After your heart attack you want to do everything possible to prevent a second event. But few things will be as powerful as the choices you will make now.
Whether you had an actual heart attack with resulting damage to the heart, or had a stent put in or the full blown open heart surgery you are still in a very high danger level. Your cardiologist will certainly put you on statins (regardless of your cholesterol level) and make sure your blood pressure is under control. But these are the primary tools of the cardiologist. And yet, they are not the most powerful tools.
If you really, really do NOT want to have another cardiac event, lifestyle HAS to be a factor in your recovery. Granted, if you are a smoker it will be made very clear to you that quitting is not an option. Any provider you see will make this recommendation. However, the depth of knowledge on the specifics of nutrition and exercise is not usually there for most cardiologists (I am, of course, generalizing here). Many will refer you to a nutritionist, but most nutritionists will stick with the “party line” of salt restriction and saturated fat reduction (ok, ok…so I’m generalizing AGAIN).
Here’s the reality. The recommendations we give for both primary and secondary prevention of heart disease still suck. They are general recommendations that don’t get down to the specifics that can make a very large difference. We hear about eating nuts to protect your heart, but not about how these nuts should be raw with no added omega-6 oils (cottonseed, peanut, soybean). It’s these subtle differences that can make all the difference in outcomes.
The same goes for aerobic exercise. I have made it no secret that I’m a big fan of short-burst aerobic activity, and yet the general recommendations are still limited to sustained-type aerobic exercise like walking for 30 minutes a day.
So what’s the point of my rant? That, even though the recommendations given are general, they are still very, very powerful. And this particular article outlines just how powerful. Researchers followed 4,174 patients for just over 4 years who were undergoing cardiac rehab after an acute event to see how much adoption of ideal lifestyle factors had on the risk of another heart attack or death (which is, arguably, worse). The ideal lifestyle factors were:
- Physical activity ≥4 times/week
- Sticking with a Mediterranean diet (highest compliance)
- Waist circumference under 35 inches for women and 40 inches for men
Here’s what the researchers found:
- Exercise (versus sitting on your butt) led to a 31% lower rate of a future cardiac event and 29% lower risk of death.
- Not smoking (versus keeping your life insurance premiums paid) led to a 50% lower risk of a future event and 47% lower risk of dying.
- Those who were more strict with a Mediterranean diet (versus not at all) had a 23% lower risk of another heart event and 16% lower risk of death.
- Waist circumference, however, did not make a difference.
- But, when patients had 3 of the ideal factors that made a difference (versus none), the risk for another cardiac event 62% lower and risk of death was a respectable 49% lower.
It is clear from this that the approach is NOT about a single change. Rather, it is the combination of multiple positive changes that goes a very long way towards making sure you’re going to be alive in 5 years.