Feel like your old self—and reduce your risk of a repeat incident—with this essential guide.
There’s little doubt that having a heart attack is a life-altering experience. For some people, it’s a wakeup call—a kick that motivates them to start taking better care of their bodies.
Even if you were doing everything “right” before, it can shake your sense of control and serve as a frightening reminder of your mortality. It’s also natural—and smart—to be concerned about having a repeat incident: According to the American Heart Association, about 26 percent of people who have a heart attack go on to experience a second one, which could be fatal.
While your genes and pure luck certainly play a role in what happens next, you’re not powerless. There are several steps you can—and should—take to swing the odds in your favor.
1. Sign Up for Rehab
People who complete a cardiac rehabilitation program following a cardiac event fare much better than those who don’t—yet only about 20 percent of eligible Medicare patients participate in cardiac rehab after heart attack. During cardiac rehab, which you might start while you’re still in the hospital and continue for up to 36 one-hour sessions over 36 weeks, you’ll work with exercise physiologists and other experts who will help you regain strength. They’ll also teach you about good nutrition and stress management.
If your doctor doesn’t refer you to such a program, ask. And if for some reason you’re not able to participate in cardiac rehab, at least make sure you get walking as soon as you’re able. “Years ago we used to put everyone on bed rest, but they were getting blood clots in their legs and becoming very deconditioned,” says Justin Bachman, M.D., M.P.H., a cardiologist and instructor of medicine and health policy at Vanderbilt University Medical Center. “We now know it’s important not to be immobile, so in most cases we’ll tell patients to walk around the halls in the hospital the very first day after a heart attack.”
2. If You Smoke, Quit
This is absolutely crucial, says Paula Miller, M.D., director of cardiac rehabilitation at UNC Hospitals Heart and Vascular Center. Cigarette smoke is as toxic to your blood vessels as it is to your airways. By breaking the habit, you’ll lower your blood pressure and cut your chances of developing dangerous blood clots.
You don’t have to do it alone. In fact, you’ll be more likely to quit smoking if you have support. You can:
- Talk to your doctor, who may recommend a combination of smoking cessation coaching and medication.
- Go to smokefree.gov or call 1-800-QUIT-NOW (1-800-784-8669) to take advantage of free resources.
- Look for smoking cessation support groups in your community or online.
3. Take Your Meds Exactly as Prescribed
If you’ve had a heart attack, there’s a good chance that your doctor has put you on a statin (to help lower cholesterol), a beta-blocker (for blood pressure control), or aspirin (or other medication to help prevent blood clots). These drugs have been proven to lower the risk of a second event. Follow the instructions for how and when to take them, and never stop them without first consulting your doctor. If you notice any bothersome side effects, speak up; your doctor may be able to adjust your dose or switch you to a different option. And before taking any over-the-counter drugs or supplements, be sure to check with your doctor to avoid any negative interactions.
4. Clean Up Your Diet
Considering how prevalent cardiovascular disease is, just about everyone should be following a heart-healthy diet—but it’s especially important if you’ve already had a heart attack. The American Heart Association recommends loading up on a wide variety of fruits, vegetables, and whole grains while cutting back on refined carbs, including sweetened drinks and desserts.
You should also minimize your intake of saturated fat, found in red meat and full-fat dairy products. Fish, poultry, low-fat dairy, and vegetable oils are better choices. Your doctor may also encourage you to limit sodium, which is found in many processed foods.
Following the DASH Diet or the Mediterranean Diet are often good ways to reach these goals. If you need help with your eating plan, ask your doctor to refer you to a registered dietitian. Another resource: these eight simple rules of eating clean.
5. Tame Your Stress
Making stress management part of your recovery plan could slash your chances of having another heart incident by half, according to research published in the journal Circulation. “Stress can increase your blood pressure and raise levels of stress hormones, plus it often leads to poor lifestyle choices,” such as choosing unhealthy foods or not exercising, says Laxmi Mehta, M.D., director of the Women’s Cardiovascular Health Program at Ohio State University Wexner Medical Center. In some cases, it can even trigger a type of heart failure called stress-induced cardiomyopathy (also known as “broken heart syndrome”).
If you’re feeling overwhelmed, look for ways to decompress: These six incredibly simple acts to relieve stress are a great start. Meditation and deep breathing are often beneficial, or ask your doctor or a mental health professional to help you find a strategy that works for you.
6. Don’t Dismiss Signs of Depression
Depression is incredibly common in heart attack survivors—15 to 20 percent will experience it—and ignoring it only makes matters worse. “If you’re depressed, you need medical attention,” says Dr. Mehta, who notes that depression increases your chances of having another heart attack and dying prematurely from any cause.
Fortunately, it’s treatable: Most people benefit from cognitive behavioral therapy (also known as “talk therapy”), medication, or a combination of the two.
Not sure if what you’re experiencing is normal or cause for concern? Learn the difference between sadness and depression.
7. Ease Back into Exercise
Ideally, you’ll complete a cardiac rehab program before striking out on your own, but either way, it’s essential to get clearance from a physician before returning to independent exercise. There’s no universal timeline for when you can resume your usual activities. “The amount of injury and your heart function should be taken into consideration,” Dr. Miller says.
Whatever your preferred form of exercise is, “you need to start slow and advance gradually,” Dr. Bachman says. It’s a good idea to carry nitroglycerin with you, which your doctor may have prescribed, he says. “When you’re starting to increase your activity level, be mindful of any type of chest pain or palpitations. If you have either or severe shortness of breath, stop and notify your physician.”
Although these types of warnings might sound scary, don’t be deterred. “A lot of patients are petrified of physical activity, because they’re afraid it will lead to another heart attack,” Dr. Bachman says. “But most people will have had their blood vessels opened back up with a stent or bypass, so they can—and should—exercise.”
The American Heart Association advises that heart attack survivors (like everyone else) aim for at least 150 minutes of aerobic activity, or cardio, each week. “You should be working hard enough so that you’re breathing a little heavier than usual, but you shouldn’t be gasping for air and should still be able to carry on a conversation,” Dr. Mehta says.
She advises patients to warm up for at least five to 10 minutes before picking up the pace and to cool down after for another five to 10 minutes. “You don’t want to suddenly jolt your heart,” Dr. Mehta says.
Great news: You could have free access to gyms, fitness classes, and a built-in community of support through SilverSneakers. You’ll find members who have improved their health through exercise after heart problems, surgeries, and other types of injuries. If you haven’t yet, check your eligibility here. Already a member? Find a location here.
8. Don’t Forget About Strength Training
Cardio is most important for keeping your ticker in top shape. But you should also incorporate some strength training—using your own body’s weight, dumbbells, or resistance bands—into your regimen, ideally two to three times per week. Strength training helps you build or preserve lean muscle mass, which is vital as you get older. People who have more muscle mass also have a higher metabolism, which combats weight gain, Dr. Mehta says. If you’re new to strength training or want a refresher, click here for everything you need to know to get started.
9. Be Patient
Everyone is different, so it’s hard to say how long it will take for you to feel like your old self again. That said, most people are able to resume their normal activities within three to six months after a heart attack, Dr. Miller says.
Of course, what’s “normal” for you also has to be factored in. If you primarily enjoyed walking and water aerobics, for instance, you can probably get back to those fairly quickly. People who were into more vigorous activity might have to wait longer, or accept that it’s time for a change.
“I’ve had my share of patients who used to run marathons, and they’re not eager to be sidelined,” Dr. Bachman says. If that sounds like you, you should know that yes, you might be able to once again cross a finish line—though it depends on how much damage was done to your heart.
“You need to be prudent,” Dr. Bachman concludes. “Talk to your doctor, do a cardiac rehab program, and take it slow.”
Luckily, once you get the clearance to get moving, you have lots of options—and you might even find a new activity you love. Check out nine best types of exercise for older adults.