Patient Takahashi (T) is a 39-year-old male, a former marathon racer who now works for an insurance company as a well-paid, high-achieving and overworked bureau chief. (In other words, he is a Type A personality.) He has recently been diagnosed "hypertensive" (170/100 mm Hg); he frequently experiences feelings of weakness and mild pain in the neck and upper chest areas; clinical analyses indicate early atherosclerosis.

Patient T does not think his condition is very serious. He tells you that both his parents lived well into their sixties, although his mother died after heart by-pass surgery complicated by hardening of the arteries. He tells you, further, that he is "just too young" and "too busy" to pay much attention to his health right now. He adds, "Nobody really knows who will come down with heart disease. Most people are just lucky -- until they get much older, that is. I think I am one of the lucky ones!"

Patient T no longer exercises. He is a heavy smoker (two packs a day). And while he knows he should reduce his smoking and take up regular exercise (perhaps start running again), he can't "find the time to bother with these things."

In addressing T's case, consider the information in the following topics from the General Issues section:

Adults with No Risk of Heart Disease;

Long Distance Running;

Hardening of the Arteries;

and Affects of Smoking.

Additionally, with regard to increasing life expectancy, consider information in

Gender and Therapy

in the Women's Issues section. Also, carefully read the following file on

Risk Factors for Heart Disease, Incidence and Hypertensive Status by Gender and Age.