Nami Komatsu writes:

        Mr. Takahashi has serious heart disease, but he doesn't think it is so serious. So, first, I have to let him know that his condition is very serious. And, also I have to inform him that if he doesn't pay much attention to his health, what might happen to him.

        One of the reasons why his condition is serious is that he has risk factors for heart disease, especially for coronary heart disease (CHD). The known major risk factors for CHD are current cigarette smoking, physical inactivity, overweight, high blood pressure, high blood cholesterol and diabetes. Mr. T has at least three obvious risk factors, current cigarette smoking, physical inactivity and high blood pressure.

        Why they are called risk factors is following. Smoking may cause hardening of the arteries. Long-distance runners double dilating capacity of their coronary arteries but he no longer exercises, which means that his arteries are getting narrow. And high blood pressure may cause a heart attack.

        His feelings of weakness and mild pain in the neck and upper chest areas may be because of early atherosclerosis. It can be thought that his blood contains much cholesterol. High blood cholesterol is very dangerous for the heart, because cholesterol deposits begin to accumulate along the inner walls of the coronary arteries, a process known as atherosclerosis. As these crusty deposits enlarge, they can cause the arterial openings to narrow, which may cause hypertension, and pinching off the supply of blood can choke blood flow off completely. If starved of sufficient blood, heart muscle begins to die, triggering a myocardial infarction, or heart attack. And I am concerned about the fact that when men such as T have chest pain, it is apt to be the sort of pain classically associated with heart attacks, a sharp pain beneath the breastbone, radiating across the chest. One more concern that I have regarding Mr. Takahashi is his family history. His mother died after heart by-pass surgery complicated by hardening of the arteries. That means he has one more risk factor.

        The next step is how I can help him start feeling better in the short term, which means how I can relieve his neck and chest pain. I have to let him take a rest to feel better, because he has to have some changes of his lifestyle, such as his overwork. He has to forget about his job and take care of himself.

        And lastly, how can I develop ways to help T prevent heart disease in the long term? To prevent heart disease in the future, he has to get over his atherosclerosis. For that, he should make his blood pressure normal. Because high blood pressure may cause atherosclerosis. In addition, he has to quit smoking, and start doing some exercises and eat regularly to keep his blood pressure well. And the most important thing for him is that he should find the time to bother with these things above and pay much more attention to his own health.

        Concretely, Mr.T has to change his mind. For example, he thinks that he is just too young and too busy to pay much attention to his health right now. And he adds, "Nobody really knows who will come down with heart disease. Most people are just lucky -- until they get much older, that is. I think I am one of the lucky ones!" But his condition is actually very serious. If he doesn't realize his condition and regard it as his own problem, he won't have a chance to recover his full health.

         

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