People with heart disease are at increased risk for suffering heart attacks or sudden cardiac death . But there is evidence that risk factor modification can help people with coronary artery disease . Lowering blood pressure and cholesterol can improve survival and quality of life if you have heart disease. Here are some therapies to help protect your heart.
The American Heart Association and American College of Cardiology have jointly released guidelines on secondary prevention for patients with cardiovascular disease. Their recommendations reflect data gleaned from large scale clinical trials that have identified which preventive therapies work best. Check to see which advice you are already using correctly, and which you may want to discuss with your doctor.
To help you stop smoking, try:
However, persons with significant heart disease may need to begin with medication and then reduce dosage (or stop medicine entirely) as these nonpharmacological treatments take effect. Surely, medication should never be a replacement for exercise, good diet, and sensible alcohol use.
All patients should have a blood test called a fasting lipid profile. Desirable ranges of lipid levels are:
These levels are only approximations and may need to be individualized depending on other risk factors. Your doctor will evaluate your lipid levels and help you determine what is desirable for you. However, the following advice is pertinent for everyone:
Have a waist measurement and body mass index (BMI) calculation.
If your weight is not in the target range, start weight management and medically supervised physical activity programs.
For all people with diabetes:
Ask your doctor to evaluate your need for preventive drugs such as aspirin , ACE inhibitors, and beta-blockers.
Get a flu shot .
RESOURCES:
American Heart Association
http://www.americanheart.org/
National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov/
CANADIAN RESOURCES:
Canadian Cardiovascular Society
http://www.ccs.ca/home/index_e.aspx/
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/Page.asp?PageID=24/
References:
Executive summary of the third report of the National Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486-2497.
Smith S, Allen J, Blair S, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic cardiovascular disease: 2006 update. J Am Coll Cardiol. 2006;47;2130-2139. Available at: http://content.onlinejacc.org/cgi/content/full/47/10/2130. Accessed May 24, 2010.
Smith S, Blair S, Bonow R et al.AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update. American Heart Association website. Available at: http://www.circ.ahajournals.org/cgi/content/full/104/13/1577. Published 2001. Accessed July 6, 2009.
Secondary prevention of coronary heart disease: what works and what doesn't. Family Practice Recertification. October 2001.
Last reviewed May 2010 by Brian Randall, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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