Written by Dr Karthik Vasudevan,
Many patients of mine often ask me if their life can continue the same way after a heart attack and if it impacts their lifespan. What next, they wonder. I tell them that the future lies in their hands, the way they keep to discipline on medication, follow-ups, lifestyle correction and exercise. The functionality of the heart, despite corrective procedures, depends on how well you monitor it and watch out for red flags.
This is particularly important after researchers at Leeds University have found that heart attack survivors go on to develop conditions at a much higher rate than normal people. Up to a third of patients in the study went on to develop heart or kidney failure, seven per cent had second heart attacks, while 38 per cent died from other causes during the nine-year study period. This is the largest study of its kind, with researchers analysing more than 145 million records covering every adult patient admitted to hospital in the UK.
While more people than ever are surviving heart attacks — up to 90 per cent by most estimates —there can be longer-term consequences. If the patient is not attended to within the first 30 to 60 minutes of a heart attack, there could be irreparable damage to the heart tissue, putting them at increased risk of heart failure. That’s why we need to control any triggers that may exacerbate this condition.
KEEP RISK FACTORS IN CHECK
A heart attack survivor must realise that they suffered an attack in the first place because of risk factors like diabetes, hypertension, obesity, chronic kidney disease (CKD), bad cholesterol or stress. And they had swung too far out of range.
While an intervention or putting a stent takes care of the immediate problem, rolling back co-morbidities takes time. Once parameters are down to safe levels, one has to hold them there over the years.
TRACK BLOOD SUGAR LEVELS EVEN IF YOU DO NOT HAVE DIABETES
Even if you do not have diabetes during a heart attack, it can develop silently with advancing years. This may lead to microvascular dysfunction, where small blood vessels feeding the heart muscle, the kidneys and retina get affected. Over a period of time they manifest as bigger problems. Sometimes, silent diabetes leads to macrovascular complications, impacting bigger arteries and resulting in plaques in the heart, brain and limbs. That’s why a patient must avoid diabetes in a post-attack scenario because it predisposes them to another event.
GO FOR CARDIAC REHAB
Do not neglect cardiac rehabilitation, an outpatient programme involving medically supervised exercise, beginning with thrice a week sessions over three months. One study found that cardiac rehab helped reduce chances of a repeat heart attack by 47 per cent. Another found how patients in cardiac rehab were 42 per cent less likely to die within an average of eight years.
CHANGE YOUR DIET
Get closer to the Mediterranean diet that emphasises fruits, vegetables, leafy greens, legumes, wholegrains, nuts, fish and lean meats. Cut out saturated and trans fats for good. Give up snacks that have partially hydrogenated oils.
STOP SMOKING, DRINKING
You can cut your risk of another heart attack by half if you stop smoking. Alcohol raises your blood pressure, blood sugar and triglyceride levels.
TAKE MEDICATION AS ADVISED
Your heart, cholesterol (statins), and blood pressure medicines are an important part of your bouncing back routine. You may be given drugs called PCSK9 inhibitors if you’re at a higher risk and your cholesterol has been hard to control.
Keep body weight in range: Being overweight greatly increases your risk for a second heart attack. Your BMI (body mass index) should be between 18.5 and 24.9.
Do not miss your follow-ups: Keeping track of your condition and recovery is not a temporary but a life-long exercise. So pay a visit to your cardiologist as advised.