How can a second heart attack be prevented?

• Take aspirin and beta-blockers (propranolol, metoprolol, atenolol) that have been shown to reduce the chances of a second heart attack and improve survival.
• Stop smoking cigarettes.
• Reduce excess weight, and exercise regularly.
• Control blood pressure and diabetes.
• Follow a diet that is low in cholesterol (less than 200 mg daily) and saturated fat (less than 7% of total calories). For more, please see the Therapeutic Lifestyle Changes (TLC) Daily Food Guide, Eating Heart Healthy.
• Reduce LDL (bad) cholesterol and increase HDL (good) cholesterol. Reduction of LDL cholesterol to a value below 100 mg/dl, particularly with the statin group of medications, has been demonstrated to prevent further heart attacks. Patients with low HDL (less than 35 mg/dl) are encouraged to exercise regularly and to take medications to increase HDL. For more in-depth information about cholesterol, LDL, and HDL, please see the Cholesterol article.
• Take ACE inhibitors that aid the healing process and improve long-term survival in selected patients, particularly those with major damage to heart muscle.
• Take a daily multivitamin that has 400-800 microgram of folic acid. This helps to reduce homocysteine levels in the blood that may aggravate atherosclerosis.
• Eat a diet rich in omega-3-fatty acids by eating more fish or take fish oil supplements. (See the fish oil article). High intake of omega-3-fatty acids decreases the risk of sudden death from heart attacks
• Undergo further testing. In the months following a heart attack, further cardiac stress testing, with or without nuclear or echocardiographic imaging, may be prescribed to determine if additional therapy will be necessary to prevent future heart attacks. In addition, special testing may be required to evaluate the risk of developing cardiac arrhythmias. All such testing should be discussed with the doctor.

What about heart attacks in women?

Risk of heart attacks in women

Coronary artery disease (CAD) and heart attacks are erroneously believed to occur primarily in men. Although it is true that the prevalence of CAD among women is lower before menopause, the risk of CAD rises in women after menopause. At age 75, a woman's risk for CAD is equal to that of a man's. CAD is the leading cause of death and disability in women after menopause. In fact, a 50-year-old woman faces a 46% risk of developing CAD and a 31% risk of dying from coronary artery disease. In contrast, her probability of contracting and dying from breast cancer is 10% and 3%, respectively.

The risk factors for developing CAD in women are the same as in men; they are increased blood cholesterol, high blood pressure, smoking cigarettes, diabetes mellitus, and a family history of coronary heart disease at a young age.