Takaaki Sugihara writes:
I should tell Mr. O that he has several
risk factors. First, his blood pressure indicates moderate to high hypertension,
165-105 mm Hg. It could be a risk factor because high blood pressure/hypertension
was listed on death certificates as the cause of death of 38,130 Americans
in 1994 and was listed as a contributing cause on more than 180,000 other
death certificates of stroke,heart attack and heart failure victims. And
it is known that men are at greater risk for high blood pressure than women
until passed age 65 or older.
Another risk factor is his cholesterol count. His cholesterol tests are
not positive. His LDL level is above 160mg/dL = high risk. Higher LDL levels
may narrow his vessels. It can be a cause of high blood pressure and hypertension.
On the other hand, low HDL cholesterol (less than 35mg/dL) is also a risk
factor, because HDL removes cholesterol from the lining of the arteries
and help maintain good blood flow.
According to causal observation, I think that 20 kilos overweight will
be a risk factor. Being overweight may increase our blood cholesterol level.
Most overweight people with elevated blood cholesterol levels can help
lower their levels by losing weight.
Even if he cuts down his smoking from a pack a day to less than half a
pack, smoking must also be a risk factor because about 417,000 Americans
died of smoking-related illnesses in 1990. In addition, nearly one-fifth
of deaths from cardiovascular diseases are attributable to smoking and
about 37,000-40,000 nonsmokers also die each year from cardiovascular diseases
as a result of exposure to environmental tobacco smoke.
And he tells me that he hardly gets
out of the office, I think he is a workaholic. But physical inactivity
is also said to be a risk factor.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.
These risk factors may bring on another myocardial infarction. Data shows
that sudden death occurs at from four to six times the rate of the general
population among people who've had a heart attack.
I want to think about what he can do if he had a heart attack. Even though
the symptoms are hard to recognize,l et's try to learn about the signals
of heart disease and your own risk factors. This is the first step if he
wants to live longer. If he experiences one or more symptoms of a heart
attack, he has to act quickly and take the following steps. Sit down or
lie down. And if symptoms persist for 2 minutes, call the local emergency
telephone number and say you may be having a heart attack. If you can go
to the hospital faster than by ambulance, have someone drive you. You should
never drive your car. If you have nitroglycerin tablets, take up pills,
one at a time every 5 minutes. The point is not to delay getting medical
treatment, even if you are not sure you are having a heart attack.
Next, I will take four measures for
his risk factors.
First, about his high blood pressure: There are several medicines known
as antihypertensives. Some, called diuretics, rid the body of excess fluids
and salt (sodium). Others called beta blockers reduce the heart rate and
the heart's output of blood. Other class of antihypertensives are called
sympathetic nerve inhibitors, vasodilators, A.C.E. or angiotensin converting
enzyme inhibitors and the calcium antagonists. If he uses these drugs following
the doctor's instructions, and one of his risk factors will be removed.
Second, about his cholesterol count: He should reduce LDL levels and gain
more HDL. Quitting smoking, losing weight, and becoming physically active
may help raise his HDL-cholesterol level. Saturated fat raises our blood
cholesterol level more than anything we eat. Foods high in cholesterol
or saturated fat are: egg yolks, sausage, kidneys, liver, and whole milk
products such as butter, cheese, yogurt and ice cream. Red meats are also
higher in cholesterol. And vegetable oils, such as palm, palm kernel, and
coconut oil, contain no cholesterol but are high in saturated fat. So avoiding
these foods as much as he can (for example, only three times a week) may
help to bringhis cholesterol level to near normal.
Third, about his being overweight combined with physically inactivity:
To keep his weight down, he should participate in routine physical exercise
and control his calorie intake. In this case he should do it carefully,
because his heart attack occurred on a hiking trip before.
Fourth, about his smoking: Just stop smoking! I propose that he make it
his first step to lead a healthy life.
The first three suggestions are what Mr.O should do in the long term to
help prevent the occurrence of another heart attack. And the fourth is
what he should do within the next few weeks to improve his health outlook.
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