Prevention of myocardial infarction primary and secondary

Its goal is to reduce risk factors that cause the development of cardiovascular diseases and increase mortality. They can be distinguished into several groups.

  • middle age
  • male
  • genetic component predisposing to the development of hypertension, diabetes mellitus, dyslipidemia,

Anatomical, physiological and metabolic differences of the body:

  • dyslipidemia,
  • hypertension,
  • overweight,
  • features of the dispersion of fat in the body,
  • diabetes.

Belonging to a certain model of behavior, lifestyle:

  • food addictions
  • smoking,
  • lack of constant motor activity,
  • alcohol abuse.

Actual risk factors for the development of myocardial infarction are: hypertension, smoking, dyslipidemia, overweight, alcohol abuse, lack of exercise.

The danger of developing this condition is that it passes asymptomatically for a long time. Therefore, it is so important to control your blood pressure for people who have a genetic predisposition to this disease, as well as people who become predisposed to it during life due to high body weight, stressful situations, physical inactivity, heavy physical exertion, etc.

Important! About 40% of the country’s adult population has arterial hypertension.

Effective components that help correct hypertension are weight loss, refusing salt or reducing its intake to a minimum (5 g per day), monitoring the amount and quality of alcohol consumed, physical activity, increasing the amount of potassium in food, etc.

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According to the WHO, 23% of deaths from coronary heart disease are attributable to smoking.

Unfortunately, adherents have a shorter life than non-smokers. Among those who quit smoking, the risk of developing cardiovascular disease is reduced several times.

Dyslip >

This term is used to determine the state of imbalance in the blood of “bad” and “good” fats, with a shift towards the former. That is, in the blood increases the amount of cholesterol and lipids, which are called “bad cholesterol.”

These are substances that transport cholesterol from the liver to all cells of the body through the blood. With their increased number, there is a threat of the formation of cholesterol plaques and blockage of the lumen of the vessel.

If such blockage occurs in the coronary vessel, then ischemia of the area of ​​the heart muscle occurs, followed by a heart attack.

To eliminate the potential risk of developing these diseases and complications in the form of myocardial infarction, you can, first of all, adjust the diet. This adjustment is associated with the fat composition of the diet, the total volume of which should not exceed 30% of the total energy volume.

The amount of saturated fat should not exceed 30% of all consumed fat. You can reduce the risk of dyslipidemia by eating omega-3 polyunsaturated fatty acids found in marine fish fatty varieties, or as fish oil supplementation.

Overweight also leads to a risk group for coronary heart disease and heart attack. The most dangerous in relation to the development of myocardial infarction is the deposition of fat on the abdomen (male type).

Important! The potential risk of heart attack can be determined by the size of the waist and hips. If the waist circumference exceeds 102 cm in men and 88 in women, and the ratio of the circumference to the circumference of the hips, respectively, for men is more than 1, and for women more than 0, 85, this is an occasion to take measures to reduce weight and fat deposits.


Diabetes mellitus of the first and second type is one of the risk factors for the development of myocardial infarction, brain stroke and other CVDs. Diabetes is often accompanied by increased body weight, obesity, hypertension, dyslipidemia, which significantly affects the possibility of myocardial infarction.

The risk factor associated with alcohol abuse is important primarily for those people who already have diseases such as hypertension and diabetes. And, even if moderate consumption of high-quality alcohol has a beneficial effect on blood vessels, it would be wrong to recommend it as a prophylaxis of IHD.

Lack of exercise is a prerequisite for the development of CVD, along with other risk factors. Conversely, exercise, in which the muscles are involved in a uniform contraction, can reduce the possibility of developing a heart attack by half.

This is vigorous walking, jogging, cycling, skiing, swimming. Determine the intensity of physical activity is necessary in each case, based on the condition of the person, his age and gender.


An indisputable negative factor for people with CVD is stress. It is often the cause of angina pectoris, arrhythmias, and can cause a sudden attack of stroke or myocardial infarction.

Effective primary prevention of myocardial infarction is associated with the main guidelines, recommendations:

  • continuous monitoring of blood pressure and cholesterol and blood sugar,
  • proper nutrition
  • physical exercise,
  • quitting smoking and alcohol abuse,
  • the exception of possible stressful situations,
  • exercising body weight control.

Nationwide, CVD prevention is carried out in two directions:

  • mass popularization of a healthy lifestyle,
  • identification of people at risk for CVD, with the aim of reducing them by prevention methods.

The purpose of secondary prevention is to prevent repeated attacks in patients after myocardial infarction. She has two strategies: medication and physical.

Medical prophylaxis of myocardial infarction is aimed at maintaining the functionality of the heart muscle, improving metabolic processes and blood circulation.

Post-infarction patients need to give up smoking and alcohol. High blood pressure requires the appointment of antihypertensive drugs, β-blockers and drugs from the group of ACE inhibitors.

  • Prophylactic drugs are selected taking into account the available diagnostic tests, the state of the heart muscle after the rehabilitation period, the age and gender of the patient.
  • Physical methods
  • Physical methods for the prevention of CVD are aimed at returning the post-infarction patient to feasible work.

Important! In the subacute period, the patient is prescribed a complex of exercise therapy. Two months later, an ECG test is performed with minimal physical activity. Based on its results, a set of exercises is prescribed.

The complex begins with a walk, at a speed of 100 steps per minute. At the same time, blood pressure and heart rate are monitored. Gradually, the walking distance increases to 3 km.

  1. For exercise therapy, special exercises are selected that are recommended to be taught in group classes, and then used for independent performance at home.
  2. In the prevention of myocardial infarction, great importance should be given to educational work, awareness of the population about the dangerous consequences of an improper lifestyle, inattentive and indifferent attitude to their health.
  3. Understanding the value of health often comes late, when a disease in the form of a myocardial infarction causes him great damage.

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Emergency conditions of a cardiological nature are considered one of the main causes of early death of patients of any age. The key contingent is over 40 people.

  • In recent years, developing countries have seen a growth trend for young people with acute coronary insufficiency, which is most likely due to poor attention to their own health, lack of early screening and a small amount of time to visit doctors.
  • Myocardial infarction is lethal in almost 40-60% of situations, extensive forms have one hundred percent mortality or slightly lower, but survival cases are more likely to refer to statistical error and rare exceptions.
  • The causes of death are cardiac arrest, malnutrition of organs and total dysfunction of all systems, as well as relapse of an emergency.
  • Myocardial prophylaxis is carried out in several directions: from regular examinations by a cardiologist to the use of drugs.
  • It is better to discuss the issue of strategy with the attending specialist, also adhering to standard recommendations.

This term refers to the prevention of acute coronary insufficiency and myocardial necrosis in patients who do not yet have a history of heart attack. Those are the absolute majority.

A sample list of activities includes the following points.

To give up smoking

Cigarettes do not benefit the body with colossal negative effects. Tobacco products contain a lot of harmful substances, which is caused not so much by the effect of tobacco itself, but by the action of its constituent elements.

Cadmium, methane, nicotine and other compounds inhibit normal cellular nutrition. This leads to hypoxia (oxygen starvation) and randomization of the whole organism.

Additionally, stenosis of all vessels occurs. The body seeks to compensate for its own work, cardiac activity is intensified. The number of heart contractions per minute, blood pressure.

Against the background of the dual process, the risk of myocardial infarction increases almost three times, and with an increase in the length of tobacco consumption, it increases by 5-6 times, which is additionally imposed on the advanced or senile age of most patients. Vessels lose their elasticity, and remain in a constricted state on an ongoing basis.

The recommendation to quit smoking is addressed not only to people at risk, but also to everyone who wants to preserve their health for many years.

It is not always possible to abandon the addiction on their own. Then you should contact a narcologist, a psychotherapist. Given the specifics of specific care in Russia and the CIS countries, it is better for anonymous, private reception, and not in an IPA or drug treatment center.

There are several effective treatment methods – from the use of medications to Erickson (shallow or mild) hypnosis. In a trance state, a smoking cessation attitude is being introduced.

Diet correction

Malnutrition is considered one of the key risk factors. Patients with impaired lipid metabolism are at particular risk. They are easy to distinguish by overweight.

Features of primary prevention

The list of provoking factors contains items that a person cannot change. No one can stop the physiological aging process, or fix the genetic code. In addition, according to statistics, men are subject to the development of myocardial infarction several times stronger than women. This factor is explained by the characteristics of the hormonal background, and it can not be influenced either. But if you take care of your own health from a young age, the risk of a life-threatening condition can be reduced to a minimum.

Preventive measures against the development of myocardial infarction can be of two types. These include:

  • primary prevention;
  • secondary prevention.

Primary prevention of myocardial infarction is intended for people who have never had to deal with this dangerous disease. That is, it is suitable for people suffering from cardiovascular diseases, or at risk.

Secondary prevention should be carried out by people who have already suffered a heart attack and want to avoid its recurrence.

Healthy lifestyle as a measure of prevention of myocardial infarction

Strictly speaking, the treatment and prevention of many diseases depends not so much on the qualifications of doctors and the level of medicine as a whole, but on the patient himself. The right way of life helps to prevent many diseases, including heart attack.

The concept of a healthy lifestyle includes the following components:

  • Physical activity;
  • Balanced diet;
  • Rejection of bad habits.

Physical activity is important for our health, and this is an indisputable fact. However, you need to engage in physical education wisely. If you have any diseases, then you should start training after consulting with a specialist. Even if, on the whole, you feel absolutely healthy, you need to increase the intensity of the exercises gradually, without trying to break all existing sports records in one day.

If a busy schedule or other circumstances do not leave time for visiting a sports club, you can start using the elevator less, walking instead of going to work (if possible) or going out on a weekend to keep fit. Any exercise helps to normalize weight, increase physical endurance and resistance to infectious diseases, give good spirits and improve mood.

Good nutrition implies that the food consumed should be a full-fledged source of the necessary nutrients (proteins, fats and carbohydrates), vitamins and minerals. In addition, the calorie content of the diet matters, that is, the number of calories consumed should be approximately equal to energy consumption.

If we talk in more detail about the diet that should be observed for the prevention of myocardial infarction, then it must necessarily include vegetables and fruits, low-fat varieties of meat and fish, low-fat dairy products, and cereals. Fatty, fried, spicy and overly salty foods should be discarded.

Refusal of bad habits, primarily from smoking and alcohol abuse – a necessary component of a healthy lifestyle. The vast majority of smokers have disorders not only of the respiratory, but also of the cardiovascular system. Nicotine leads to the development of atherosclerosis, causes spasm of blood vessels, including coronary, disrupts the supply of organs and tissues with oxygen.

Excessive alcohol consumption is often accompanied by an increase in blood pressure, threatening to complicate the course of existing coronary heart disease with the development of myocardial infarction. Therefore, if you have high blood pressure, the use of alcoholic beverages is best minimized or eliminated altogether.

It is carried out in the case when the patient has already had a heart attack, and is aimed at preventing its recurrence. Secondary prevention is performed after a rehabilitation course under the supervision of a cardiologist. In general, the same methods are used for it as for the primary one.

Prevention of recurrent myocardial infarction includes the observance of the principles of good nutrition, and the rejection of bad habits. Physical activity is introduced gradually and only under medical supervision. Drug therapy of diseases leading to a heart attack is also important. Preparations for this purpose are prescribed individually and only by the attending physician.

With an existing coronary heart disease, cardiorehabilitation in a sanatorium is very effective. Special reconstructive and preventive treatment many times reduces the risk of heart attack and improves the current condition of the patient.

Thus, the prevention of myocardial infarction consists of two components: maintaining a healthy lifestyle and, if necessary, referring to specialists for the treatment of existing predisposing diseases.

In any case, the disease is better to prevent than to treat. Remember this and know: the sooner you take up your health, the less dangers will threaten him in the future.

Secondary prevention of myocardial infarction is necessary for people who have had this dangerous disease. It is carried out after a rehabilitation course, and its main purpose is to prevent the development of a second attack.

Prevention after a heart attack practically does not differ from the measures that people should take in order to prevent the development of this condition. However, having suffered a myocardial infarction once, people should take the medicines prescribed by them for the rest of their lives and live according to the new rules.

Preventive measures after myocardial infarction are divided into two periods:

  • the first period lasts for two years and is aimed at restoring the heart muscle and general condition of the patient after the disease;
  • the second period lasts for the rest of your life and implies compliance with certain rules, as well as regular visits to the doctor.

The number of secondary measures designed to prevent myocardial infarction includes four areas. These include:

  • taking medication;
  • increased motor activity;
  • recovery of psychoemotional state;
  • prevention of sexual activity.

After a heart attack, each patient is assigned several groups of drugs. These include:

  • anticoagulants contribute to a decrease in blood viscosity and the elimination of inflammatory processes on the walls of blood vessels;
  • ACE inhibitors (angiotensin-converting enzyme) contribute to vasodilation and lower blood pressure;
  • calcium antagonists – a group of drugs that contribute to the expansion of the coronary and peripheral arteries;
  • B-blockers can reduce heart rate and load on the heart muscle, reducing the oxygen demand of the heart.

Prevention of myocardial infarction is not possible without increasing the patient’s motor activity. Immediately after returning from the hospital ward to the walls of your home, it is recommended to start physical therapy exercises and walking, the duration of which depends on the general condition of the patient.

Before starting physical education, a person who has had a myocardial infarction undergoes a special test with a load. Before increasing the intensity of the loads, you should consult your doctor. Neglect of this rule significantly increases the risk of developing a new attack of myocardial infarction.

In especially severe cases, when conversations do not help, patients are prescribed medications that have a calming and anti-stress effect.

Young patients seek, as early as possible, to return to their normal course and resume sexual relations with the opposite sex. It should be remembered that sexual intercourse is equivalent to physical activity, which in a certain period after the illness can be contraindicated.

A return to the usual sexual life is possible a month and a half after the disease. However, this period depends on the severity of the disease and the physical condition of the patient. Sex can be renewed in the following cases:

  • if a person can climb the stairs to the second floor without stopping to rest;
  • if during the test with a load, the pulse rate did not exceed 120 beats / min:
  • if the blood pressure does not rise above 160/100 mm Hg

Treatment of existing diseases

A separate place is the treatment of existing diseases that may be complicated by the development of myocardial infarction. First of all, these include cardiovascular problems that can lead to it: atherosclerosis, coronary heart disease, arterial hypertension. They can be treated with drugs prescribed by a cardiologist. But even if a person does not have such diseases, upon reaching the age of 40 with a preventive purpose, he is recommended to conduct an annual ECG.

Sleep problems can also provoke the development of myocardial infarction. The first place among them is complicated snoring – obstructive apnea syndrome (OSAS). In this state, in a person’s dream, snoring is disturbed by normal breathing, episodic stops occur, which causes oxygen starvation of the heart muscle, especially already affected by coronary artery disease. And this can lead to a heart attack .

According to statistics, about a third of patients with myocardial infarction suffer from sleep apnea. Therefore, for the full prevention of heart attack, the problem of snoring and OSAS must be solved. Doctors at the Center for Sleep Medicine at the Khamovniki Rehabilitation Clinic have vast experience in their treatment; furthermore, they specialize in these violations.

Watch an interview with a patient who has had multiple myocardial infarction before she has been diagnosed with sleep apnea.

High blood pressure as a blood vessel destroyer

The main reason for the development of myocardial infarction is the destruction of cholesterol plaque, which leads to damage to the walls of blood vessels. The body, seeking to eliminate the gap, increases blood coagulation and proceeds to the formation of blood clots, replacing the atherosclerotic plaque.

The destruction of plaques most often contributes to high blood pressure. Therefore, it is very important to control its level and, if necessary, take medications that stabilize it.

As the people say: “Drinking and smoking is harmful to health.” The ability of nicotine to provoke the development of myocardial infarction has not found scientific confirmation. However, with each puff of the cigarette spasm of the arteries occurs, which undoubtedly worsens the blood flow and causes oxygen starvation.

Alcohol in small quantities has a beneficial effect on blood vessels, contributing to their expansion. However, the daily amount of alcohol in terms of pure alcohol for women should not exceed 20 ml, and for men – 30 ml.

High blood sugar indicates insufficient production of insulin – a hormone responsible for the delivery of glucose to the cells of the body. And glucose for them is energy, that is, the main food. Having not received the next portion of food, tissue cells are starving. The heart and blood vessels experience the same thing.

Vessels with a lack of energy become brittle, which increases the risk of blood clots, which are designed to repair the formed defects. Therefore, at the slightest deviation of the blood glucose level from the norm, it is necessary to register with the endocrinologist and begin treatment.

Major risk factors

Cardiovascular diseases, including myocardial infarction, appear due to the fault of the person himself. Improper lifestyle directly affects health.

“Accelerators” of myocardial infarction are:

  • smoking, alcohol addiction;
  • high blood cholesterol;
  • sedentary lifestyle;
  • obesity, overweight;
  • high blood pressure;
  • diabetes;
  • age after 50 years, etc.

It is worth noting that the risk of developing a heart attack in men is much higher than the appearance of a heart attack in women. In men, a heart attack can occur at 40 – 50 years old, and in modern living conditions it is very common to 30 years. In women, seizures usually occur a little later at 50-60.

Excess weight puts a strain on the lower limbs and contributes to the development of varicose veins. Varicose veins, in turn, leads to the development of thrombosis, a disease in which there is a high probability of a blood clot breaking off and entering the coronary artery.

In addition, each kilogram of adipose tissue contains many tiny vessels through which blood circulates. And this means that every extra kilogram significantly increases the load on the heart.

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Tatyana Jakowenko

Editor-in-chief of the Detonic online magazine, cardiologist Yakovenko-Plahotnaya Tatyana. Author of more than 950 scientific articles, including in foreign medical journals. He has been working as a cardiologist in a clinical hospital for over 12 years. He owns modern methods of diagnosis and treatment of cardiovascular diseases and implements them in his professional activities. For example, it uses methods of resuscitation of the heart, decoding of ECG, functional tests, cyclic ergometry and knows echocardiography very well.

For 10 years, she has been an active participant in numerous medical symposia and workshops for doctors - families, therapists and cardiologists. He has many publications on a healthy lifestyle, diagnosis and treatment of heart and vascular diseases.

He regularly monitors new publications of European and American cardiology journals, writes scientific articles, prepares reports at scientific conferences and participates in European cardiology congresses.