Written By: American Heart Association
A heart attack or stroke is an unwelcome event that often repeats itself.
About one in five people who’ve had a heart attack will be readmitted to the hospital for a second one within five years. Each year, there are about 335,000 recurrent heart attacks in the United States. Each year, about one in four stroke survivors suffers another.
To avoid a recurrence, it’s crucial to immediately consider treatment and prevention measures.
“The patient has to change their lifestyle with appropriate diet and exercise,” said Marwan Nasif, MD, a cardiologist with Lake Health. “They also have to take prescribed medications. These medications have been shown to be very effective in improving survival and quality of life.”
After a heart attack, a physician likely will prescribe:
- Aspirin to thin the blood and prevent another blood clot from forming;
- A beta blocker to decrease the heart rate and force of contraction, which lowers blood pressure and makes the heart beat more slowly and with less force;
- Statin therapy to help lower low-density lipoprotein (ldl) cholesterol, also known as “bad” cholesterol, in the blood; and
- Perhaps other drugs to improve heart muscle function.
Dr. Nasif emphasized the importance of keeping regular medical appointments and monitoring risk factors such as blood pressure. Be aware that a symptom, even a mild one that goes away, may signal the possibility of a recurrence.
“Chest pain or chest pressure, dizzy spells, arm pain, nausea and not feeling well – all may be initial warnings for a second heart attack,” Dr. Nasif said.
To recover after a heart attack, it’s important to participate in cardiac rehabilitation, an outpatient program that uses medically supervised exercise – usually an average of three times per week for three months. It also includes nutrition counseling and risk management.
“Numerous studies have shown that cardiac rehab improves quality of life and functionality of patients after heart attack,” Dr. Nasif said.
One study found that cardiac rehab helped reduce chances of a repeat heart attack by 47%. Another found that patients who participated in cardiac rehab were 42% less likely to die within an average of eight years.
The preventive regimen for stroke is similar, with attention on controlling cholesterol and reducing blood pressure. Also, Dr. Nasif said, “It’s important to rule out carotid disease that may need surgical treatment and silent paroxysmal atrial fibrillation in some patients with outpatient monitoring for two weeks.”
Diet, physical activity, not smoking and taking medications as directed play important roles keeping a second heart attack or stroke at bay.
Aim for a healthy diet that emphasizes vegetables, fruits and whole grains. Include low-fat dairy products, poultry, fish, legumes, nuts, seeds and non-tropical vegetable oils such as olive oil. Limit saturated fat, sodium, added sugars, sugar-sweetened beverages and red meat.
Move more and sit less. If you can, aim for 150 minutes of moderate- to vigorous-intensity aerobic exercise per week. Moderate exercise such as walking briskly or riding a bike should make you break a sweat or increase your heart rate. For a vigorous activity, try jogging.
Tobacco use is a major risk factor for heart attack and stroke. If you smoke, get help to quit. Effective tools include behavior modification programs, nicotine replacement medicines and other quit-smoking medications. You don’t have to do it alone. Support groups and hotlines can help you.
Take your medications as prescribed
Right after a heart attack or stroke, taking medication may be your highest priority. If your health care professional prescribes medications to help control blood sugar, cholesterol, blood pressure or manage other conditions, take them as directed. If you don’t know what a medication is for, ask your doctor, nurse or pharmacist.
It’s a team effort. Your health care team can help you build a prevention plan that works for you. Ask questions and make decisions together. Talk about challenges in your life that may affect how you manage your risk factors and ask for support.