL level will be correct, too. Because exercises burn fat. If he can keep this advice, quitting smoking gradually, doing exercise regularly, paying attention to his diet and taking care of his cholesterol level and his weight, he can reduce his risks of heart disease.
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