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Taking care after a heart attack



There’s nothing like a brush with death to inspire a person to live better. A heart attack, if survived, is a potent warning that a second, deadly attack could happen.

If you’ve had a first heart attack, the risk for another one is substantially increased. More than a third (35 percent) of women and 18 percent of men who survive a first heart attack experience a second one within six years after the first.

Doing what’s good for you

Although some people stick with their healthful lifestyle changes, others don’t. A recent study found more than half of heart attack survivors diagnosed with uncontrolled high blood pressure before their attacks still had hypertension afterward. Similarly, 46 percent of those who had dangerously high cholesterol beforehand still had high cholesterol.

Avoiding a second heart attack requires working closely with your doctor to pinpoint all the factors that put you at risk and addressing each of them aggressively.

Your doctor may prescribe changes such as these:

  • Quit smoking. Smoking affects heart rate and blood pressure and increases the risk for blood clots. If you have coronary heart disease and continue to smoke, your chance of dying is twice as high as when you kick the habit. Encourage others in your household to quit smoking to help you stay off cigarettes and avoid secondhand smoke.
  • Control your weight. Losing as little as five to 10 pounds can improve an overweight person’s heart risk.
  • Be physically active. An appropriate exercise program should be developed with the assistance of rehabilitation staff and tailored to your individual needs. Research has shown that people who started exercising after a first heart attack had a 60 percent reduction in second heart attacks compared with those who didn’t.
  • Eat foods low in calories and dietary fat. Eat more fruits, vegetables and whole grains, and limit salt and alcohol. Healthful eating can help you lower LDL (bad) cholesterol and keep your weight at a healthier level.


Lifesaving medications

Important advances in heart treatments, many of them just in the last decade, have had significant effects in increasing life span and reducing the prevalence of heart disease.

Nearly everyone who has a heart attack ends up on some combination of these four medications: low-dose aspirin, statins, beta-blockers and ACE (angiotensin-converting enzyme) inhibitors. Although any drug you take has a potential for side effects, many of these heart medications are very safe.

Medications should never replace therapeutic lifestyle changes, but they’re an important part of overall treatment. There are limits to how much you can lower cholesterol by using diet and exercise alone.

Also, be aware that daily aspirin isn’t a healthful choice for everyone. Ask your doctor about the benefits and risks to you.

Feelings and emotions

Feelings of fear, anger or depression are common after a heart attack, and these emotions significantly increase a person’s risk of experiencing a second one. If you’re having trouble with your emotions, seek help from a counselor.

All in all, if you’ve had a heart attack, it takes substantial effort to turn your risks around. But once a person realizes the benefits of drug therapy and lifestyle changes, it’s very rare for someone who has already had a heart attack to not do anything possible to avoid a second one.

Reducing your risk factors can make a substantial difference in long-term survival and decreasing the chance of having a second attack.