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Prevention

By Mayo Clinic staff

It's never too late to take steps to prevent a heart attack — even if you've already had one. Taking medications can reduce your risk of a subsequent heart attack and help your damaged heart function better. Lifestyle factors also play a critical role in heart attack prevention and recovery.

Medications
Doctors typically prescribe drug therapy for people who've had a heart attack or who are at high risk of having one. Medications that help the heart function more effectively or reduce heart attack risk may include:

  • Blood-thinning medications. Aspirin makes your blood less "sticky" and likely to clot. Doctors recommend a daily aspirin for people who've had a heart attack unless they have had an allergic reaction to aspirin or some other serious reason not to take it. If your doctor hasn't recommended that you take a daily aspirin, check with your doctor to find out why.

    Doctors may prescribe aspirin and an anti-clotting drug, such as clopidogrel (Plavix), for people undergoing an angioplasty or stent procedure to open narrowed coronary arteries, both before and after the procedure.

    If you're already taking aspirin due to a previous heart attack or to help prevent a heart attack, be aware that taking these blood thinners and ibuprofen (Advil, Motrin, others) at the same time may increase the risk of gastrointestinal problems and may interfere with the heart benefits of aspirin. If you need to take a pain-relieving medication for certain conditions, such as arthritis, discuss with your doctor which pain reliever is best for you.

  • Beta blockers. These drugs lower your heart rate and blood pressure, reducing demand on your heart and helping to prevent further heart attacks. Many people will need to take beta blockers for the rest of their lives following a heart attack.
  • Angiotensin-converting enzyme (ACE) inhibitors. Doctors prescribe ACE inhibitors for most people after heart attacks, especially for those who have had a moderate to severe heart attack that has reduced the heart's pumping capacity. These drugs allow blood to flow from your heart more easily, prevent some of the complications of heart attacks and make a subsequent heart attack less likely.
  • Cholesterol-lowering medications. A variety of medications, including statins, niacin, fibrates and bile acid sequestrants, can help lower your levels of unwanted blood cholesterol. The majority of people who've had a heart attack take cholesterol-lowering medications — drugs that help lower the risk of a subsequent heart attack. These medications can help prevent future heart attacks even if your cholesterol was not very high at the time of the heart attack.

Lifestyle changes
In addition to medications, the same lifestyle changes that can help you recover from a heart attack can also help prevent future heart attacks. These include:

  • Not smoking
  • Controlling certain conditions, such as high blood pressure, high cholesterol and diabetes
  • Staying physically active
  • Eating healthy foods
  • Maintaining a healthy weight
  • Reducing and managing stress
Coping and support Lifestyle and home remedies
References
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  2. Hefland M, et al. Emerging risk factors for coronary heart disease: A summary of systematic reviews conducted for the U.S. Preventive Services Task Force. Annals of Internal Medicine. 2009;151:496.
  3. U.S. Preventive Services Task Force. Using nontraditional risk factors in coronary heart disease risk assessment: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2009;151:474.
  4. Chobanian AV, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. New England Journal of Medicine. 2003;289:2560.
  5. Stimulants. National Institute on Drug Abuse. http://teens.drugabuse.gov/facts/facts_stim2.php. Accessed July 15, 2011.
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  7. Wright RS, et al. 2011 ACCF/AHA focused update incorporated into the ACC/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction. Journal of the American College of Cardiology. 2011;57:215.
  8. Antman EM, et al. Use of nonsteroidal antiinflammatory drugs: An update for clinicians. Circulation. 2007;115:1634.
  9. Pignone M, et al. Aspirin for primary prevention of cardiovascular disease in people with diabetes. Circulation. 2010;121:2694.
  10. U.S. Preventive Services Task Force. Aspirin for the prevention of cardiovascular disease: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine. 2009;150:396.
  11. King SB, et al. 2007 update of the ACC/AHA/ SCAI 2005 guideline update for percutaneous coronary intervention. Circulation. 2008;117:261.
  12. Shaw LJ, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden. Circulation. 2008;117:1283.
  13. Hannan EL, et al. Adherence of catheterization laboratory cardiologists to American College of Cardiology/American Heart Association guidelines for percutaneous coronary interventions and coronary artery bypass graft surgery: What happens in actual practice? Circulation. 2010;121:267.
  14. Rind DM, et al. Intensity of lipid lowering therapy in secondary prevention of coronary heart disease. http://www.uptodate.com/home/index.html. Accessed July 12, 2011.
  15. How will I recover from my heart attack? American Heart Association. http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ ucm_304573.pdf. Accessed July 12, 2011.
  16. Alcoholic beverages and cardiovascular disease. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Alcohol-Wine-and-Cardiovascular-Disease_UCM_305864_Article.jsp. Accessed July 12, 2011.
  17. Lightwood JM, et al. Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation. 2009;120:1373.
  18. Field JM, et al. Part 1: Executive summary - 2010 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2010;122(suppl):S640.
  19. CardioGen-82 PET Scan: Drug safety communication - Increased radiation exposure. U.S. Food and Drug Administration. http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm263157.htm. Accessed July 20, 2011.
DS00094 Nov. 17, 2011

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