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- Control high blood pressure (hypertension): One of the most important things that can be done for prevention of a heart attack is to reduce high blood pressure. Blood pressure should be a systolic reading of 120, and a diastolic reading of 80 (120/80mmg Hg). Exercising, managing stress, maintaining a healthy weight, and limiting sodium (salt) and alcohol intake are all ways to keep blood pressure in check. Medications to treat hypertension, such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers may be used.
- Lower cholesterol and saturated fat intake: Eating less cholesterol and fat, especially saturated fat, may reduce the amount of plaque (deposits) in the arteries. Most people should aim for a low density lipoprotein (LDL) level below 130mg/dL. If there are other risk factors for heart disease, the target LDL may be below 100mg/dL. If the individuals are at very high risk for heart disease, such as having a previous heart attack, an LDL level below 70mg/dL may be optimal. Statin drugs (HMG-CoA reductase inhibitors, such as lovastatin or Mevacor ®) can be prescribed to help maintain healthy cholesterol levels.
- Platetet inhibitors: Platelet inhibitors keep platelets from clumping together. In otherwise healthy men older than 50 years, aspirin 325 mg every other day prevents myocardial infarction (at a rate of 2 men per 1,000) but not stroke. In otherwise healthy women older than 45 years, aspirin 100mg every other day prevents ischemic stroke (at a rate of 3 women per 1,000) but not myocardial infarction. Aspirin may increase in the risk of gastrointestinal bleeding. Other platelet inhibitors include dipyridamole (Persantine ®), ticlopidine (Ticlid ®), and clopidogrel (Plavix ®). A 15% relative risk reduction in vascular events (stroke, heart attack, and death) has been documented for aspirin compared with placebo.
- Stop smoking: Smoking is a major risk factor for coronary artery disease and heart attack. Nicotine constricts blood vessels and forces the heart to pump harder. A buildup of carbon monoxide (CO) reduces oxygen in the blood and damages the lining of the blood vessels.
- Control diabetes: Managing diabetes with diet, exercise, weight control and medication is essential. Strict control of blood sugar may reduce damage to the heart.
- Flu shots: Flu shots for patients with chronic cardiovascular disease are now used routinely.
- Weight control: Being overweight contributes to other risk factors of a heart attack, such as high blood pressure, cardiovascular disease, and diabetes. Weight loss of as little as 10 pounds may lower blood pressure and improve cholesterol levels.
- Exercise: Exercise can lower blood pressure, increase the level of HDL cholesterol (good cholesterol), and improve the overall health of blood vessels and heart. It also helps control weight, control diabetes and reduce stress. Thirty minutes daily of exercise is normally recommended.
- Manage stress: Stress can cause an increase in blood pressure along with increasing the blood's tendency to clot. Managing stress can be vital to keeping a heart healthy.
- Diet: Eat healthy foods. A brain-healthy diet should include five or more daily servings of fruits and vegetables, foods rich in soluble fiber (such as oatmeal and beans), foods rich in calcium (dairy products, spinach), soy products (such as tempeh, miso, tofu and soy milk), and foods rich in omega-3 fatty acids, including cold-water fish, such as salmon, mackerel and tuna. However, pregnant women and women who plan to become pregnant in the next several years should limit their weekly intake of cold-water fish because of the potential for mercury contamination. The U.S. Food and Drug Administration (FDA) has announced that whole grain barley and barley-containing products are allowed to claim that they reduce the risk of coronary artery disease.
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