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Life After a Heart Attack

Explore and Embrace your Options - Life After a Heart Attack You had a heart attack.

Now what? 

If you don’t know the answer, you’re not alone. Many survivors feel scared, confused and overwhelmed after a heart attack and it’s no surprise. You experienced a life changing event. You probably received a lot of information and instructions from your doctor. Now, you’re trying to understand what happened and — more importantly — what you need to do to make sure it doesn’t happen again.

Navigating the road to recovery isn’t easy. Questions, confusion, fear and uncertainty are normal and common. Get answers to your questions and learn more about what to expect.

Don’t Wait for a Second
Where were you when you had your first heart attack? It’s an experience you’ll never forget — and one you never want to repeat. After a first heart attack, most people go on to live a long, productive life. However, around 20 percent of patients age 45 and older will have another heart attack within five years of their first.

Don’t wait for a second; make preventing another heart attack your first priority. Here are five things you can do:

Take your medications as prescribed. Certain medicines can greatly lower your risk of another cardiac event. That’s why it’s important for you to understand your medicines and take them correctly. Learn about how to manage your medications.

Attend your follow-up appointments. Attending your follow-up appointments will help your doctors keep track of your condition and recovery. You can make the most of your time with your doctor by preparing for your appointment.

Participate in cardiac rehabilitation. Cardiac rehabilitation is a medically supervised program designed to help you recover after a heart attack. You should have received a referral to cardiac rehab when you were discharged from the hospital — if you did not, ask your doctor about it. 

Get support. It is normal to feel scared, overwhelmed or confused after a heart attack. Getting support from loved ones or from people who have also had a heart attack can help you cope. 

Manage your risk factors. After a heart attack, it is important to manage risk factors like high blood pressure, high cholesterol and diabetes by taking medications, quitting smoking, eating healthy food, and getting active. 

 

View original article on American Heart Association


Nearly half of U.S. adults could now be classified with high blood pressure, under new definitions

ANAHEIM, California — Nearly half of American adults are at risk for major health problems because of high blood pressure, according to a new scientific guideline that redefines the dangerous condition and provides tactics for doctors to detect, treat and prevent it.

People with readings of 130 as the top number or 80 as the bottom one now are considered to have high blood pressure, according to the guideline released Monday by the American Heart Association. High blood pressure used to be defined as 140/90.

The change means 46 percent of U.S. adults are identified as having high blood pressure, compared with 32 percent under the previous definition. A blood pressure of less than 120/80 still will be considered normal, but levels at or above that, to 129, will be called “elevated.”

The new guideline is designed to help people take steps to control their blood pressure earlier, according to the authors. High blood pressure, also known as hypertension, is a major risk factor for heart disease and stroke – the two leading causes of death in the world.

“Yes, we will label more people hypertensive and give more medication, but we will save lives and money by preventing more strokes, cardiovascular events and kidney failure,” said Kenneth Jamerson, M.D., Ph.D., professor of internal medicine and hypertension specialist at the University of Michigan Health System. He is one of 21 experts on the guideline writing committee. “If you are going to put money into the healthcare system, it’s to everyone’s advantage if we treat and prevent on this side of it, in early treatment.”

Still, the guideline – in the works for about three years and based on hundreds of studies and clinical trials – doesn’t suggest a massive increase in the number of people who will need to take medication to control hypertension.

Of the estimated 14 percent more adults to be classified with high blood pressure, about one in five will need medication, according to Paul Whelton, M.D., who chaired the guideline writing committee. But taking into account the overall population of adults who now will have hypertension, the guide predicts only a small percentage more should be prescribed medicine for it, compared with the previous guideline’s recommendations released in 2003.

Instead, the guideline, published in the AHA’s journal Hypertension, emphasizes that doctors need to focus on a whole framework of healthier lifestyle changes for patients.

“We need to send the message that yes, you are at increased risk and these are the things you should be doing,” said Whelton, chair of global public health at Tulane University in New Orleans. “I’m not saying it’s easy to change our lifestyles, but that should be first and foremost.”

The recommendations for a heart-healthy diet include reducing salt and incorporating potassium-rich foods such as bananas, potatoes, avocados and dark leafy vegetables. The guideline also gives specific suggestions for weight loss, quitting cigarettes, cutting back on alcohol and increasing physical activity.

The guideline, the first comprehensive one in 14 years, homes in on making sure doctors’ offices and patients understand how to accurately measure blood pressure and diagnose hypertension in the first place.

Hypertension occurs when the force of blood pushing against vessel walls is too high. This added pressure causes the heart to work too hard and blood vessels to function less effectively. Over time, the stress damages the tissues within arteries, which can further damage the heart and circulatory system.

Often called the “silent killer” because there are often no obvious symptoms, hypertension accounts for more heart disease and stroke deaths than almost all other preventable causes. It’s second only to smoking.

Robert M. Carey, M.D., vice chair of the guideline writing committee, said he expects some controversy over how the report treats older adults. It recommends people 65 and older be treated to the same 130/80 goal as younger patients. A guideline early this year from the American College of Physicians and the American Academy of Family Physicians suggested patients 60 and older be held to a standard below 150/90.

But Carey, professor of medicine and dean emeritus at the University of Virginia School of Medicine, said several intensive studies since 2015 show treating older adults to a lower blood pressure goal is beneficial.

“You have to escalate the treatment slower and monitor any side effects,” he said. “But it’s true there is benefit to treating ambulatory, older subjects.”

The guidelines say it can be lifesaving: “BP lowering therapy is one of the few interventions shown to reduce mortality risk in frail older individuals.” Men and women age 65 to 74 under the new classification will see high blood pressure rates increase by 13 percent and 12 percent, respectively.

Here are how some other groups will be affected by the new measurements:

     — High blood pressure rates could nearly triple among men age 20 to 44 – up to 30 percent from 11 percent. Women in that age group will see their rates almost double, to 19 percent from 10 percent.

     — Roughly three-quarters of men between 55 and 74 could be diagnosed with high blood pressure.

     — Black and Hispanic men will experience a 17 percent increase in rates. Asian men will see a 16 percent increase.

The new classifications and recommendations are specific in how they determine who is at risk and what they should do about it, Jamerson said.

Doctors should use a “risk calculator” to determine a patient’s risk of heart disease or stroke over the next 10 years. That assessment, combined with the other recommendations, can prompt more thorough doctor-patient conversations to determine whether lifestyle changes alone can help, or if medicine is needed as well.

“These new guidelines give patients a voice because it gives them an opportunity to ask healthcare providers, ‘What’s my risk?’” Jamerson said. “Consumers should be getting an explanation. Physicians ought to be calculating risk as they think about how to treat.”

Article from American Heart Association


More than 100 million Americans have high blood pressure, AHA says

The number of Americans at risk for heart attacks and strokes just got a lot higher. An estimated 103 million U.S. adults have high blood pressure, according to new statistics from the American Heart Association. That’s nearly half of all adults in the United States.

“With the aging of the population and increased life expectancy, the prevalence of high blood pressure is expected to continue to increase,” said epidemiologist Dr. Paul Muntner, co-chair of the group that wrote the AHA’s Heart Disease and Stroke Statistics—2018 Update, published Wednesday in Circulation.

The death rate from high blood pressure increased by nearly 11 percent in the United States between 2005 and 2015, and the actual number of deaths rose by almost 38 percent — up to nearly 79,000 by 2015, according to the statistics. Worldwide, high blood pressure affects nearly a third of the adult population and is the most common cause of cardiovascular disease-related deaths, said Muntner, a professor and vice chair in the Department of Epidemiology at the University of Alabama at Birmingham.

Guidelines published last November redefined high blood pressure, also known as hypertension, as a reading of 130 on top or 80 on the bottom. The standard used to be 140 over 90. The percentage of U.S. adults with high blood pressure jumped from 32 percent under the old definition to nearly 46 percent.

“Before this guideline, if your blood pressure was at 130, you weren’t supposed to do anything,” said cardiologist Dr. Kenneth Jamerson, an author of the high blood pressure guidelines.

“With the new [high blood pressure] guideline, we’re having patients do something about it,” he said. For his patients, that includes 30 minutes of physical activity five days a week and the DASH diet, plus medication if the patient has additional heart disease risk factors, Jamerson said.

According to the statistics, only about one in five Americans gets enough exercise and poor eating habits contributed to 45 percent of U.S. deaths in 2012 from heart disease, stroke and Type 2 diabetes. 

Overall, cardiovascular diseases remain the leading cause of death in the world, claiming nearly 18 million lives in 2015. In the United States, heart disease is the No. 1 cause of death and stroke is No. 5.

Even so, these latest statistics show progress is being made, said Dr. Emelia Benjamin, who led the group that wrote the statistics report.

“We’ve made incredible inroads in cardiovascular disease,” said Benjamin, a professor of cardiology at Boston University’s School of Public Health. “There’s a real focus on improving health by adopting a healthy lifestyle, not just waiting to develop disease before one focuses on risk factors.”

Article from the American Heart Association 


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