Preventing a Second Heart Attack

Heart attacks, or myocardial infarctions, occur when a blood clot or piece of plaque blocks one of the arteries that carries blood to the heart. This blockage of a coronary artery creates an oxygen-deprived area of the heart, damaging the muscle and affecting its proper function.

The American Heart Association reports that 90 percent of the estimated 605,000 heart attacks that occur in the United States each year are survived. But subsequent heart attacks – about 200,000 a year, according to the latest statistic – occur within five years and can be deadly. Therefore, preventing a second heart attack may save your life.

John Morytko, M.D., a cardiologist with Miami Cardiac & Vascular Institute, gives the top six ways he advises his patients to prevent another heart attack.

No. 1: Education Is Key

“I let my patients know right away that a second heart attack is likely,” Dr. Morytko said. “They often think that it can’t happen to them again, but it can, and it does.”

Dr. Morytko tells heart attack patients to follow up with their cardiologist after their initial treatment to talk about reducing their risk of another heart attack.

“Risk reduction is an ongoing process, and we know the most effective ways to reduce risks are through lifestyle modifications,” he said.

No. 2: Take Your Medication

Dr. Morytko also emphasizes the importance of taking prescribed medications following a heart attack. Low-dose aspirin, especially, has been shown to prevent another heart attack, he says. Additionally, he advises his heart attack patients to take their cholesterol-lowering statins to ward off future heart attacks.

“It’s essential for people to be compliant with their medications following a heart attack,” he said. “We see patients, especially our younger patients, stop taking their medicine when they start to feel OK. That’s a dangerous practice that could easily lead to another heart attack.”

No. 3: Improve Your Nutrition and Fitness Habits

Studies show that overweight, obesity and sedentary lifestyles play key roles in setting the stage for heart attacks. So, Dr. Morytko urges a healthy diet and regular moderate exercise.

He suggests eating foods that are low in sodium, trans fats and cholesterol and limiting the intake of carbohydrates, especially those from processed, high-sugar foods. He recommends the American Heart Association Diet and the Mediterranean Diet, which both encourage the consumption of plant-based fruits, vegetables, whole grains, beans and nuts, along with the moderate intake of fish and poultry, and only occasional consumption of red meat and dairy products.

Dr. Morytko also encourages heart attack patients to increase their physical activity level. To do so, he advocates for enrollment in a cardiac rehabilitation program to strengthen their heart muscle and their cardiovascular system, while improving their overall health. Following the recommended 12-week program, he advises patients to stick to the exercise guidelines of the American Heart Association and exercise at a moderate intensity, where you’re still able to carry on a conversation, for 150 minutes each week.

No. 4: Manage Stress

The exercise that Dr. Morytko recommends has the added benefit of helping to manage stress, improve sleep and reduce anxiety and depression.

“Stress is a known contributor to heart attacks,” he said. “By reducing and managing stress, you reduce your heart attack risk significantly.”

Dr. Morytko points to bad sleep hygiene as a contributing factor to raising stress levels and urges people to take steps to get a good night’s sleep. These include going to bed and waking up at the same time daily, keeping a cool bedroom environment, turning off electronics at least an hour before bedtime and avoiding caffeine. He also encourages people to avoid altogether or limit their alcohol consumption to fewer than two drinks a day.

No. 5: Control Blood Pressure and Diabetes

Hypertension, or high blood pressure, occurs when the heart must work harder to pump blood throughout the body. The constant pressure on the walls of the arteries and veins that carry blood can cause damage that can lead to heart attack, stroke and other circulation problems. Similarly, the high blood sugar levels seen with diabetes weaken circulation and heart function.

Dr. Morytko says that controlling both blood pressure and blood sugar are imperative to preventing a second heart attack.

“Healthy diets and taking prescribed medications to control these factors are so important,” he said. “Working with your primary care physician or endocrinologist can help you achieve optimal control and significantly reduce your chances of a repeat heart attack.”

No. 6: Quit Smoking

Dr. Morytko also strongly recommends that people quit smoking and vaping.

“If you don’t quit smoking, you’ll have another vascular event. It’s only a matter of when,” he warned.

Smoking cessation programs and nicotine replacement therapies are readily available through insurance providers and community health programs. Dr. Morytko says finding these resources through your doctor or insurance provider should be a first step to reducing your risk if you smoke or vape.

By following these six recommendations, Dr. Morytko says the chance of a repeat heart attack declines significantly.

“These tips are evidence-based, scientifically backed and work,” he said. “Risk reduction is an ongoing process that’s necessary to prevent another heart attack that could be deadly.”