Preventing Your Second Heart Attack

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If you or a loved one have experienced a heart attack, then you’ve heard the warnings of a second, more damaging cardiac event.

A subsequent heart attack is not always bigger or worse than the first one. But, it increases the risk for heart disease and complications, which can lead to more damage to the heart muscle. After surviving a heart attack, you can make life-saving changes to improve your heart health and significantly reduce your risk of a second myocardial infarction.

second heart attack“Heart attack patients have about a 10% incidence of another cardiac event within the first two years after their heart attack,” says Carlos Enrique Alfonso, M.D., an interventional cardiologist at the University of Miami Health System. For half of those patients, the second attack is related to a heart vessel impacted by the first heart attack, while the other half is related to another blood vessel.

“I tell patients and their families how it is: If you don’t control your risks and manage your overall health, your chance of a second heart attack is increased dramatically, which can be more detrimental than the first one. It’s not scare tactics — it’s reality,” Dr. Alfonso says. “Temporary behavioral changes based on fear can lead to slipping back into old habits, so we need to encourage a real lifestyle change.”

How to live heart-healthy

You can improve your odds of avoiding another heart attack by at least 50% if you commit to incorporating some lifestyle changes and taking all of your medications as directed.

Know your numbers and keep them in the healthy range.
  • Weight — Speak to your physician about a healthy weight range for your height and age.
  • Blood pressure — Monitor your BP numbers at home with a mobile device. The most accurate machines use a restricting sleeve like they do at the doctor’s office. Aim for your systolic blood pressure to remain below 130 and your diastolic pressure to stay below 80.
  • Cholesterol and triglycerides — Try to cut your LDL (bad cholesterol) level in half (reduce it by 50%).
  • Blood sugar — This is especially important if you have diabetes.

Take your medications as prescribed.

When taken consistently at the proper dosage, the following medications can help delay the progression of heart disease and decrease the risk of a second heart attack.

  • blood thinners (such as aspirin)
  • statins
  • diabetes medications
  • beta-blockers antithrombotics (antiplatelets/anticoagulants)
  • angiotensin-converting enzyme (ACE) inhibitors

Continue to see your cardiologist as directed to ensure that your meds effectively manage your underlying conditions with minimal side effects. Your doctor can adjust your prescriptions or dosages as needed while supporting your efforts to manage your weight.

“Once you’ve had a heart attack, you need to remain on cholesterol-lowering prescriptions, even if your cholesterol wasn’t high to begin with,” Dr. Alfonso says. “If your cholesterol numbers remain elevated despite statin therapy, you may benefit from additional medications or newer medications to treat triglycerides, as well.”

If you’re hesitant to take a particular medication, consult with your cardiologist about the benefits versus the risks.

Make healthy long-term commitments

Quit smoking — This commitment is not only good for your heart, it also reduces your risk for many cancers and lung diseases.

Avoid recreational drugs — Smoking and hard drugs can cause inflammation of heart muscles and vessels.

Drink alcohol in moderation — Moderate drinking is up to one drink per day for women and up to two drinks per day for men.

Exercise regularly — To strengthen your heart muscle, the American Heart Association recommends 150 minutes of moderate-intensity cardio exercise or 75 hours of high-intensity exercise each week. A cardiac rehabilitation program can help you incorporate exercise into your routine in the weeks and months after a heart attack. (Ask your cardiologist if a medically supervised program is right for you.)

Stick to a heart-healthy diet — This means less sugar, lots of fiber (non-starchy vegetables), less saturated fat (red meat and full-fat dairy), and more lean proteins (grilled and baked fish, chicken, and plants).

Reduce your stress — Emotional stress and anxiety can put pressure on your cardiovascular and nervous systems. Make time to socialize, spend time in nature, meditate, exercise, and enjoy relaxing hobbies. Don’t hesitate to speak to a professional or join a support group to learn how to regulate your thoughts and emotions better.

Get enough sleep — Quality sleep can reduce stress, lower blood pressure, and help control food cravings.

Health is at the heart of your family

Want to make heart-healthy habits and long-term positive changes easier? Do it as a team with your partner, family, or friends.

“Life changes like these tend to be more successful if everyone is participating, especially with diet and exercise,” Dr. Alfonso says. Make a commitment as a household to cut out fried foods, eat more veggies, try plant-based proteins a couple of nights a week, or follow what’s known as the Mediterranean Diet. Exercise together as a family. Pick a time of day that works for you and your partner or a friend to take brisk walks together. Tell those closest to you that you’re giving up smoking so they can help support your decision. Cooking and exercising together will help everyone improve their overall health.


Dana Kantrowitz is a contributing writer for UMiami Health News.


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