​​SELF MANAGEMENT OF CORONARY RISK FACTORS 

5 "major" risk factors 
have been identified which increase the probability of suffering a heart attack or acute myocardial infarction. Dr. Martin J O'Hara cardiology cardiology in Arlington cardiologists 

They are: 

1. High blood levels of LDL (bad) cholesterol
2. Smoking
3. Hypertension (high blood pressure)
4. Lack of exercise

5. Diabetes 

Together with consumption of fried foods and lack of consumption of fruit or vegetables these "risk factors" account for over 90% of all acute myocardial infarctions in all populations in the countries of all 5 continents.

Although drug treatment can be essential and highly effective for controlling high blood pressure and to lower cholesterol levels, the other risk factors can only can be controlled by individuals changing their habits of eating, smoking and taking exercise. 

Not only do these risk factors increase the risk of heart attack; controlling them has been shown to reduce that risk substantially (by more than 50%). 




BLOOD PRESSURE LOWERING (other than by taking drugs):

1. Exercise; the more exercise, the greater will be the reduction in BP. Moderate exercise (150 minutes per week) may drop Systolic BP by 5-10 mmHg. Intense exercise (running 10 miles per week): 15-25 mmHg drop is possible.
During exercise the BP increases, but it falls soon after exercise and, if exercise is regular, stays down.

2. Moderate alcohol intake to no more than 1-1 1/2 drinks per day [1 drink = beer 12 fl. oz. or wine 4 fl. oz.]; can reduce SBP by 20 mmHg, depending on how much you were drinking.
How alcohol increases BP is poorly understood, but if causing high BP, the blood pressure will not come under control until alcohol intake is moderated.

3. Lose weight (if overweight); at least 5-10 lbs. Can lower SBP by 10 mmHg, enough to reduce the need for medication or maybe avoid it.

4. Restrict Sodium (i.e. salt) intake as much as possible. In half the population this lowers SBP by only 3-5 mmHg; in the other half it has no effect.
 



SODIUM RESTRICTION LOWERS THE RISK OF HIGH BLOOD PRESSURE'S COMPLICATIONS, which are: 

Stroke, Heart attack (myocardial infarction), Heart Failure and Kidney Failure.

TO RESTRICT SODIUM INTAKE: 

Add no salt to food; use no or minimal salt in cooking.

AVOID prepared or canned foods; read the labels, keeping in mind the goal of taking in no more than 1 gram (1000 mg) or at the very most 2 grams (2000 mg) per day. 

AVOID foods labelled "Low Sodium". They contain large amounts of Sodium, just less than the even larger amounts in the equivalent product not so labelled.




TO LOSE WEIGHT: 

1. Reduce carbohydrate intake - emphasize starch, because that's where the calories are. Keep starch in diet (potatoes, rice, flour products, including pasta, baked goods) to max. 2 days/week. 

2. Exercise at least 150 minutes/week at moderate intensity; or 80 minutes/week at high intensity. 
Will review weight and BMI at next visit.


CHOLESTEROL LOWERING (OTHER THAN BY TAKING A MEDICATION): 

LIMIT animal fat; restrict beef or lamb to once/week;
white meat of chicken or pork up to twice/week total;
fish twice/week

Vegetarian at least once/week.

AVOID fried foods (exception allowed once or twice/month). 



DIABETES PREVENTION; OR TO LOWER RISK OF PROGRESSION TO DIABETES: 

1. Keep starch in diet (potatoes, rice, flour products, including pasta, baked goods) to max. 2 days/week. 

2. Exercise at least 150 minutes/week at moderate intensity; or 80 minutes/week at high intensity. 

3. Lose 10-15% of body weight. 







TO CONTROL EDEMA (ankle swelling) RESTRICT SODIUM INTAKE (SEE ABOVE): 

Add no salt to food; use no or minimal salt in cooking.

AVOID prepared or canned foods; read the labels, keeping in mind the goal of taking in no more than 1 gram (1000 mg) or at the very most 2 grams (2000 mg) per day. 

AVOID foods labelled "Low Sodium". They contain large amounts of Sodium, just less than the even larger amounts in the equivalent product not so labelled.

  


Martin J. O'Hara, MD, M.R.C.P.I., F.A.C.C.

611 S. Carlin Springs Rd.

Suite 409

Arlington, VA  22204

703-247-2901 office   703-988-2404 fax

Dr. Martin J O'hara Cardiology