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Reducing Risks When You Have Heart Disease
- Quit smoking.
- Avoid exposure to secondhand smoke.
- A nicotine patch, gum, spray, or inhaler
- A formal smoking cessation program
- Drug therapy, such as varenicline (Chantix) or antidepressants, such as bupropion
- Aim for a blood pressure less than 140/90.
- If you have chronic kidney disease or diabetes, keep blood pressure less than 130/80.
- If you have high blood pressure, your doctor may have you take medication.
- In addition to medication, make healthy lifestyle changes, such as:
- Reducing your salt intake
- Losing weight
- Exercising regularly—check with your doctor for guidelines on starting an exercise program
- Limiting alcohol intake
- Eating more fruits, vegetables, and low-fat dairy products. (DASH diet)
- LDL (bad) cholesterol less than 100 milligrams per deciliter (mg/dL).
- Non-HDL cholesterol (combination of bad cholesterol) less than 130 mg/dL if triglycerides are greater than 200 mg/dL.
- Follow a low-fat diet.
- Reduce intake of saturated fat, trans fat, and cholesterol.
- Increase consumption of omega-3 fatty acids, found in fatty fish, like salmon. You may also want to talk to your doctor about taking omega-3 supplements.
- If you are overweight, lose weight. Aim to maintain a healthy weight.
- If you smoke, quit.
- Exercise regularly—Check with your doctor for guidelines on starting an exercise program.
- Talk with your doctor about whether you need to take cholesterol-lowering medication.
- Your doctor should approve the type and amount of exercise you do.
- Try to perform at least 30 minutes of moderate intensity activity, such as brisk walking, on most days of the week
- Incorporate more physical activity by increasing daily activities, like walking, cycling, gardening, or household work.
- Include two days per week of strength training.
- The desirable BMI range is 18.5-24.9 kg/m².
- Desirable waist measurements are no more than 40 inches (102 centimeters) for men, and no more than 35 inches (89 centimeters) for women.
- Have your HbA1c tested regularly. The HbA1c test provides information about your diabetes management over the past few months.
- Aim for HbA1c below 7%.
- If blood sugar is too high, intensify therapy to control blood sugar.
- Address other risks, such as weight, activity level, blood pressure, and cholesterol.
- Aspirin is recommended for most people with CAD. If you cannot take aspirin, your doctor may recommend another type of blood thinner.
- If you are at high risk or have had a heart attack, your doctor may recommend other medications, such as ACE inhibitors, beta-blockers, and cholesterol-lowering medication.
American Heart Association http://www.heart.org
National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov
Canadian Cardiovascular Society http://www.ccs.ca
Heart and Stroke Foundation of Canada http://www.heartandstroke.com
American College of Cardiology/American Heart Association (ACC/AHA) guidelines for secondary prevention of coronary artery disease. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 3, 2013. Accessed January 31, 2014.
Antman EM, Hand M, Armstrong PW, et al. 2007 Focused update of the ACC/AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2008;117(2):296-329.
Executive summary of the third report of the National Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). JAMA. 2001;285:2486-2497.
Glycemic goals in patients with type 2 diabetes. EBSCO DynaMed website. Available at: http://www.ebscohost.com. Updated January 22, 2014. Accessed January 31, 2014.
Smith S, Allen J, Blair S, et al. AHA/ACC guidelines for secondary prevention for patients with coronary and other atherosclerotic cardiovascular disease: 2006 update. J Am Coll Cardiol. 2006;47;2130-2139.
Smith S, Blair S, Bonow R et al. AHA/ACC guidelines for preventing heart attack and death in patients with atherosclerotic cardiovascular disease: 2001 update. American Heart Association website. Available at: http://www.circ.ahajournals.org/cgi/content/full/104/13/1577. Published 2001. Accessed January 31. 2014.
Tobacco use disorder. EBSCO DynaMed website. Available at: http://www.ebscohost.com. Updated December 16, 2013. Accessed January 31, 2014.
- Reviewer: Michael Woods, MD
- Review Date: 01/2014
- Update Date: 00/13/2014