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Harvard Commentaries
35320
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Healthy Heart Healthy Heart
 

New Year's Resolutions for Cardiac Patients


August 29, 2012

By Thomas H. Lee M.D.

Harvard Medical School

About the best thing you can say about New Year's resolutions is that you only have to make them once per year. That said, the end of one year and the beginning of the next represent an opportunity for people to assess their overall health, and to identify one, two or three things that they are going to commit to doing in an effort to live longer and feel better. Some of those resolutions actually turn into lifelong changes.

These lifestyle issues that are very much under your control are actually much more important for most people than the new "new thing" coming out of research laboratories. So here is one cardiologist's wish list for your consideration when you are contemplating your resolutions. And I promise not to tell you to lose weight.

1. Exercise at least 30 minutes every day.

No matter how old, how heavy, how healthy or sick you may be, regular physical exercise makes you feel better and live longer. It keeps the walls of your arteries flexible, which helps dampen rises in blood pressure, reducing your risk of stroke and atherosclerosis. You don't have to be a marathon runner — just walking a half hour every day will help to control your weight and improve your health.

Lots of older guidelines recommend exercising at least three to five days a week. Don't be a wimp. Commit to exercise every day. You'll feel better for it.

2. If you smoke cigarettes, absolutely, positively stop now.

No "wonder drug" does as much to reduce a smoker's risk of heart attack as does giving up cigarettes. There is a lot more known today about helping people quit now than in the past, so if you have tried and failed before, don't give up. Talk about the issue with your doctor. Ask him or her if you might benefit from medications to help you stop. Pick a quit date — ideally in January — and on that date, put your cigarettes away.

Do something special for yourself as a reward. A patient of mine told me in early December that he realized that he was spending $5 per day, or $35 per week, on cigarettes. He stopped, and started putting $20 per week away in a special savings account. The other $15 per week he spends on himself.

3. Take your medications every day the way they are prescribed.

Only about half of people take their pills as regularly as they are supposed to. The result is that blood pressure, cholesterol, diabetes and other conditions are not nearly as well controlled as they might be. Figure out how to make it easier to take your pills every day. For example, put them right next to your toothbrush, or post a chart on your refrigerator that you check off after you have taken your medications. If you are having side effects that dampen your enthusiasm for your medications, tell your doctor. There are so many good choices today, physicians almost always can find an alternative that works for you.

4. Work at improving communication with your physicians.

Your doctors want to help you, but a lot of action gets packed into those brief office visits. With a few simple steps, you can help your doctor to take care of you by giving him or her better understanding of your needs. I recommend thinking through just what you want before every office visit, and then tell the doctor when you walk in the door. Writing your issues down is a good idea, and when the doctor talks to you, write his or her points down. At the end of the visit, try summarizing your understanding of what the doctor has said. ("You want me to stop this medication, and start this new one, and call you if I develop a cough or light-headedness, right?") The physician ought to be doing this, but you can if he or she doesn't.

5. Lose weight.

OK, I lied. But I couldn't help it, because being overweight has so many bad effects. It taxes your heart and your joints, and it increases your risk of hypertension, high cholesterol and diabetes. Drastic weight loss measures such as surgery may be right for some people, but the kind of New Year's resolution I recommend is "Lose one pound per month for the year." One pound per month isn't much — it just takes walking a bit more each day, or giving up one cookie per day. But if you do this, you'll need new clothes a year from now — and feel better for it.

Thomas H. Lee, M.D., is the chief executive officer for Partners Community HealthCare Inc. He is a professor of medicine at Harvard Medical School. He is an internist and cardiologist at Brigham and Women's Hospital. Dr. Lee is the chairman of the Cardiovascular Measurement Assessment Panel of the National Committee for Quality Assurance.

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