Miyuki Daio writes:
The most important issue for T is
that he has many risk factors for developing coronary heart disease. He
is 39 years old, and is not very young. And he is a Type A personality,
an overworked bureau chief. To make matters worse, he is hypertensive,
has feelings of weakness and mild pain in the neck and upper chest areas.
He has early atherosclerosis. He hasn't exercise recently, and he smokes
very much, 2 packs a day. The worst point is that he doesn't pay attention
to his own health condition at all. He thinks that he is still young and
healthy. It is not good for clinical treatments.
I think that lack of exercise and heavy smoking are the obvious serious
problems for his heart condition, but there are other problems. For example,
he used to run a marathon, but he doesn't exercise now. I think that physical
inactivity is another bad problem. Long-distance runners have a greater
capacity to dilate their coronary arteries and thus markedly increase blood
flow to their heart muscles. According to this, patient T was not hypertensive
before. And his mother died after heart by-pass surgery complicated by
hardening of the arteries (atherosclerosis). So I think that this is another
indirect concern that he has a family history of heart disease.
I must help him feel better in the short time. I will give him some medicine
for taking weakness and pain out, and to reduce his high blood pressure.
Then he will feel better soon.
And if he tries to reduce smoking, he will be feeling better, because cigarettes
constrict blood vessels. So his blood pressure will become lower, if he
can stop smoking gradually. And I must advise him that it is not good to
overwork, to think about his business too seriously. I will tell him he
needs to enjoy his life, think about his life positively and easily, because
his mentality will affect medical treatment.
And I must tell him how to prevent heart disease in the long term. At first,
I will tell him how serious his health condition is. He should find he
has risks to develop serious atherosclerosis and heart disease. But I must
not forget to encourage him. To become pessimistic will obstruct the good
effect of medical care.
He should do more regular exercise and reduce and quit smoking. Then his
blood pressure will become normal. And he wouldn't get overweight. Because
exercises, especially running for him, will help his coronary arteries
dilate and help his blood pressure to get lower. It is important that he
is careful about his diet and eating habits. Especially, he should pay
attention to intake of sugar and fat. He might not get overweight if he
does exercise regularly and eats healthy. His HDL level will be correct,
too. Because exercises burn fat. If he can keep this advice, quitting smoking
gradually, doing exercise regularly, paying attention to his diet and taking
care of his cholesterol level and his weight, he can reduce his risks of
heart disease.
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