Kouichi Yano writes:

        The most important issue for T to understand right now is that his condition is very serious, because his pain in the neck is caused by narrowing carotid arteries and the upper chest pain is caused by coronary heart disease. So he must pay much attention to bad his health.

        I have the biggest concern with T's early atherosclerosis. Atherosclerosis is a condition of arteries characterized by deposits of fat, cholesterol and other substances. Smoking is very harmful to atherosclerosis, because smoking narrows his arteries. I also have concern that he is a type A personality and his family history in which his mother died of hardening arteries.

        In order to feel better for him in a short time I will remove his pain. His pain is caused by narrowing carotid arteries and coronary heart disease. To remove his pain, I had better give him medicine that opens his arteries. So I think his pain will be reduced.

        In order to prevent heart disease in the long term, I will make him pay attention to the next 5 points. First, I make him stop smoking. He is a heavy smoker. But he does not know smoking accelerates arterial thickening. If he does not stop smoking, his pain is not reduced.

        Second, I will make him exercise. He is a former marathon racer. Now he does not do it. A study shows that long-distance runners have a greater capacity for "dilating" their coronary arteries and thus markedly increase blood flow to their heart muscle. Perhaps now his arteries are narrowing. If he wants to feel better, he had better exercise.

        Third, if he has high blood cholesterol, he had better lower his blood cholesterol. Blood cholesterol deposits accumulate along the inner walls of the coronary arteries. High blood cholesterol is improved by taking a lower cholesterol diet. Fourth, if he is overweight, he had better lose his weight. Because being overweight is apt to cause high blood pressure. High blood pressure is a burden for the heart.

        Fifth, if he can, he had better decrease his work. He is an overworked bureau chief. (In other words, he is a Type A personality.) The Type A personality strains his nerves and he always is tense. So a Type A personality is very tiring and a burden for his arteries.

        If he follows the above 5 points, perhaps he can prevent heart disease and he will feel better in the long term.

         

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