Mami Oki writes:

        1) Coronary disease risk factors are cigarette smoking, cholesterol, physical inactivity, being overweight and diabetes. Mr. O has many of these risk factors. Mr. O had once been a heavy cigarette smoker, but he has cut down his smoking from a pack a day to less than half a pack. The results of cholesterol tests are not positive: LDL -- 173 mg/dl; HDL -- 26 mg/dl. His only exercise is walking across the street from his apartment to his office and back. Mr. O is almost 20 kilos overweight.

        2) Sudden death occurs at from four to six times the rate of the general population among people who have had a heart attack. you should know what do when a heart attack . First, sit down or lie down. If symptoms persist for 2 minutes, call your local emergency telephone number and say you may be having a heart attack. Leave the phone off the hook so that medical personnel can locate your address if you should become unconscious. If you have nitroglycerin tablets, take up to three pills, one at time every 5 minutes.

        3) First, stay on medication. O's dietary and lifestyle changes also may help control high blood pressure. For example, reducing sodium in his diet. Blood pressure also is reduced if he lose weight. Increasing physical activity can reduce blood pressure. Before drugs are prescribed, these methods to control blood pressure are often recommended for Mr.O with only mildly elevated blood pressure.

        4) In the long term he should change his life style. He once had been a heavy smoker, but he has cut down his smoking from a pack a day to less than half a pack. But even if he cuts his cigarette smoking to half, it is still bad for his heart. Smoking relates to many illnesses. So, it would be better for him to decrease the amount of cigarette smoking little by little.

        Another problem for Mr. O to prevent heart disease is cholesterol. It is reported that among elderly Japanese-American men in the Honolulu Heart Program Fourth Examination (1991 -- 93), 42 percent had cholesterol levels greater than or equal to 200 mg/dL or were taking cholesterol-lowering medication. As you can see from this report, decreasing your cholesterol may be lead to preventing your possibility of another heart diseases. Cholesterol is a type of fat made by your liver and it is also contained in certain foods that you eat, such as eggs, meat and dairy products. When you eat these foods often, the amount of cholesterol in your blood is increased. Foods high in saturated fat can also raise the amount of cholesterol in his blood, because his liver turns saturated fat into cholesterol. Cholesterol travels through the blood in different types of packages called lipoproteins. The low density lipoprotein (LDL) delivers cholesterol to the body. The high density lipoprotein (HDL) removes cholesterol from the blood stream. It is important for you to reduce LDL and increase HDL. To reduce fat, trim away all visible fat and boil, bake, or broil rather than fry meats. You can reduce dairy products you take. You can use margarine instead of butter.

        The third problem is that he is 20 kilos overweight. This probably results from the fact that he hardly gets out of the office to do exercise. People with lower incomes and less than a 12th grade education are more likely to be sedentary. The relative risk of coronary heart disease (heart attack) associated with physical inactivity ranges from 1.5 to 2.4, an increase in risk comparable with that observed for high cholesterol, high blood pressure or cigarette smoking. Less active, less fit persons have a 30 -- 50 percent greater risk of developing high blood pressure. To keep his weight down, he should participate in routine physical exercise and control his calorie intake. He should also go to hospital and have an examination regularly.

         

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