TAKING CONTROL
Possibly the greatest challenge facing you after a diagonsis of CHD is simply changing your daily habits. This is much harder than it seems, and will require commitment and persistence on your part.
Start by reassessing what you eat and then making some smart dietary changes. your goal is to replace artery-clogging fare (floods high in saturated fat, total fat and cholesterol) with a healthy variety of fruit, vegetables, grains and low-fat dairy products. The likely result will be lower cholestrol levels, both total and 'bad' LDI. (see on next)
Your next order of business is to get some regular exercise. Walk. Run. Cycle. Swim. Burning at least 1025 kilojoules a day through exercise (the equivalent of about 45 minutes of brisk walking or 25 minutes of jogging) confers the greatest protection against CHD. Vigorous exercise not only works your heart muscle--encouraging blood flow through clogged vessels and making them more flexible---it also helps by raising 'good' HDL cholesterol levels. And don't be intimidated by the need to work up a big sweat. A well-known Harvard study of 40,000 female health professionals found that walking just one hour a week, at any pace, reduces the risk of CHD.
Exercising will also help you take off extra kilos, and losing excess weight has long been known to reduce your risk of CHD.
About angina
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Angina (angina pectoris) is the intense chest pain that occurs when the heart muscle isn't getting enough occurs when the heart muscle isn't getting enough oxygen. The harder the heart works--whether due to physical exertion or strong emotions--the more oxygen it needs. To control angina, educate yourself about why it happens and how aspirin and anti-anginal drugs can help.
Prevention (healthy diet, blood pressure control, no smoking) is critical, but nitrates are the pharmaceutical cornerstone of angina treatment. Nitrates release nitric oxide, relaxing key blood vessels. Forms include under-the-tongue tablets and sprays, ointments and patches. Rapidly acting nitrates (such as glyceryl trinitrate) dilate blood vessels and relieve or prevent symptoms. Preserve nitrate potency by storing no more than 100 tablets at once (in the orginal container). Screw the cap on tightly after each use. Longer-acting nitrates (such as isosorbide dinitrate) are used to dilate blood vessels and relieve or prevent symptoms. Surgical options for severe angina are limited. Myocardial laser revascularisation, for example, involoves aiming laser energy at blocked areas. It's very risky, but can bring relief in some cases.
If you've been treated for angina and develop heart attack symptoms, take glyceryl trinitrate (anginine or nitro-lingual spray). Take another does every five minutes until the pain subsides. Don't exceed three does. Call 000 in Australia or 111 in New Zealand. Chew an aspirin.
with less weight on your frame, your heart won't have to work so hard to keep blood circulating. Another vital role is to stop smoking. One out of five CHD deaths can be traced directly to a tobacco habit. Smoking not only lowers 'good' HDL Cholestrol, it sabotage the elasticity of the aorta and ups your risk of a blood clot. In just three years of cigarette-free living, you may well wipe out a lifetime of accumulated heart damage.
But all your good habits could be in vain if you can't work stress reduction into the mix. Chemicals released during stress can raise your blood pressure and trigger heart rhythm disturbances. Whatever your stress triggers, it's now time to get your priorities straight and look at things differently. Try juggling your schedule to easy work overload. Explore meditation, yoga or tai chi, all ancient stress-busters that have endured for a reason: they work.
Studies indicate that by lowering stress, clogged arteries may actually reopen, reducing angina and lessening your risk for a heart attack.
>I started taking Hormone Replacement Therapy (HRT) to help my heart. Now I've heard it may not be heart-protective at all.The fall of oestrogen at menopause often results in more LDL and lesS HDL cholestrol, which is bad for CHD. Doctors thought prescribing HRT would extend premenopausal oestrogen protection to older women. Although early trials were promising, follow-up studies show that HRT doesn't alter CHD risk after all, or even lessen the risk of a fatal heart attack. In 2001, the American Heart Association declared that women shouldn't start taking HRT solely to prevent heart disease, a second heart attrack or a stroke. Furthermore, women with existing heart disease who are on HRT specifically for heart health should ask their doctor about stopping the therapy.>I've battled migraines for years. Will migraine drugs affect my CHD?
They might. Research reported in the journal Circulation indicates that migraine medications including ergotamine (contained in Cafergot and others), methy-sergide (Deseril), sumatriptan (Imigran), Zolmitriptan (Zomig) and naratripan (Naramig) can cause coronary arteries to constrict. If the vessels leading to your heart are already narrowed by disease, such an effect might bring on angina and even a heart attack. Talk to your doctor if you take one of these antimigraine drugs.
Medications
Even with lifetstyle changes, many people require drugs to control the progression of the disease and its symptoms. If you do have CHD (mild or advanced) or stable (predictable) angina, you'll likely be told to take a daily low-dose aspirin. This blood thinner is an antiplatelet agent, meaning it inhibits tiny disc-shaped particles in your blood (patelets) from clumping together and blocking an artery.
If your CHD is deemed severe, the doctor may recommend the antiplatelet drug clopiddogrel (Plavix, Iscover) rather than aspirin. In a major 2001 study, the number of heart attacks, strokes and deaths from heart disease in patients on clopidorgrel was much lower than in those an aspirin. It's also better than aspirin in reducing heart attack after angioplasty.
To lighten the demands on your heart, your doctor may also prescribe a beta-blocker can reduce the risk of dying from CHD. They are especially valuable if you have silent cardiac ischaemai, in which oxygen to your heart is reduced but you don't have chest pain (angina). And if you do have angina, the beta-blocker may lessen the need for pain-relieving nitrates. (Remember, beta-blockers don't) stop angina pain once it's started. Glyceryl trinitrate is best for that.)
- Ask about your odds (for a longer life, a stroke, a fatal complication) before commiting to bypass surgery or angioplasty. Many people never bother to check.
- Eat more fish. Recent trials show that people with CHD can dramatically lower their risk of dying by regularly eating fish (such as salmon) rich in omega-3 fatty acids.
- Be cautious about supplements. Popular herbs and vitamins, such as ginkgo biloba, garlic, vitamin E, fish oil and coenzyme Q10, can thin blood. If you're taking a heart drug that does the same thing--aspirin, warfarin (Coumadin), clopidogrel (Plavix)---serious bleeding problems could develop problems could develop. Ask your doctor about interactions.
- Don't forget your daily aspirin. Do as your doctor advises. If you don't, you are twice as likely to die from CHD. A 1999 Duke University study also found that one in five people with CHD fails to take aspirin regularly. If aspirin upsets your stomach, discuss effective alternatives with your doctor.
- Deal with martial stress. A 2000 study found that tension with a spouse hurts women's hearts in particular (while men react more to work stress). If you've got problems at home, share them with a good friend.
Possibly the greatest challenge facing you after a diagonsis of CHD is simply changing your daily habits. This is much harder than it seems, and will require commitment and persistence on your part.
Start by reassessing what you eat and then making some smart dietary changes. your goal is to replace artery-clogging fare (floods high in saturated fat, total fat and cholesterol) with a healthy variety of fruit, vegetables, grains and low-fat dairy products. The likely result will be lower cholestrol levels, both total and 'bad' LDI. (see on next)
Your next order of business is to get some regular exercise. Walk. Run. Cycle. Swim. Burning at least 1025 kilojoules a day through exercise (the equivalent of about 45 minutes of brisk walking or 25 minutes of jogging) confers the greatest protection against CHD. Vigorous exercise not only works your heart muscle--encouraging blood flow through clogged vessels and making them more flexible---it also helps by raising 'good' HDL cholesterol levels. And don't be intimidated by the need to work up a big sweat. A well-known Harvard study of 40,000 female health professionals found that walking just one hour a week, at any pace, reduces the risk of CHD.
Exercising will also help you take off extra kilos, and losing excess weight has long been known to reduce your risk of CHD.
About angina
------------------------------------------------------------------------------------------------------------------------------------------
Angina (angina pectoris) is the intense chest pain that occurs when the heart muscle isn't getting enough occurs when the heart muscle isn't getting enough oxygen. The harder the heart works--whether due to physical exertion or strong emotions--the more oxygen it needs. To control angina, educate yourself about why it happens and how aspirin and anti-anginal drugs can help.
Prevention (healthy diet, blood pressure control, no smoking) is critical, but nitrates are the pharmaceutical cornerstone of angina treatment. Nitrates release nitric oxide, relaxing key blood vessels. Forms include under-the-tongue tablets and sprays, ointments and patches. Rapidly acting nitrates (such as glyceryl trinitrate) dilate blood vessels and relieve or prevent symptoms. Preserve nitrate potency by storing no more than 100 tablets at once (in the orginal container). Screw the cap on tightly after each use. Longer-acting nitrates (such as isosorbide dinitrate) are used to dilate blood vessels and relieve or prevent symptoms. Surgical options for severe angina are limited. Myocardial laser revascularisation, for example, involoves aiming laser energy at blocked areas. It's very risky, but can bring relief in some cases.
If you've been treated for angina and develop heart attack symptoms, take glyceryl trinitrate (anginine or nitro-lingual spray). Take another does every five minutes until the pain subsides. Don't exceed three does. Call 000 in Australia or 111 in New Zealand. Chew an aspirin.
with less weight on your frame, your heart won't have to work so hard to keep blood circulating. Another vital role is to stop smoking. One out of five CHD deaths can be traced directly to a tobacco habit. Smoking not only lowers 'good' HDL Cholestrol, it sabotage the elasticity of the aorta and ups your risk of a blood clot. In just three years of cigarette-free living, you may well wipe out a lifetime of accumulated heart damage.
But all your good habits could be in vain if you can't work stress reduction into the mix. Chemicals released during stress can raise your blood pressure and trigger heart rhythm disturbances. Whatever your stress triggers, it's now time to get your priorities straight and look at things differently. Try juggling your schedule to easy work overload. Explore meditation, yoga or tai chi, all ancient stress-busters that have endured for a reason: they work.
Studies indicate that by lowering stress, clogged arteries may actually reopen, reducing angina and lessening your risk for a heart attack.
>I started taking Hormone Replacement Therapy (HRT) to help my heart. Now I've heard it may not be heart-protective at all.The fall of oestrogen at menopause often results in more LDL and lesS HDL cholestrol, which is bad for CHD. Doctors thought prescribing HRT would extend premenopausal oestrogen protection to older women. Although early trials were promising, follow-up studies show that HRT doesn't alter CHD risk after all, or even lessen the risk of a fatal heart attack. In 2001, the American Heart Association declared that women shouldn't start taking HRT solely to prevent heart disease, a second heart attrack or a stroke. Furthermore, women with existing heart disease who are on HRT specifically for heart health should ask their doctor about stopping the therapy.>I've battled migraines for years. Will migraine drugs affect my CHD?
They might. Research reported in the journal Circulation indicates that migraine medications including ergotamine (contained in Cafergot and others), methy-sergide (Deseril), sumatriptan (Imigran), Zolmitriptan (Zomig) and naratripan (Naramig) can cause coronary arteries to constrict. If the vessels leading to your heart are already narrowed by disease, such an effect might bring on angina and even a heart attack. Talk to your doctor if you take one of these antimigraine drugs.
Medications
Even with lifetstyle changes, many people require drugs to control the progression of the disease and its symptoms. If you do have CHD (mild or advanced) or stable (predictable) angina, you'll likely be told to take a daily low-dose aspirin. This blood thinner is an antiplatelet agent, meaning it inhibits tiny disc-shaped particles in your blood (patelets) from clumping together and blocking an artery.
If your CHD is deemed severe, the doctor may recommend the antiplatelet drug clopiddogrel (Plavix, Iscover) rather than aspirin. In a major 2001 study, the number of heart attacks, strokes and deaths from heart disease in patients on clopidorgrel was much lower than in those an aspirin. It's also better than aspirin in reducing heart attack after angioplasty.
To lighten the demands on your heart, your doctor may also prescribe a beta-blocker can reduce the risk of dying from CHD. They are especially valuable if you have silent cardiac ischaemai, in which oxygen to your heart is reduced but you don't have chest pain (angina). And if you do have angina, the beta-blocker may lessen the need for pain-relieving nitrates. (Remember, beta-blockers don't) stop angina pain once it's started. Glyceryl trinitrate is best for that.)
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