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If you've had a heart attack, what can you do to prevent a second one?

A heart attack is one of the strongest signals your body can send that it's time to make some changes.

Fortunately, the choices you make about eating, exercise, smoking and healthcare can significantly reduce your risk of having a heart attack again.

The American Heart Association offers this advice on avoiding a second heart attack:

Stop smoking
Quitting smoking after a heart attack greatly reduces your risk of having another one. Smoking raises your blood pressure, narrows your blood vessels, and reduces the oxygen levels in your blood and, therefore, the oxygen supply to your heart. If you smoke, ask your doctor about medicines and programs that can help you quit.

Control cholesterol
Cholesterol is a soft, waxy substance that can stick to the inside walls of your arteries, building into plaques that block blood flow. This process is called atherosclerosis, and it sets the stage for heart attacks.

To help keep your arteries clean, you should keep your LDL (low-density lipoprotein) cholesterol—or bad cholesterol—level low.

Higher levels are better with HDL (high-density lipoprotein) cholesterol, or good cholesterol. HDL carries excess cholesterol to the liver so it can be removed from the body.

Triglycerides are a type of fat in the blood that also contribute to atherosclerosis. Levels of this fat should be kept in check—combined with a high LDL or low HDL level, the risk for heart attack increases.

Your doctor can find out about all of your blood fats by taking a small sample of blood. In general, blood fats can be improved by:

• Eating less saturated fat, trans fat and cholesterol.
• Getting regular physical activity.
• Maintaining a healthy weight.
• Taking cholesterol-lowering medicines, such as statins, when and how your doctor prescribes them.

Lower your blood pressure
High blood pressure can overwork your heart, increasing the risk of damage to your heart and arteries. Optimal blood pressure is less than 120/80 millimeters of mercury (mmHg).

To keep blood pressure in check:

• Lose excess weight. Extra body weight and high blood pressure are closely related. In a heavy person, blood pressure can be reduced by losing as little as 10 pounds. Weight loss also tends to boost the effectiveness of medications used to treat high blood pressure.
• Avoid alcohol. Alcohol can raise blood pressure and interfere with efforts to control it.
• Limit sodium. Try to consume less than 1,500 milligrams daily. Check food labels for sodium content and use the saltshaker sparingly.
• Eat healthfully. Studies have found that a diet low in fat and cholesterol and high in fruits, vegetables and low-fat dairy products can help reduce blood pressure.
• Take your medicine. Your doctor may recommend one or more medicines to help control your blood pressure. It's important to take these medicines exactly as recommended.
• Exercise regularly. Try to get at least 30 minutes of physical activity on five or more days of the week. Ask your doctor about the best form of exercise for you.

In addition to lowering high blood pressure, regular physical activity can:

• Improve blood cholesterol levels.
• Help reduce excess weight.
• Improve the function of the heart and lungs.
• Help control diabetes, a risk factor for heart attack.

Be sure to talk to your doctor before increasing your level of physical activity. Also, report symptoms such as chest pain during exercise right away.

Stay in touch with your doctor
Regular medical care is important for everyone, but it's essential after a heart attack. Your doctor may recommend medicines, lifestyle changes, counseling or other tools to help you and your heart stay as healthy as possible. Regular checkups also help make sure that any problems can be caught early, before they've progressed far enough to cause symptoms.

Reviewed 6/21/2023