Muneyoshi Futami writes:
The most important thing for patient
T to understand right now is that he is hypertensive (170/100mmHg) and
has early atherosclerosis. He needs to pay more attention to his health.
He is too optimistic about his health condition. He thinks the cause of
coming down with heart disease is whether he is lucky or not. He says he
is too young to pay attention to his health, but being young doesn't mean
that he should not pay attention to his health.
Regarding patient T's condition, I have some concerns in addition to lack of exercise and heavy smoking. His mother died of hardening of the arteries, which means that he has a family history of heart problems which could include other risk factors such as high blood cholesterol. Deposits of cholesterol cause atherosclerosis and because he already has early atherosclerosis, he is in quite a danger. Also, he is a type A personality and that means he is too busy to take a rest and has no time to take a rest. In addition, being a male, he is part of a group who have more cardiovascular events.
To help patient T to feel better in the short term, I will suggest that he should consider his health more seriously, because he has some risk factors for heart disease. He has to reduce his cigarette smoking because smoking accelerates arterial thickening and increases risk of heart attack and stroke. At the same time, he has to take more rest, free from his work.
To help patient T to feel better in the long term, I will suggest that he should change his lifestyle. First, he must pay attention to his meals to avoid high blood cholesterol because deposits of fat and cholesterol cause atherosclerosis, which I have already said. Second, he must take exercise such as running because it improves the coronary arteries' dilating capacity. Third, referring to life expectancy, he must quit smoking and lower his high blood pressure. If he can do these two things, he can add on average almost 5 years to his life expectancy.
In the end, I think I have to talk with T about his attitude to his health. Now he must understand that his health condition is serious and that he can't be optimistic about his health. He must make big efforts to reduce his risk factors of atherosclerosis. Being "too young" or "too busy" won't be the reasons for not paying attention to his health anymore. He can't be too careful considering his health condition.
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