Stephen J. Schueler, M.D.

Ashd (atherosclerotic heart disease) Home Care

Home care for coronary artery disease includes:

  • Stop smoking
  • Avoid exposure to secondary smoke
  • Eat a healthy heart diet:
    • Limit your intake of fat to 30% of your total calories.
    • 10% to 15% of your total calories should be in the form of monounsaturated fats, such as olive oil, canola oil and peanut oil.
    • Low cholesterol diet.
    • Low salt diet.
    • Eat foods rich in omega-3 fats
  • If you have been prescribed medications to control high cholesterol, so not skip doses.
  • Follow an exercise plan developed with your doctor
  • Weight loss if you are overweight.
  • Take any prescribed heart medications as directed:
    • Don't skip doses of your heart medication
    • Avoid running out of your prescribed heart medications
    • Don't stop your medication when you feel better
    • Talk to your doctor before stopping your heart medication if you feel worse.
    • Be aware of potential drug side effects
  • Learn how to take your blood pressure.
  • Check your blood pressure every day:
    • Keep a log of your results.
  • If you have diabetes:
  • Learn how to take your own pulse.
  • Control chronic stress and anxiety
  • Let your doctor know if you are suffering from severe or prolonged depression.
  • Avoid alcohol, or drink alcohol in moderation:
    • For men: no more than 2 alcoholic beverages per day
    • For women: no more than 1 alcoholic beverage per day

Ashd (atherosclerotic heart disease) BP Checks

If you have coronary artery disease, it is important to learn how monitor your blood pressure at home.

Regular blood pressure monitoring is important for anyone with heart disease. Early detection and treatment of high blood pressure can help prevent heart damage.

Taking your Blood Pressure
A number of devices are available for home blood pressure measurement. Digital blood pressure devices are easy to use: they automatically calculate the pulse and display the systolic and diastolic pressures. However, a simple blood pressure cuff with a stethoscope is the most accurate way to measure blood pressure.

Tips for Obtaining an Accurate Blood Pressure

  • Remain seated or lying flat with the arm supported at heart level.
  • No smoking or caffeine for 30 minutes prior to measurement.
  • Rest for 5 minutes before taking your blood pressure.
  • The blood pressure air bladder should nearly encircle the arm: persons with large arms may require an extra large adult cuff. Cuffs are usually marked to indicate the acceptable size range.
  • Apply cuff 1/2 inch above elbow crease.
  • Locate brachial pulse and place the stethoscope bell at this location.
  • With the valve closed, pump up cuff bulb to approximately 210 mm Hg, or a point where no sounds are heard through the stethoscope.
  • Open the valve slowly (2-3 mm Hg per second) and listen for the point where the tapping sounds are first heard. The corresponding reading on the dial is the systolic pressure.
  • Then, listen for the point where the tapping sounds stop. The corresponding reading on the dial is the diastolic pressure.
  • Perform two more readings per session, separated by 5 minutes.
  • The blood pressure must be elevated during at least 3 separate sessions to diagnose hypertension.

Systolic Pressure Guideline for Adults
Systolic Blood PressureAssessment
120-139Prehypertension
Over 140-159Hypertension Stage 1
160 or higherHypertension Stage 2

Diastolic Pressure Guideline for Adults
Diastolic Blood PressureAssessment
Below 80Normal
80-89Prehypertension
90-99Hypertension Stage 1
100 or higherHypertension Stage 2

Ashd (atherosclerotic heart disease) Diet

It is important to follow a healthy diet if you have coronary artery disease.

Dietary guidelines for those who have heart disease include:

  • Control calories:
    • Eat just enough calories to achieve and maintain a healthy weight.
  • Eat quality fats:
    • Use virgin olive oil and other unsaturated, low-cholesterol fats.
    • Eat foods that are rich in omega-3 fatty acids
  • Eat the right amount of fats, carbohydrates and protein:
    • Limit your fat intake to 20 or 30 percent, but don't substitute simple carbohydrates for fat.
    • Less than 7% of the day's total calories from saturated fat.
    • Up to 10% of the day's total calories from polyunsaturated fat.
    • Up to 20% of the day's total calories from monounsaturated fat
  • Avoid fad diets:
    • Eat a well-rounded diet instead.
    • Eat small, frequent meals.
    • Avoid large and heavy meals.
  • Limit cholesterol in diet:
    • To less than 200 milligrams a day.
  • Limit iron intake:
  • Eat enough dietary fiber:
    • Whole grains are best.
  • Eat plenty of fresh fruit and vegetables
  • Reduce salt in your diet
    • Optimal: no more than 1,500 milligrams per day.
  • Check with your doctor about supplementing your diet with B vitamins:

Ashd (atherosclerotic heart disease) Lifestyle

Lifestyle changes that can slow the progression of coronary artery disease include:

Ashd (atherosclerotic heart disease) Taking Control

The successful treatment of coronary artery disease requires your participation. Here are answers to some important questions.

Do you have control over your health and wellness?
Many people believe they have no control over their health and wellness. Many ignore personal health decisions or simply leave them to their doctors, relatives, or friends. In reality, you have the greatest potential to determine your relative health.

How is this possible? Do people really have control of their own health? The biggest killers are heart disease and cancer. Although many of these diseases seem to strike at random, our lifestyle choices greatly influence personal risk.

How can you participate in your health care?
To participate you must:

  • Learn to take responsibility for your own health.
  • Learn to partner with your doctor.
  • Learn how to make active decisions about your health.

How can you learn what you need to know?
  • Educate yourself.
  • Be skeptical: Learn to separate fact from fiction.
  • Billions of dollars are spent each year marketing dietary supplements, vitamins, and new medical treatments. Much of this is unnecessary and wasteful.
  • Be careful about where you get your health information.
    • Some of the best sources for health information on the web are professional societies and non-profit organizations.
    • Ask your doctor what he or she recommends.
  • Examine the credentials of the authors.
    • If you are reading about symptoms and disease, your best source is a licensed physician.
    • Pay attention to when the content was last updated.
    • Make sure the person is not just trying to sell you something.

Important questions you need to answer:
  • What things in your control can increase your risk for disease?
  • What can you do to decrease this risk?
  • What are vaccines and how can they help you?
  • How do your lifestyle choices increase your risk for disease?
  • How can you reduce stress?
  • What minor health problems can you treat at home?
  • When is a medical problem "serious"?
  • When should you call the doctor?

How can you find the right doctor?
Key points:
  • Everyone should have a primary care physician or family doctor. A primary physician is usually a family practitioner, internist, or pediatrician.
  • Establish a relationship in advance with your doctor.
  • Make sure you are comfortable with your primary care physician.
  • The internet contains many resources where you can do research to locate the doctor that is best for you.
  • You may wish to schedule a brief visit with the doctor to see if he or she is right for you.
    • Be open-minded, and allow your doctor to know you well. This will improve communication.

Important information you need to make your decision:
  • Physician credentials:
    • Internship and residency training is usually best from respected institutions, universities, and major hospitals.
    • Look for board certification in the specialty.
    • Ask about membership in medical societies.
  • Community and professional reputation are also important.
    • Are other patients happy with the doctor?
    • Has the doctor been disciplined by hospitals or agencies?
    • How long has the doctor been in practice?
    • In general, more than a few malpractice suits over a 5-10 year period should trigger caution.
  • Does the doctor communicate well? Are your questions answered during busy times?
  • Does the doctor welcome you to help make decisions about your care?
  • Is the doctor available when you need care?
  • What is the doctor's after-hours coverage?
  • Is he or she a member of a large group?
    • Do the doctors' cross-cover one another?
  • Where do they admit patients?

What is shared decision making?
You and your doctor must work together to jointly decide the best course of action to manage your health. This process is called "shared decision making". Your doctor becomes a guide and teacher and helps steer you toward the best treatment. Most doctors welcome this partnership. You must learn about your illnesses for shared decision-making to work.

For any recommended test, medication, or surgery, remember to ask:
  • How will this help me?
  • How much will it cost?
  • Is it covered by your insurance?
  • What are the potential side effects and risks?
  • What are my alternatives?

For tests, remember to ask:
  • Is it done in the office or at another facility?
  • Is it painful?
  • How will the results of this test influence my care?

For surgery or other procedures, remember to ask:
  • How long will it take to heal?
  • How many cases has the doctor done?
  • What would your doctor do if he or she were the patient?
  • Where is it done?
  • Who will perform it?
  • What are the doctor's qualifications?

What should you expect?
Shared decision making becomes impossible if you do not know what to expect from your doctor.

The American Hospital Association has published a "Patient's Bill of Rights" that is a good guide. It states that you have the right:
  • To be spoken to in words that you understand
  • To be told what's wrong with you
  • To know the benefits of any treatment and any alternatives
  • To know what a treatment or test will cost
  • To share in treatment decisions
  • To read your medical record
  • To refuse any medical procedure

What should you do before an office visit?
  • Bring all important medical information with you to the visit.
  • Make sure you can answer questions about the following:
    • Allergies and side effects to medicines
    • Current medicines you are taking. This includes herbs and vitamins. Make a list if necessary.
    • Insurance information
    • Marital and sexual history
    • Past injuries and hospital stays
    • Past medical problems
    • Past surgeries and operations
    • Pre-visit questionnaires
    • Use of tobacco, alcohol and drugs
    • Work history

What should you expect from the visit?
  • You should plan to wait if you go without an appointment. Emergencies or sick patients in the hospital may interrupt your doctor.
  • Bring along a book or toys for the kids. You may also have to wait during busy times.
  • Tell your doctor about your problem in a clear manner. Start from the beginning and go through each symptom as it appeared.
  • Before the visit, think about what makes your problem better or worse. Your doctor will probably ask you questions about this.
  • Most doctors ask many questions about unrelated symptoms. These questions help assure that there are no other problems that need attention.
  • Be sure to answer all questions truthfully. This includes sensitive questions about smoking, drug use, sexual activity, and work. Your history is the most important part of deciding what is wrong with you.
  • If you have any difficulty communicating your concerns, bring a family member or friend to assist in this task.
  • Talk to your doctor and do not leave the office without asking necessary questions. Your doctor can make you more comfortable if he or she understands your concerns.

What should you know about your medications?
Every year many people become ill because of problems with medications.

Remember to ask:
  • What side effects to expect.
  • What drug interactions are possible.
    • Find out if a new medicine reacts with those that you are taking now.
    • Many over-the-counter drugs and dietary supplements can also cause serious side effects and drug interactions.
    • Some drugs interact with certain foods, vitamins, nicotine, and alcohol.
  • Make sure you can drive or operate machines safely while taking a medicine.
  • Ask your doctor how much a prescription costs.
    • Is there a less expensive option or a generic version?

What is a treatment plan?
A treatment plan is what you and your doctor decide to do for an illness. A treatment plan cannot be effective without your participation.

Three simple questions can help you get the most from your treatment plan:
  • What is my main problem?
  • What do I need to do?
  • Why is it important for me to do these things?

Other important points:
  • Be sure you understand your treatment plan.
  • Stick with the treatment plan and allow time for improvement.
  • Don't stop medicines when you feel better; check with your doctor first.
  • Call your doctor if your condition is becoming worse.
  • Your doctor should tell you what to expect and when to follow-up or call the office.

Ashd (atherosclerotic heart disease) Warning Signs

Notify your doctor if you have coronary artery disease and any of the following:

Continue to Ashd (atherosclerotic heart disease) Prevention

Last Updated: Dec 8, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
Copyright DSHI Systems, Inc. Powered by: FreeMD - Your Virtual Doctor

PubMed Ashd (atherosclerotic heart disease) References
  1. ALLHAT Collaborative Research Group: Major outcomes in moderately hypercholesterolemic, hypertensive patients randomized to pravastatin vs usual care: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT). JAMA 2002 Dec 18; 288(23): 2998-3007. [12479764]
  2. Bild DE, Bluemke DA, Burke GL, et al: Multi-ethnic study of atherosclerosis: objectives and design. Am J Epidemiol 2002 Nov 1; 156(9): 871-81. [12397006]
  3. Brown TL, Merrill J, Hill P, Bengel FM. Relationship of coronary calcium and myocardial perfusion in individuals with chest pain. Assessed by integrated rubidium-82 PET-CT. Nuklearmedizin. 2008;47(6):255-260. [19057799]
  4. Thuresson M, Jarlov MB, Lindahl B, Svensson L, Zedigh C, Herlitz J. Symptoms and type of symptom onset in acute coronary syndrome in relation to ST elevation, sex, age, and a history of diabetes. Am Heart J. 2005 Aug;150(2):234-42. [16086924]
  5. Viles-Gonzalez JF, Fuster V, Corti R, Badimon JJ. Emerging importance of HDL cholesterol in developing high-risk coronary plaques in acute coronary syndromes. Curr Opin Cardiol. 2003 Jul;18(4):286-94. [12858127]
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