The first days and weeks after you get out of the hospital after a cardiac event or diagnosis can be a frightening, confusing time. You may be taking new medicines and following many new instructions. You may sometimes feel as if your world has changed.
Focusing on three simple tasks can help you manage your condition while you recover and regain your strength:
Goal 1: Know Your Treatment Plan
The goal of cardiac rehab is to help you learn to reduce the risk factors — such as smoking, high blood pressure, high cholesterol, physical inactivity, diabetes and being overweight — that increase your chances of future health problems.
The American Heart Association and the American College of Cardiology have developed national guidelines to help you reduce the risk of future problems. These guidelines can help your doctor develop a treatment plan — including medicines and lifestyle changes such as diet and physical activity — for all your risk factors. Make sure you know your goal numbers and work with your healthcare team professionals to achieve them.
| Risk Factor | Goal |
| Smoking | Quit for good |
| Smoking is the leading preventable cause of death and disability in the United States. Cigarette smoking results in a 2- to 3-fold increased risk of dying of coronary heart disease. Smoking robs the heart of oxygen-rich blood and increases the effects of other risk factors, including blood pressure, blood cholesterol levels and physical inactivity. Thinking about quitting? We can help. | |
| Blood Pressure | Less than 140/90 mm Hg OR Less than 130/80 mm Hg if you have diabetes or chronic kidney disease |
| Optimal blood pressure is less than 120/80 mm Hg (systolic pressure is 120 AND diastolic pressure is less than 80). Prehypertension is systolic pressure from 120-139 systolic OR diastolic pressure from 80-89. High blood pressure is systolic pressure of 140 or higher OR diastolic pressure of 90 or higher. When blood pressure is higher, your heart has to work harder. Changes in health habits such as losing weight, eating less sodium (salt) and enjoying regular physical activity can help lower blood pressure. If you have high blood pressure, staying on your medicines is critical to prevent heart attacks, strokes, kidney disease and heart failure. Monitor your blood pressure as your doctor advises. Keep track of your readings with our blood pressure tracker. | |
| LDL (bad) Cholesterol | Less than 100 mg/dL OR Less than 70 mg/dL if you are at very high risk of a heart attack or sudden cardiac death |
| High blood cholesterol occurs if your body makes too much cholesterol and/or if you eat too much saturated fat, trans fat and dietary cholesterol. For patients with coronary heart disease, treatment focuses on LDL (bad) cholesterol. The goal for LDL cholesterol is below 100 mg/dL. If you are a very high-risk patient, your doctor may decide that your LDL level needs to be below 70 mg/dL. Be sure to ask your doctor what your LDL cholesterol goal is. To lower your LDL cholesterol, you may need to change your eating habits and lose weight. Speak with your doctor to see if you should be taking a cholesterol medicine along with making these lifestyle changes. | |
| Fasting Triglycerides | Less than 100 mg/dL is optimal |
| Like LDL (bad) cholesterol, triglycerides can affect your risk of future heart problems. You may be able to lower your triglycerides through weight loss, dietary changes and physical activity. Your doctor may also prescribe medicine to help. | |
| HDL (good) Cholesterol | 40 mg/dL or higher for men and 50 mg/dL or higher for women |
| HDL (good) cholesterol can affect your risk of future heart problems. You may be able to raise your HDL (good) cholesterol levels through weight loss, dietary changes and physical activity. Your doctor may also prescribe medicine to help. | |
| Physical Activity | At least 150 minutes of physical activity (brisk walking, jogging, cycling, etc.) per week in bouts of at least 10 minutes (preferably) spread out through the week |
Regular physical activity has many benefits such as helping you quit smoking, lose weight, reduce stress, lower blood pressure and increase HDL cholesterol. Doing aerobic exercise — using large muscles of the legs and arms — on most days of the week for 30 to 60 minutes helps your heart work more efficiently. Physical activities to improve your strength, flexibility and balance help you stay agile as you age. | |
| Weight | Ideal body mass index (BMI) is 18.5–24.9 kg/m2 |
| Waist circumference not more than 40 inches for men and not more than 35 inches for women (Recommendations are lower for people of Asian descent: 37–39 inches for men and 31–35 inches for women.) A 10-pound weight loss may help lower your blood pressure and improve both cholesterol and blood sugar. The tips and tools in this Web site can help you lose 5 to 10 pounds. Entering your height and weight in the Body Mass Index (BMI) calculator can help you determine if you're overweight. Your waist circumference also helps determine whether you need to lose weight — all you need is an ordinary measuring tape. Learn more about choosing the right foods to help you eat well and lose weight. | |
| Blood sugar (glucose) | Normal fasting blood glucose of less than 100 mg/dL |
| Diabetes | If you are diabetic, a HbA1c (glycosylated hemoglobin) of less than 7 percent |
| Managing diabetes is important to your long-term health, especially if you have heart disease. Diabetes is best controlled by diet, weight loss, physical activity, medicines and regular monitoring of your blood sugar. Many studies have shown that medicines such as statins, aspirin, ACE-inhibitors and beta-blockers, which lower the risk of future heart problems, have even greater benefit in people with diabetes. That's why it's important for you to start and continue taking these medicines. They will help to lower your cholesterol and blood pressure, which will decrease your risk of heart attack, stroke and kidney disease. The HbA1c test measures how well your blood sugar is controlled over weeks and months. The Heart of Diabetes program was created for people like you — find out more. | |
The goal of cardiac rehab is to help you learn to reduce the risk factors — such as smoking, high blood pressure, high cholesterol, physical inactivity, diabetes and being overweight — that increase your chances of future health problems.
The American Heart Association and the American College of Cardiology have developed national guidelines to help you reduce the risk of future problems. These guidelines can help your doctor develop a treatment plan — including medicines and lifestyle changes such as diet and physical activity — for all your risk factors. Make sure you know your goal numbers and work with your healthcare team professionals to achieve them.
| Risk Factor | Goal |
| Smoking | Quit for good |
| Smoking is the leading preventable cause of death and disability in the United States. Cigarette smoking results in a 2- to 3-fold increased risk of dying of coronary heart disease. Smoking robs the heart of oxygen-rich blood and increases the effects of other risk factors, including blood pressure, blood cholesterol levels and physical inactivity. Thinking about quitting? We can help. | |
| Blood Pressure | Less than 140/90 mm Hg OR Less than 130/80 mm Hg if you have diabetes or chronic kidney disease |
| Optimal blood pressure is less than 120/80 mm Hg (systolic pressure is 120 AND diastolic pressure is less than 80). Prehypertension is systolic pressure from 120-139 systolic OR diastolic pressure from 80-89. High blood pressure is systolic pressure of 140 or higher OR diastolic pressure of 90 or higher. When blood pressure is higher, your heart has to work harder. Changes in health habits such as losing weight, eating less sodium (salt) and enjoying regular physical activity can help lower blood pressure. If you have high blood pressure, staying on your medicines is critical to prevent heart attacks, strokes, kidney disease and heart failure. Monitor your blood pressure as your doctor advises. Keep track of your readings with our blood pressure tracker. | |
| LDL (bad) Cholesterol | Less than 100 mg/dL OR Less than 70 mg/dL if you are at very high risk of a heart attack or sudden cardiac death |
| High blood cholesterol occurs if your body makes too much cholesterol and/or if you eat too much saturated fat, trans fat and dietary cholesterol. For patients with coronary heart disease, treatment focuses on LDL (bad) cholesterol. The goal for LDL cholesterol is below 100 mg/dL. If you are a very high-risk patient, your doctor may decide that your LDL level needs to be below 70 mg/dL. Be sure to ask your doctor what your LDL cholesterol goal is. To lower your LDL cholesterol, you may need to change your eating habits and lose weight. Speak with your doctor to see if you should be taking a cholesterol medicine along with making these lifestyle changes. | |
| Fasting Triglycerides | Less than 100 mg/dL is optimal |
| Like LDL (bad) cholesterol, triglycerides can affect your risk of future heart problems. You may be able to lower your triglycerides through weight loss, dietary changes and physical activity. Your doctor may also prescribe medicine to help. | |
| HDL (good) Cholesterol | 40 mg/dL or higher for men and 50 mg/dL or higher for women |
| HDL (good) cholesterol can affect your risk of future heart problems. You may be able to raise your HDL (good) cholesterol levels through weight loss, dietary changes and physical activity. Your doctor may also prescribe medicine to help. | |
| Physical Activity | At least 150 minutes of physical activity (brisk walking, jogging, cycling, etc.) per week in bouts of at least 10 minutes (preferably) spread out through the week |
Regular physical activity has many benefits such as helping you quit smoking, lose weight, reduce stress, lower blood pressure and increase HDL cholesterol. Doing aerobic exercise — using large muscles of the legs and arms — on most days of the week for 30 to 60 minutes helps your heart work more efficiently. Physical activities to improve your strength, flexibility and balance help you stay agile as you age. | |
| Weight | Ideal body mass index (BMI) is 18.5–24.9 kg/m2 |
| Waist circumference not more than 40 inches for men and not more than 35 inches for women (Recommendations are lower for people of Asian descent: 37–39 inches for men and 31–35 inches for women.) A 10-pound weight loss may help lower your blood pressure and improve both cholesterol and blood sugar. The tips and tools in this Web site can help you lose 5 to 10 pounds. Entering your height and weight in the Body Mass Index (BMI) calculator can help you determine if you're overweight. Your waist circumference also helps determine whether you need to lose weight — all you need is an ordinary measuring tape. Learn more about choosing the right foods to help you eat well and lose weight. | |
| Blood sugar (glucose) | Normal fasting blood glucose of less than 100 mg/dL |
| Diabetes | If you are diabetic, a HbA1c (glycosylated hemoglobin) of less than 7 percent |
| Managing diabetes is important to your long-term health, especially if you have heart disease. Diabetes is best controlled by diet, weight loss, physical activity, medicines and regular monitoring of your blood sugar. Many studies have shown that medicines such as statins, aspirin, ACE-inhibitors and beta-blockers, which lower the risk of future heart problems, have even greater benefit in people with diabetes. That's why it's important for you to start and continue taking these medicines. They will help to lower your cholesterol and blood pressure, which will decrease your risk of heart attack, stroke and kidney disease. The HbA1c test measures how well your blood sugar is controlled over weeks and months. The Heart of Diabetes program was created for people like you — find out more. | |
Goal 2: Recognize Your Symptoms
You need to know, and know what to do about, symptoms that may suggest a heart attack or stroke. Reacting quickly is key. If you have any of the listed symptoms, call 9-1-1 immediately or have someone take you to the nearest emergency room.
The warning signs of heart attack are:
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
- Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath with or without chest discomfort.
- Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
The warning signs of stroke are:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden, severe headache with no known cause
Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help right away. Every minute counts if you're having a heart attack or stroke. The sooner you get medical help, the more likely you are to recover. Don't delay — you can save your heart or brain from severe damage if you act quickly. Learn these symptoms and share them with your family, friends and caregivers.
Angina
Angina usually feels like a squeezing, burning, pressure, heaviness or tightness under the breastbone. It may also spread to your left arm, back, throat or jaw. Some people, especially women and people with diabetes, may not have typical chest discomfort. Their symptoms may be shortness of breath or feeling very tired. Tell your doctor if you think you're having angina. Knowing how often your angina occurs will help your doctor decide if you need a change in your medicines or other treatments. You can use the Angina Log to keep a record of your symptoms.
Your doctor may give you a prescription for nitroglycerin. This medicine comes in a tablet or spray to provide immediate relief of angina. If you have angina that doesn't go away immediately when you rest, taking nitroglycerin should relieve your discomfort very quickly. If you still have angina after five minutes, or if you also have other symptoms like nausea and sweating, call 9-1-1. You may be having a heart attack.
Nitroglycerin tablets last only six months. Throw them away after six months and get a new supply. Nitroglycerin comes in a small, easy-to-carry container. Keep several tablets with you at all times.
You should always report these changes to your doctor:
- Any new chest discomfort (angina)
OR any change in how often, how intensely or how long you have it. - Any new shortness of breath, especially with physical activity.
- Feeling extremely tired.
- Feeling dizzy or fainting.
Goal 3: Make a Plan for Getting Medical Help
| You and your loved ones will feel better and be more prepared if you know who to call about discomfort and other worrisome symptoms. Your early response to symptoms may prevent an emergency. Find out in advance:
Download the Medical Contact List , complete it and post it in an obvious place at home where other family members can see it. Remember — if you think you're having symptoms of a heart attack or stroke, call 9-1-1 or have someone take you to the nearest emergency room immediately. |  |
In this section you will find these articles:
- Coping with Feelings
- Reducing Stress
- Quitting Smoking
- Eating Well and Losing Weight
- Getting Physically Active
"This content was last reviewed on 09/22/2011."
