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If an unhealthy individual were given this news, could they make enough life style changes in a single month to prevent an impending heart attack without medical intervention? What would be the first steps in undergoing this transformation?

Editing to make my intent more clear: The basics behind preventing cardiovascular disease are fairly straightforward, but the situation I'm trying to propose is what can be done with someone that is right on the edge? For example: for a good portion of the population jogging a mile would be considered a healthy activity. Does that remain true for the individual above? How do recommendations change when you're that close to the brink?

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    To be honest, I don't really understand your question which is actually based on wrong assumptions. Nobody can tell you with such a precision that you will have a heart attack in one month. If this were possible, that would avoid many morbidity and mortality associated with heart attacks in high risk patients as this could be avoided by hospitalising those patients during one month and "wait" for the heart attack to come... Do you want to know what a person at high risk for cardiovascular disease can do to prevent a heart attack? That would make more sense in my opinion. Best wishes. – S.Victor Aug 23 '16 at 17:33
  • @S.Victor I apologize - Yes, this is a "crystal ball" type of scenario. If you prefer, your interpretation is perfectly valid: a patient at high risk for cardiovascular disease sits down in your office, and after doing an observation your gut feeling is this individual has a good chance to have a heart attack in a month. What do you tell them? – gerg Aug 23 '16 at 17:37
  • Well, not sure if those "crystall ball" type of scenario make really sense, particularly considering that medicine is based on facts... And what do you mean by "doing an observation"? And what is an "unhealthy individual" for you? Depending on the gender/enthnicity/country you could calculate his cardiovascular risk score: health.stackexchange.com/questions/8685/…. Depending on the risk factors, you could refer to the adequate guidelines, to guide you through the management of these risk factors. Best wishes. – S.Victor Aug 23 '16 at 17:44
  • @S.Victor Thank you for the link, that will likely lead me in the direction I wanted to go. Cheers! – gerg Aug 23 '16 at 17:49
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    I have seen that you edited your question but in my opinion, the question has still some inconsistencies. You say "unhealthy" and you say "obese" and "pre-hypertension" so obviously the individual doesn't even meet the criteria for a metabolic syndrome (according to the info you are providing in your question) so he might be a so called "metabolically healthy obese". In some studies, those individuals have similar risk for CVD as normal individuals (for a good review: bmcpublichealth.biomedcentral.com/articles/10.1186/…). But maybe I am too fussy... Best wishes – S.Victor Aug 23 '16 at 17:55
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There's very little you could do in terms of lifestyle changes. Quitting smoking, stopping excessive drinking, and stopping the use of stimulants such as cocaine and amphetamines are the only things I can think of that would have fairly immediate results, but I doubt it would be enough to prevent that arterial plaque from rupturing that's going to cause the heart attack. The time to prevent that was lifestyle changes 30 years ago.

What I would do if I had such information would be head to the best interventional cardiologist available and ask for a full workup and aggressive treatment of any pending problems they find.

  • Would you somehow be able to fiddle in citation(s) that stopping drugs/alcohol etc. will help with a heart attack? I know it's rather trivial, but your answer would then serve as a good role-model for new users who we request to include references. – Narusan Jun 27 '17 at 19:52
  • @Narusan Done. They're not all the most rigorous citations, but I chose them for directly addressing the specific issue and showing how it would produce immediate results. – Carey Gregory Jun 27 '17 at 22:07
  • Thank you for grasping was I was attempting to convey. This is exactly the type of information I was looking for in an answer. Much appreciated. – gerg Jun 29 '17 at 1:08
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Many people get bad news from their own hearts in the form of a chest pains when actually getting a heart attack. But not all of these people can be treated, there are cases where angioplasty of a bypass cannot be performed. Such patients have a bad prognosis, they have a very high probability of suffering another heart attack in the near future. Dr. Esselstyn has been experimenting with a very strict plant based, fat free diet on such hopeless patients, like this one with what he claims are good results.

Now, the patients here did get medical treatment in the form of medicines, so anticoagulants, blood pressure medication, nitrates, statins etc. would all be administered where appropriate. Nevertheless, without the lifestyle changes imposed by sticking to Esselstyn's diet, most of his patients would have lived for no more than a few years, dying directly from another heart attack or from heart failure caused by subsequent heart attacks.

Now, this does not mean that we should all stick to Esselstyn's diet. More rigorous tests are needed to verify his claimed results. Also, even if verified, an intervention that can prevent a death from some cause with a period of a few years may not be good for a young person who is not facing that risk at all. Also, the short of diet Esselstyn is arguing for may lead to deficiencies on the long term if you're not very careful about your nutrient intake.

Compare this to taking aspirin. If you somehow know that you're going to have a heart attack in the near future, you'll be able to reduce the probability of getting that heart attack simply by taking an aspirin. But if you don't have that information, then taking an aspirin just in case will not help you to increase your life expectancy, because it increases the probability of a fatal intestinal bleeding, while the reduction of the probability of having a heart attack is going to have a lesser effect in this case.

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    This diet (whatever it is - I won't sit through a video to find out) is going to have an effect in 30 days? I find that difficult to believe. – Carey Gregory Jun 28 '17 at 13:40
  • @CareyGregory It won't reverse atherosclerosis on that time scale, but eating junk food has an immediate negative effect apart from the long term problems this causes, so if you eat junk foods regularly and if you can look into the future and see that you're going have a heart attack in a month, then not eating junk foods may well do the trick. See also here. – Count Iblis Jun 28 '17 at 23:37
  • Also note that the landmark study comparing the Mediterranean diet to the one that was traditionally prescribed to heart patients was stopped prematurely by the ethics committee because of a lot more heart attacks in the group that was eating the traditional diet. So, there is also an effect of diet on a short time scale. – Count Iblis Jun 28 '17 at 23:38
  • I'm sorry, but I find it almost impossible to believe you can reverse (or even affect) decades of vascular disease in one month. And again, I won't watch videos. If you can't find the evidence in written form, then I don't believe it exists. – Carey Gregory Jun 29 '17 at 1:49
  • @CareyGregory I didn't say that. It takes a long time to reverse the disease, but you can immediately get rid of factors such as the higher blood pressure due to eating salt by simply drastically reducing salt intake. If a piece of plaque is going to rupture if you go on eating a normal diet and you take away the salt, then the drop in blood pressure may just prevent that. Drastically reducing salt intake falls within the OP's criterion of a non-medical intervention. Give that we need less than half a gram of salt per day and most people get more than a few grams, this is possible to do. – Count Iblis Jun 29 '17 at 2:12

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