Reducing the Risk of a Second Heart Attack

Main Category: Cardiovascular / Cardiology
Article Date: 03 Oct 2004 - 0:00 PST

email to a friend   printer friendly   opinions  

Brian Hickey was only 47 years old when he experienced chest pain while driving home from a party. Feeling that something was very wrong, Hickey drove himself to an emergency room where doctors determined that he was having a heart attack.

Each year, approximately 1.2 million Americans suffer a heart attack. Of these, about 500, 000 have already had at least one heart attack. Research consistently shows that aggressively making changes to risk factors can reduce the likelihood of coronary artery disease. Learning about - and then actually making - lifestyle changes can be an important tool for people who have had a heart attack and who are willing to follow through with new heart-healthy habits to avoid another cardiac event.

The University of Michigan Health System's Coronary Artery Disease Management Program is a nurse practitioner-based, case manager program that assists primary physician and cardiologist care. It does this by enhancing patient understanding and compliance with measures that promote quality of life and reduce recurrent coronary events. For patients like Brian Hickey, the program is making a difference.

"I'd been very healthy, maybe getting a little thicker than I used to be, but I'd always stayed active and played sports throughout my life. But, about two years ago, I experienced a life-changing event," Hickey says of his heart attack.

Today, Hickey is a graduate of the U-M's Coronary Artery Disease Management Program, which teaches high risk patients about what the risk factors are for heart disease and what they can do to reduce their own risk factors.

"The Coronary Artery Disease Management Program can make tremendous improvements in patients' health. Our goal is to increase patients' understanding, and then to increase the quality of their lives," says Susan Housholder, MSN, CCRN, CS, nurse practitioner in Preventive Cardiology at UMHS.

There's no question that patients can live a healthy, normal, vigorous life after having a cardiac event. The key is to make sure their risk factors are under control through understanding the safe way to exercise, the best way to eat, and how to reduce stress.

Housholder notes that it's very difficult for people to change their lifestyles because they've lived with a certain set of habits for years. Her program involves a team of physicians, nurses, exercise physiologists, nutritionists, smoking cessation counselors and stress management experts who work with patients to modify their risk factors. As the most important member of the team, patients work with these professionals to examine:

-- History: family and medical, including medications

-- Psycho-social: support systems, learning style, social and religious affiliations, what activities are enjoyable

-- Smoking cessation, for smokers

-- Nutrition: how to improve diets, including strategies for lowering fats, increasing fiber and improving cholesterol

-- Fitness: on-site cardiac rehabilitation monitored by cardiac professionals, as well as one-on-one exercise consultations so patients can transition to a home program

-- Stress management: meditation, yoga, muscle relaxation techniques

-- Medication management and education: to understand what prescribed medications do, and why it's important to continue taking them

"Any recent cardiac patient has to wonder what's OK to do now, at this stage. Having a heart attack changes your view of yourself as a healthy human being," Hickey says. The U-M program helped, he says.

Less than a week after discharge from the hospital, Hickey's primary care physician recommended he take part in the U-M's Coronary Artery Disease Management Program. Two years later, Hickey knows a lot about eating right, exercising and managing stress, and he knows how these contribute to fighting heart disease.

"Those are my take-aways. They do an excellent job of making you aware of what you can be doing on a daily basis to live a healthier life. I'll always have those lessons, and I'm grateful," he says.

Housholder says that all heart attacks are serious heart attacks, so patients really do have to commit to learning more about the risk factors and the ways they can reduce their own risks. They need knowledge and a good support system in order to feel confident about changing their behaviors. Her team of health care providers is there to help.

For more information, visit the following Web sites:

U-M Cardiovascular Center: Disease Management/Cardiovascular Disease
http://www.med.umich.edu/cvc/adult/discar.htm

U-M Cardiovascular Center: Prevention/Coronary Artery Disease Management Program
http://www.med.umich.edu/cvc/adult/precadm.htm

U-M Health Advisor: Myocardial Infarction (Heart Attack)
http://www.med.umich.edu/1libr/aha/aha_myoinf_car.htm

National Heart, Lung, and Blood Institute: Heart Attack
http://www.nhlbi.nih.gov/health/dci/Diseases/HeartAttack/HeartAttack_Treatments.html

National Heart, Lung, and Blood Institute: Coronary Artery Diseases
http://www.nhlbi.nih.gov/health/dci/Diseases/Cad/CAD_Treatments.html

National Heart, Lung, and Blood Institute: Heart and Vascular Disease
http://www.nhlbi.nih.gov/health/public/heart/index.htm

Centers for Disease Control: Receipt of Cardiac Rehabilitation Services
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5244a4.htm

University of Michigan Health System
Public Relations & Marketing Communications
2901 Hubbard St., Ste. 2400
Ann Arbor, MI 48109-2435
United States
Phone 734-764-2220
Fax 734-615-2169

• Additional
• References
• Citations