Heart Attack and Unstable Angina

Life After a Heart Attack

Coming home after a heart attack may be unsettling. Your hospital stay may have seemed too short. You may be nervous about being home without medical oversight after being so closely attended to in the hospital. But you have had tests that tell your doctor that it is safe for you to return home. Also, to reduce your risk of having another heart attack, your doctor may recommend that you:

• Quit smoking and avoid secondhand smoke. Quitting smoking may be the most important step you can take to reduce your risk. Evidence suggests that the risk of death or recurrent heart attack is rapidly reduced for people with coronary artery disease who stop smoking. For more information, see the topic Quitting Smoking.
• Be physically active. Talk with your doctor about exercising safely and about enrolling in a cardiac rehabilitation program. Regular exercise can help reduce your risk of another heart attack by helping you control cholesterol and blood pressure, regulate blood sugar (important for people with diabetes), and lose weight. See the Cardiac Rehabilitation topic. Before you start an exercise program or do any strenuous exercise, your doctor can do pre-exercise testing to find out your risk for heart attack. For more information, see the following:

  Heart disease: Exercising for a healthy heart

• Take an aspirin every day. If you have a stent, you may also take an antiplatelet medicine, such as clopidogrel (Plavix).
• Lower your cholesterol by taking medicines such as statins or other lipid-lowering medicines. Lowering cholesterol can reduce the risk for another heart attack.
• Control your blood pressure by taking medicines as directed by your doctor. Some nutrients in the diet can affect blood pressure. See nutrition for hypertension (including the DASH diet) for more information about this eating plan, which has been proved to lower blood pressure. Also see:

  High blood pressure: Using the DASH diet.

• Keep your blood sugar under control if you have diabetes. Having high blood sugar over a long period of time is linked with developing heart disease. The American Diabetes Association and the American Heart Association recommend that people with diabetes have an hemoglobin A1c level of less than 7%.⁶
• Follow a heart-healthy diet. A heart-healthy diet includes eating more fish. You may also follow the Mediterranean diet. A heart-healthy diet may help you lose weight, lower your blood pressure, and reduce your cholesterol. For more information, see:

  Heart disease: Eating a heart-healthy diet.

• Reduce stress. Stress management may lower rates of heart attack or death in people with coronary artery disease.
• Participate in a cardiac rehabilitation program. You will learn how to exercise safely, change habits that put you at risk for another heart attack, and deal with stress and emotional issues. Studies have found that cardiac rehab reduces your risk of having another heart attack.
• Avoid getting sick from the flu. Get a flu shot every year.
• If you drink alcohol, drink moderately (1 alcoholic drink a day for women or 2 drinks a day for men). Drinking alcohol moderately, along with living a healthy lifestyle, may lower your risk for a heart attack or complications after a heart attack. Although studies show that wine may be beneficial, the link between wine and reduced coronary artery disease has not been proved. Ask your doctor about the benefits and risks of drinking alcoholic beverages.
• Seek help for depression. Having a heart attack is scary, and depression afterward is common. Asking for and receiving support from friends and relatives can help you avoid depression. If you continue to feel depressed, talk to your doctor about counseling and medicine for depression. People who get treatment for depression may recover better after a heart attack than those who do not. For more information, see the topic Depression.
• Resume sexual activity after a heart attack. One common myth is that resuming sex after a heart attack can cause another heart attack, stroke, or sudden death. According to the American Heart Association, people who have had heart attacks can resume sexual activity as soon as they feel ready for it. Talk with your doctor if you have any concerns. If you take a nitrate, like nitroglycerin, do not take erection-enhancing medicines. Combining these medicines can cause a life-threatening drop in blood pressure.
• Seek help for sleep problems. Your doctor may want to check for sleep apnea, a common sleep problem in people with heart disease. For more information, see Sleep Apnea.

Most often the cause of a heart attack is coronary artery disease (CAD). Knowing what CAD is and how to treat it may help prevent a future heart attack. For more information, see the topic Coronary Artery Disease.

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Author:	Robin Parks, MS	Last Updated: May 5, 2009
Medical Review:	Caroline S. Rhoads, MD - Internal Medicine John A. McPherson, MD, FACC, FSCAI - Cardiology
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