Satoshi Akamaru writes:

        1) You suffered a mild heart attack two months ago. It was a very dangerous indication of cardiovascular disease (CVD), even though you feel fine now. Statistics say that about one-fourth of heart attack patients like you will have another heart attack within six years after the first trouble. One out of ten patients will experience sudden death within the same time.

        I think your coronary arteries are under constriction and can not provide sufficient fresh blood to cardiac muscles when necessary, such as when you go hiking. Oxygen shortage in cardiac muscles occurs as symptomatic pain in the chest or upper limb. You have had several acute chest pains right after dinner meals, haven't you?

        It is probably safe to say that narrowing arteries accompany arteriosclerosis. Arteriosclerosis deprives arteries in the whole body of their ductility and leads to hypertension. Hypertension accelerates arteriosclerosis. A vicious circle is formed in this way. Your blood pressure measurements, 165/105mmHg, indicate stage 2 of hypertension and need medical treatment.

        Complicated factors concern the progress of arteriosclerosis. It is generally believed that arteriosclerosis is elevated with high total cholesterol, high LDL levels and low HDL levels in the blood. With LDL--173 mg/dl, HDL--26 mg/dl, you are classified in the high risk group. High levels of total cholesterol and LDL are brought by imbalance between energy intake and output. Your overweight condition indicates overeating and physical inactivity. In fact, your only exercise is walking across the street from your apartment to your office and back. Other factors are smoking and stress in life. Though you cut down your smoking, progress of arteriosclerosis doesn't stop. Even a minor quantity of nicotine in tobacco promotes arteriosclerosis. Your stressful life has bad influence on arteriosclerosis too.

        Also you have a genetic background of CVD. You lost your brother to CVD.

        2) Please prepare sublingual nitroglycerin 0.3 to 0.6mg, which is the most effective drug for angina pectoris. When you feel acute chest pain, you can take it under your tongue. Dramatic relief is usually within 1.5 to 3 minutes, and is completed by about 5 minutes.

        If initial treatment is incomplete, that is, the pain doesn't disappear, there is a possibility of myocardial infarction rising.

        Call your local emergency telephone number and leave the phone off the hook so that medical personnel can locate your address if you should become unconscious. You can ask another person to take you to a hospital by car in case you are close to the hospital which has an ER.

        3) You need medical treatment. First, it is important for you to expand your narrowed coronary arteries, not to obstruct them. For example, you can use cutaneous patches containing nitroglycerin in various sizes, which provide prolonged therapeutic effect. Second, hypertensive drugs will lower your blood pressure. There are diuretics and sympathetic nerve inhibitors and so forth. Third, you must solve your hyperlipidemia, lipids excessive pathosis in the blood and incidents of arteriosclerosis. Fortunately there are anti-hyperlipidemic drugs, invented in recent years.

        You should change some behaviors immediately. You must not do hard exercise such as hiking, which is a burden on your heart and may cause another heart attack. You had better throw your habit of smoking away. Smoking spoils some effects of medical treatments.

        4) Good diet and proper physical activity will improve your hypertension and hyperlipidemia. Please reduce your total calorie intake, especially from fatty food. I recommend you take 30 kinds of foods a day in order to avoid diet imbalance. The best and safe way to reform your physical inactivity is walking. I suggest you have a dog. A lovely partner will ask you to walk him every morning and evening. I know a case in which walking a dog lowered his master's blood pressure without drugs.

        And maybe you don't notice that your stressful business life is affecting your heart. Please cut down your overtime work and don't bring your work home. You should decrease the number of times you do social drinking. You may be afraid of the effect of not drinking, cutting down overtime, etc., on your success in your company. However I don't want to hear the news of your sudden death with you sitting in your chair in your company!

         

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