Kaori Tonaki writes:

        1) Mr. O has some risk factors for another myocardial infarction such as high cholesterol, high blood pressure, being overweight. First, he needs to reduce his cholesterol level. The results of his cholesterol test are not positive. His LDL (so called "bad cholesterol") level is 173 mg/dl, and the HDL (so called "good cholesterol") level is 26 mg/dl. These levels mean that total cholesterol and LDL levels are elevated and levels of HDL are low. Along with fat, cholesterol circulates in the blood and builds up in the walls of the arteries and can slow or block the flow of blood. This condition is called atherosclerosis. Furthermore, without sufficient oxygen to the heart, this may cause chest pain called "angina", or if the blood supply is cut off, there is heart muscle injury and a "heart attack", possibly resulting in sudden death. Therefore, he should reduce total cholesterol level to less than 200mg/dl (LDL level ---less than 130 mg/dl, HDL level---higher than 35 mg/dl).

        Second, he had better lose weight because he is almost 20 kilos overweight. Being overweight may also increase his blood cholesterol level.

        Third, he has to stop smoking because smoking is said to prevent the flow of blood. Also, it is said that nearly one-fifth of deaths from cardiovascular diseases are attributable to smoking. Fourth, Mr. O's elder brother died of heart disease five years ago. Because genetic factors affect blood cholesterol level and can determine how much he can lower level by diet and risk of heart disease, he has to be careful of his health.

        Finally, 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. Consequently, he needs to do exercise regularly.

        2) To get quick treatment for a heart attack can be lifesaving. When he experiences one or more symptoms of a heart attack, first, he had better sit down and lie down. If symptoms persist for 2 minutes, he needs to call a local emergency telephone number and say he may be having a heart attack. And, he had better leave the phone off the hook so that medical personnel can locate his address if he should become unconscious. Or, if he can get to the hospital faster by car than by ambulance, he had better have someone drive him. Then, if he has nitroglycerin tablets, he should take up to three pills one every 5 minutes. In short, it is important that he gets to the hospital and see a doctor as soon as possible.

        3) On improving his health outlook within the next few years, he has to go to hospital and see a doctor. And then, he had better have his medicine to lower blood pressure prescribe by a doctor. There are many types of this medicine. Quite often people respond very differently to these medicines. Thus patients must go through a trial period to find out which medicines are most effective while causing the fewest side effects. Also, it is important to stay on medicine.

        4) If he wants to develop ways to prevent the occurrence of another heart attack, I want to advise him to change his life style. First, he should reduce eating cholesterol and fat, because cholesterol consumed in foods is unnecessary to our body's proper functioning. (But cholesterol is essential to human life.) Also, saturated fat raises his blood cholesterol level more than anything else he eats. Food high in cholesterol or saturated fat are egg yolks, whole milk products, sausage and so on. In addition, vegetable oils, such as palm, palm kernel, and coconut oil, contain no cholesterol but are high in saturated fat. So, he had better eat vegetables, fish, seaweed, and so on.

        Second, he has to do regular and moderate exercise. This reduces LDL levels and increases HDL levels. So, I'd recommend walking because this way that fat in body is easily oxidized and decomposed. In this way, regular physical activity may help control his weight and is associated with a reduced risk of heart disease and lower blood pressure. Finally, he should quit smoking because it prevents the blood from flowing.

        If he carries out and continues these suggestions, he can solve his problem related to heart disease, I think.

         

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