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7 Cardiologist Tips for Preventing Another Heart Attack

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    You can prevent another heart attack.
    As a cardiologist, I want my patients to know that if you have had a heart attack, you can still lead an active, full life. Medicine has improved dramatically, and patients do well if they work with their cardiologists to minimize their risk factors, so there’s a lot of hope for our patients. However, patients who have had one heart attack are at a high risk of having another one, so it’s important to commit to a treatment plan to keep your heart healthy. Here are some things I want my patients to keep in mind to help prevent another heart attack.

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    1. Partner with your cardiologist.
    If you’ve had a heart attack, don’t despair. Instead, work closely with your cardiologist to make sure risk factors, such as high blood pressure, high cholesterol, uncontrolled diabetes, smoking, and excess weight, are well controlled to help reduce your risk for a subsequent heart attack. There are simple things one can do to make that happen, such as take medicines as prescribed and make lifestyle changes, but success requires a close partnership with your doctor. There are many smart cardiologists in this country, but the best ones are those who form a partnership with patients and commit to helping them live a healthy life.

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    2. Take your medication.
    Taking your medications after a heart attack is critically important. I find, based on research studies as well as my own experience, that nearly half of patients who have had a heart attack don’t take their medications as prescribed. There are myriad reasons why this is so; some patients have problems affording expensive medications, some have problems remembering to take them regularly, and some experience significant side effects. Whatever the reason, your cardiologist should be aware so you can work with him or her to overcome these barriers. For example, if cost or side effects are issues, your cardiologist can help you find alternative medications at lower costs or without the side effects. If you’re simply forgetting to take your medications, your cardiologist could share insights and simple tips to help you remember. If you are taking blood thinner medications after a heart attack, then you need to be especially careful. If blood thinners are not taken as prescribed, this could lead to life-threatening bleeding or clotting problems. Taking medications after a heart attack significantly lowers your risk of another one, so work with your doctor to ensure you’re able to take the therapies as prescribed.

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    3. Follow a heart-healthy diet.
    The American Heart Association recommends heart attack patients follow the DASH diet, which stands for Dietary Approaches to Stop Hypertension. In essence, the DASH diet focuses on protein, fiber, fruits, vegetables and lean meats. Patients on the DASH diet avoid saturated and trans fats and significantly reduce salt and sugar intake. I encourage my patients to avoid drinking high-sugar beverages like soda, because the high sugar content promotes weight gain and cholesterol plaque buildup, increasing the risk for recurrent heart attacks and strokes. However, I also convey to my patients that you’re allowed to indulge a little bit, but be honest with yourself and make conscientious decisions. Fill up on a salad first and then please your taste buds with a couple bites of a burger. Moderation is the way to go.

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    4. Try cardiac rehabilitation after a heart attack.
    It is especially important after a heart attack and successful stents or bypass procedures to get back into a healthy, active lifestyle. I find many of my patients are somewhat apprehensive to begin exercising, so I’ll typically send them to cardiac rehabilitation. It’s a helpful way for patients to learn how to be active again in a supervised setting. In cardiac rehab, nurses and medical professionals track your progress, monitor the electrical activity of your heart, and measure your blood pressure as you learn to exercise again, helping to guide you toward living an active life. These programs not only tone and condition your heart, lungs and muscles but most importantly allow patients to overcome their fears after a heart attack and gain confidence to realize they can exercise again.

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    5. Make exercise part of your routine.
    Once cardiac rehab ends, I encourage patients to join a gym and commit to working out on a regular basis. Studies show the risk of heart attack and stroke drops dramatically for patients who exercise regularly. It does not have to be intense exercise; just walking is enough. The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic exercise, such as walking, at least 5 days a week, for a total of 150 minutes per week. I advise my patients that consistency is important, so establish a routine that is doable and commit to it. Many of my patients are elderly, have arthritis problems or weight problems and are intimidated by exercise, but any amount of activity is a step in the right direction. It is important to begin slowly and maintain consistency for real results. I’ve seen many success stories with this kind of graded, step-by-step approach, and I have several patients in their 70s and 80s who walk daily for 30 minutes and have controlled their risk factors and done very well.

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    6. Take care of your mental health.
    Your mental health is just as important as your physical health after a heart attack. It is common to feel low or depressed after a heart attack, and you may have anxiety about your future health and the social and financial consequences a heart attack can have. We now know that this depression or anxiety plays a huge role in outcomes after a heart attack, so it is important to overcome this. I find depressed patients don’t take their medications regularly, don’t have the energy to get up and start working out, and don’t eat a heart-healthy diet. These all contribute to a higher risk of a second heart attack. Talk to your cardiologist if you are feeling low or depressed. There’s also no shame in seeking assistance from a psychologist or psychiatrist to help you stay on top of your mental health. Exercise is another great way to reduce anxiety and depression about your heart attack, and studies show depression levels go down when heart attack patients start a cardiac rehab program and develop a sense of robustness and well-being. Overcoming depression or anxiety will help you focus on your overall health.

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    7. Set small, achievable goals.
    I often see patients struggling with all the changes they must make after their heart attack. It can seem overwhelming to think you need to change everything about your life at once. But when you have a mountain to climb, just take the first step. I tell patients to begin with one little change, focus on that change or goal, achieve that goal, gain confidence, and then work toward the next change. I recently saw a patient after a heart attack who loved ice cream and was consuming a gallon daily. I did not ask him to stop, but together we committed to reducing it by half before the next visit. We set incremental goals at every visit for a year. Today this patient has adopted a very healthy lifestyle, eats a healthy diet and is doing well. Work with your cardiologist to identify small, reasonable goals and commit to achieving one goal by your next doctor’s visit. Then, move on to the next goal and the next and the next. After all, your heart health is a long-term committment.

Heart Attack Prevention | Tips to Prevent Second Heart Attack

About The Author

Dr. Amit Amin, MD, MSc, is a board-certified interventional cardiologist with Barnes-Jewish Hospital in St. Louis. He’s also an assistant professor of medicine at Washington University School of Medicine in St. Louis. View his Healthgrades profile >
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THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.
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