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Legally Speaking


Issue: June, 2005
Author: Dr. John Barrasso

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Today's Medicine Provides a Second Chance for Healthy Hearts

Several decades ago, preventing heart attacks was something of a hit-and-miss proposition. Today, medical science has advanced to the point that we CAN prevent many heart attacks, especially heart attacks brought on by coronary artery disease. Through coronary artery bypass surgery and less invasive techniques such as angioplasty or insertion of artificial arterial wall supports called stents, we can open clogged arteries and give patients a second chance at having a healthy heart.

But with that second chance comes some personal responsibilities. Getting a second chance at a healthy heart isn't a guarantee our hearts will stay healthy. Coronary artery bypass surgery, angioplasty, or stents don't CURE coronary artery disease. Unless we improve our cardiovascular health, we may once again find ourselves with clogged arteries, increasing again our risk of chest pain or a heart attack. In fact, 15 percent of coronary bypass patients experience chest pain again within five years of their surgery and 10 percent experience a heart attack or must undergo another procedure to unclog their arteries and restore flow to their hearts. So if you get a second chance, don't waste it. It's important to recognize that your arteries could clog up again if you don't change your habits and lifestyles.

Those who have suffered coronary artery disease need to take the same steps we urge healthy people to take to keep their hearts healthy and reduce their risk of developing clogged arteries or having a heart attack. Things like healthier low-fat diets and regular exercise are important. So is quitting smoking, learning to manage stress and taking the proper medications, including a daily aspirin. Coronary bypass patients who quit smoking are 15 percent more likely to be alive 10 years after their bypass surgery than bypass patients who continue to smoke. Bypass patients who quit smoking also are less likely to require a second bypass procedure and have half the rate of heart attacks as those who continue to smoke.

We have reached the inescapable conclusion that smoking reduces our risk for heart attacks. Not every smoker has a heart attack or suffers an early death, but many do. And if you've already had one coronary bypass surgery, why keep doing what got you to that surgery in the first place? Coronary artery patients who enroll in cardiac rehabilitation programs generally do better after procedures to open clogged arteries than patients who go back to their old habits. Why? First of all is the exercise. Aerobic exercise featured in most coronary rehab programs helps reduce weight, helps burn off fat, and helps lower unhealthy cholesterol. But a secondary benefit is the instruction and support that heart patients receive in other aspects of their recovery, including diet, smoking cessation, and managing both new medications and stress. Most bypass patients will need a combination of medications and lifestyle changes to stay healthy. So if you're getting a second chance to have a healthy heart, make the most of it.

John Barrasso M.D. is an orthopaedic surgeon active in community affairs. He serves in the Wyoming State Senate representing Natrona County. He is medical director of the Wyoming Health Fairs and reports on medical problems for Wyoming's K-2 television.

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