9 Things To Know About Cholesterol Management After A Heart Attack
After a heart attack, there are many steps you can take to reduce the risk of another one.
A heart attack can change a person’s life, both physically and mentally. Even if the symptoms don’t last, they can make it difficult to move around, make recovery more difficult, or make you feel weak again.
Many people don’t realize the importance of getting cholesterol management advice from their doctor until many years after a heart attack.
The link between high cholesterol and heart attacks
Produced in the liver and found in animal products, cholesterol plays an important role in many functions of the body, including the building of new cells. However, high levels of cholesterol in the blood can lead to a build-up of plaque – a hard layer of cholesterol and other substances – in the blood vessels, known as atherosclerosis.
When areas of plaque in the arteries that supply blood to the heart become unstable and rupture, a blood clot can form, completely blocking blood flow to that area of the heart and depriving it of oxygen. This can lead to a heart attack, which often causes lasting damage to the heart muscle.
According to the American Heart Association (AHA), one in five people who have had a heart attack will have another heart attack within five years. The report notes that there are steps you can take to reduce your risk of a recurrence, including controlling your cholesterol.
How to lower your cholesterol
The good news is that even if you had unhealthy cholesterol levels years before your heart attack, there’s evidence that lowering cholesterol can have real benefits.
Here are some tips on how to lower your cholesterol and reduce the risk of another heart attack, and what not to do
- Take your medication exactly as prescribed by your doctor
While it’s important to live a healthy lifestyle, it’s equally important to take your cholesterol medication as prescribed.
The goal is to lower your “bad” low-density lipoprotein (LDL) cholesterol using a combination of as many medications and lifestyle measures as possible.
Talk to your doctor about which medication or combination of medications is best for you. Other cholesterol-lowering medications include PCSK9 inhibitors, selective cholesterol absorption inhibitors, bile acid, fibrates and niacin.
- Participate in cardiac rehabilitation therapy
Cardiac rehabilitation programs help you become physically active after a heart attack by guiding you through a safe and effective exercise program, and you can eventually continue exercising on your own while building your strength.
Not all doctors refer patients for cardiac rehabilitation, perhaps because they suspect that someone who has not exercised in the past will suddenly change his or her lifestyle after a heart attack.
A typical program consists of three one-hour sessions per week for 12 weeks, with at least half of the time devoted to aerobic exercise. The rest of the time is spent providing advice on exercise, nutrition and other aspects of a healthy, mindful lifestyle.
According to an article published in February 2015 in the Journal of the American College of Cardiology, an exercise-based cardiac rehabilitation program can reduce the risk of a second heart attack by 47 percent, based on an analysis of 34 randomized controlled trials.
- Do more aerobic exercise
Whether you’re in a cardiac rehabilitation program or not, it’s important to get enough aerobic exercise, which includes activities such as walking, swimming and bicycling.
The AHA recommends at least 150 minutes of moderate aerobic exercise per week, with at least 30 minutes five days a week.
- Aim for a healthy weight
If you get enough exercise and eat a healthy diet, you can lose excess weight even if you don’t want to. If you are overweight, losing weight has also been shown to reduce an individual’s risk of cardiovascular events, such as heart attacks.
According to Andrews, weight loss is one of the most discussed topics in cardiac rehabilitation. However, he notes that the behaviors that lead to weight loss – eating well and exercising – are more important than achieving weight loss goals, even if there are benefits to not losing weight.
- Choose healthy fats over unhealthy ones
You don’t have to eliminate all fats from your diet, but you must be careful about the fats you choose.
Healthy fats are liquid at room temperature. They are unsaturated fats. Foods high in unsaturated fats include olive oil, nuts and seeds, avocados and fatty fish, and according to the AHA, unsaturated fats can help improve cholesterol when consumed in place of saturated or trans fats.
Unhealthy saturated fats, which are solid at room temperature, have been shown to raise LDL (bad) cholesterol levels. Examples include butter, cheese, meat and poultry fats. Trans fats, found in baked goods, fried foods and shortening, can raise LDL and lower high-density lipoprotein (HDL), the “good” cholesterol that absorbs excess cholesterol from the blood and returns it to the liver.
The AHA recommends limiting saturated fat to 5 to 6 percent of daily calories and minimizing trans fat intake.
- Don’t drink too much alcohol
Alcohol simply becomes a form of carbohydrate in the body, which leads to weight gain. However, it also appears to increase HDL levels, which may have a protective effect against cardiovascular disease.
In addition, red wine contains antioxidants that may help prevent harmful inflammation and increase the risk of heart disease.
According to the AHA, excessive alcohol consumption, combined with high LDL levels or low HDL levels, can increase levels of triglycerides, a type of fat that causes plaque buildup. If you drink alcohol, talk to your doctor about the benefits and risks of moderate alcohol consumption.
- Avoid stress
Stress, especially chronic stress, has been shown to increase the risk of cardiovascular events such as heart attacks. For this reason, many cardiac rehabilitation programs include a stress reduction component, in which a specialist talks with participants to identify sources of stress in their lives and how to manage it.
But you can also cope with stress yourself by examining the causes of stress and finding ways to avoid or treat the stressors. Many people find yoga, meditation and guided imagery helpful.
- Don’t ignore your emotions
A study published in the Journal of Clinical Neuroscience in October 2017 showed that depression is common among older adults with cardiovascular disease. In addition, depression is associated with more severe cardiovascular events and death-related outcomes.
If you experience feelings of despair or anxiety after a heart attack, talk to your doctor or mental health professional. You may benefit from joining a heart attack survivor support group or social commitment associated with a cardiac rehabilitation program.
- Do not act alone
If a heart attack makes you feel scared, vulnerable or angry, there is no reason to let it make you feel alone, as there are probably many people in your community who have had the same experience.