Take Steps to Survive Heart Disease after a Heart Attack or Surgery

SPRINGFIELD — Feeling sad, anxious, or depressed after having a heart attack or heart surgery is normal, and so is worrying that you might have another heart attack.

It’s a fact that 90% of people survive a heart attack, and according to the National Institute for Health and Clinical Excellence, survival rates one year after open-heart surgery are 96% to 97%. That’s good news for patients. But that doesn’t mean they can go back to their normal ways as before without some healthy lifestyle changes.

“Back in the 1950s, four to six weeks of bed rest was recommended for heart-attack patients. Soon after, contrary evidence was presented that getting a patient out of bed to walk and exercise right away offered better outcomes. Now that advice applies to not only heart-attack patients, but for those who have undergone heart surgery and even others with heart failure,” said Dr. Quinn Pack, preventive cardiologist in the Heart & Vascular Program at Baystate Health.

“Cardiac rehabilitation programs, such as those offered at Baystate Health, are the pillar of recovery and are critical to regaining function and optimal health, as well as reducing the risk of another heart attack or other cardiovascular problems,” he added.

While he noted that some people may be nervous about resuming exercise or activity after having a life-changing cardiovascular event, cardiac-rehabilitation exercise is held in a medically safe environment where heart-attack, surgical, and congestive heart-failure patients, under close supervision of cardiac-health professionals, can discover what their limitations are and what they can do to alleviate their fears.

“Getting started on a walking program right after hospital discharge is a good first step,” Pack said.

Start slow, but be sure to actually get moving, as too much bed rest can be harmful. When not in cardiac rehab, patients are encouraged to exercise at home, with the goal to get 150 minutes of exercise each week and 7,000 steps each day.

Survival is a lifelong process, Pack noted. “I once had a patient who was hospitalized after his second heart attack. After his first heart attack and bypass surgery, he thought he was ‘fixed’ and so did nothing else for his own health, including taking recommended mediations. Unfortunately, his bypass surgery only lasted three years, when it should have lasted 10 to 15 years. Coronary disease is a chronic illness and requires continuous attention throughout your life.

“You will need to partner with your physician and listen carefully to advice given,” he went on. “Many of your risk factors will need to be addressed to improve your heart health after a heart attack or heart surgery. We have good treatments and medications to manage almost all of these risk factors and improve your quality of life. It’s all about lifestyle changes.”

The Baystate cardiologist noted that a doctor may prescribe statin medications to lower cholesterol and others to control high blood pressure and diabetes for those with high sugars; recommend working with a dietitian to eat healthier, quitting smoking, and losing weight if obese; and offer advice on managing stress, which can lead to high blood pressure and increase one’s risk for another heart attack or even a stroke.

For smokers, Pack said he is “a big fan of addressing this bad habit first,” and that “it’s never too late to quit smoking” because research has shown that quitting smoking can cut the risk of repeat heart attacks and death from heart disease by about half. “It’s the most important and powerful behavior change I know of to prevent heart disease.”

Many medications and online are available to help people quit, he added. “The goal is total cessation. Although promoted as a quitting agent, e-cigarettes as a bridge to quitting smoking has so far been mostly unsuccessful. Also, e-cigarettes have been linked to thousands of cases of serious lung injury. The CDC recommends that people not use e-cigarettes.”

Not smoking also applies to marijuana, Pack said. “One joint is equivalent to inhaling the smoke from one cigarette. While one won’t kill you, smoking a joint every day can catch up with your heart and cause other health issues.”

As for alcohol consumption, the World Heart Federation released a statement last month noting “the evidence is clear: any level of alcohol consumption can lead to loss of a healthy life, with studies showing that even small amounts of alcohol can increase a person’s risk of cardiovascular disease.”

Therefore, Pack noted, “if you are drinking wine for the health benefits of the antioxidants it contains, you are much better off getting antioxidants from eating fresh blueberries and grapes instead.”

Addressing mental health is also important, he explained. Exercise has powerful effects on reducing depression and anxiety. Additionally, stress reduction can be important. This can include medication, prayer, purposeful gratitude, and mindfulness. Even taking a minute or two to notice one’s surroundings and find gratitude can improve health, he said.

There is good news and bad news, Pack noted.

“The good news is that we are living in the golden age of cardiology. If you adhere to your physician’s advice to stop smoking, follow your recommended diet, exercise, take your medications regularly, and actively participate in therapies your doctor orders, then your chance of survival has never been better. If you choose not to, then you can expect to have multiple more problems with your heart and a shorter lifespan.

“The bad news is that we have no cure for heart disease yet,” he added. “But today’s modern therapies can slow the disease greatly, and that is good news overall.”

February is American Heart Month, a time to shine a spotlight on heart disease, the number-one killer of Americans, when people can focus on their cardiovascular health and address their risk factors for the disease.