Ongoing Treatment After a Heart Attack
Treatment after a heart attack: medications, exercise, and giving up smoking
Treatment after a heart attack doesn't suddenly end when someone is released from the hospital. But ongoing treatment is very different from acute care. Instead of focusing on immediate survival, long-term treatment is geared toward improving quality of life and preventing future heart attacks. Here are some key elements of a heart-healthy lifestyle -- and how you can help implement them:
Medications after a heart attack. Long-term treatment after a heart attack usually requires medications. You can help the person in your care by making sure he takes these as directed. The doctor will prescribe different drugs for different purposes, but these are the general categories:
- Medications that reduce the heart's workload and oxygen needs
- Medications to control heart rhythm
- Medications for controlling cholesterol
- Medications for controlling blood pressure
- Blood thinners and anticoagulants
An annual flu shot. Also encourage the person in your care to get a yearly flu shot, which may help protect him from having a stroke or heart attack, especially if he's under the age of 75. September through November is the best time to get a flu shot, although older adults may still benefit through the month of January. Heart patients should be sure to check with their doctors before getting vaccinated.
Stop smoking. People who keep smoking after a heart attack are one-and-a-half times more likely than nonsmokers to have another heart attack. For people who stop smoking, the risk decreases gradually over three years until it's the same as the risk for nonsmokers. It's also important to avoid secondhand smoke, so if there's someone else in the household who smokes, that person needs to quit, too.
But quitting smoking is much easier said than done. Here are a few ways to help someone stop smoking:
- Ask what he thinks would make it easier to stop. He may have suggestions you haven't thought of.
- Encourage him to talk about his feelings and what he's going through. Smoking may be a comforting lifelong habit; let him mourn a little.
- Be positive and encouraging. Resist the temptation to nag or yell if he slips up -- it's more effective to remind him that you love him no matter what. Vent your frustration to a friend instead.
- Help him avoid situations that trigger the desire for a smoke. If he's used to enjoying a cigarette after meals, try going for a short walk outside instead.
- Be understanding as he goes through withdrawal symptoms. Try not to take it personally if he's especially irritable, short-tempered, and tired.
- Quit smoking yourself. You'll set a good example, eliminate secondhand smoke, and better understand what he's going through.
- Talk to a doctor about getting help. Aids such as nicotine replacement therapy, counseling, and support groups can all help a smoker quit the habit -- and resist the temptation to take it up again.
Exercise regularly. Regular physical activity provides several benefits for former smokers:
- Decreased risk of coronary heart disease and heart attack.
- Improvement in HDL ("good") cholesterol levels.
- Better-controlled diabetes.
- Lowered blood pressure.
Better maintenance of a healthy weight.
The Centers for Disease Control and the American Heart Association (AHA) recommend accumulating at least 30 minutes of moderate-intensity physical activity on most days. This doesn't mean the person in your care needs to do half an hour of aerobics each day; instead, you can encourage short bursts of activity throughout the day. Just parking farther away from the store and walking the extra distance, or taking the stairs instead of the elevator, can quickly add up. But before beginning any exercise program, it's important to talk to a doctor about possible restrictions.
Treatment after a heart attack: managing diet, stress, and depression
Other important lifestyle changes to make include eating a heart-healthy diet, managing stress and depression, and using medications as appropriate.
Follow a low-fat, low-sodium diet. The AHA offers specific dietary guidelines for reducing the risk of heart attack:
- Choose a diet rich in whole grains, vegetables, fruits, fish, poultry, lean meats, and low-fat or fat-free dairy products.
- Limit fat intake (total fat between 25 and 35 percent of daily calories, saturated fat less than 7 percent, and trans fat less than 1 percent).
- Limit cholesterol intake (less than 200 milligrams per day if LDL levels are high; less than 300 milligrams per day if they aren't).
- Limit sodium (less than 1,500 milligrams per day for high blood pressure, less than 2,300 milligrams per day otherwise).
- Eat dietary fiber -- 25 to 30 grams every day.
- Limit alcohol consumption -- women should consume no more than one alcoholic beverage per day; men no more than two.
Manage stress and depression. A person's emotional and psychological state can have a very real effect on his physical health. An important way to maintain good cardiovascular health and avoid heart attack is by minimizing stress, anger, and depression.
- Encourage a social life. If an older adult lives alone, he may feel disconnected and isolated; even if he lives with someone else, sitting around the house can lead to boredom and unhappiness. Help him get out, make new friends, or simply engage in stimulating activities. A local place of worship or community center is an excellent place to connect with other people in his age group.
- Keep an eye on his mood. Perhaps he's already a social butterfly but still seems to be having difficulty with stress or depression. Try these stress-busting strategies:
- Cut back on caffeinated beverages and alcohol.
- Try meditation or yoga.
- Play relaxing music.
- Go for a walk outdoors.
- See his doctor. If he has tried everything and still struggles with his mood, he should talk to his doctor. Depression is a serious but treatable illness.