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Published on June 05, 2017

How not to have a heart attack

A grocery cart in a doctors’ office? This unexpected piece of equipment may look out of place, but it is proving itself nearly as important as the standard EKG machine.

“I use a cart filled with groceries to show patients how to read labels, learn what foods have high levels of sodium, identify the size of a standard portion, and help determine how potential choices can fit into each patients recommended dietary profile,” said Shannon List, RN, FNP, MSN, nurse practitioner manager at Cape Cod Healthcare’s Heart Failure Clinic. “We talk about ways everyone can modify their risk factors to maintain good cardiac health.”

A top tip? Limiting salt. Even if you don’t add salt when you cook, you can be getting huge amounts in canned foods, processed foods and other unexpected places, she explained.

Salt can increase blood pressure, which is a risk factor for heart disease. People who have coronary artery disease should have no more than 2,000 milligrams of salt a day. Those with heart failure should limit daily salt intake to 1,500 milligrams.

“This recommendation is really crucial as a cornerstone of treatment to avoid recurrent exacerbations of disease,” said List. “We use this ‘dietary sodium budget’ similarly to someone’s financial budget and adjust accordingly with changes in their intake and routine. The knowledge of what sodium ‘budget’ they can afford gives control back to the patient and really corresponds with greater compliance.”

Information like this can make a difference in the way you feel every day, according to List.

As a cardiac nurse practitioner, she has enjoyed teaching patients how to make healthy lifestyle changes for the past 16 years.

Having a family history of coronary artery disease increases your risk for heart problems, but there is mounting evidence that you can modify your risk factors. For instance, one study of 55,685 participants reported in the New England Journal of Medicine showed that adults with a high genetic risk (age, gender, ethnicity and family history) had a nearly 50 percent lower risk of coronary artery disease if they adopted healthy lifestyles.

“In other words, if you’ve been dealt a poor genetic hand, there are things you can do to reduce your cardiac risk and stay healthier longer,” List said, and she is more than happy to spend time teaching patients about healthy lifestyle practices.

How to avoid a heart attack

Whether you’ve been given a clean bill of health or you have heart disease, research shows the prescription is the same. These are proven “directions” for a healthy lifestyle:

  1. Exercise regularly – List suggests exercising 30 to 35 minutes at least four to five days a week. If you can’t begin at this pace, start slowly and increase the time as you progress. Check with your physician before starting an exercise program.
  2. Don’t smoke.
  3. Maintain a good weight.
  4. Eat a healthy diet – Include nuts, grains, fruits, vegetables and fish.
  5. Limit alcohol consumption

Patients See Improvements

As a cardiac nurse practitioner, List loves seeing patients thrive. Like the man who was referred to the Heart Failure Clinic after being hospitalized at least once a month for more than a year. With help and encouragement from the entire team, all aspects of his care, from medicine to nutrition, adaptation of healthier behaviors were addressed. Since modifying some of this risk factors, he has not been hospitalized for four months.

“We provided him support, that included regular office visits to assess and treat his disease with medications to lower blood pressure and cholesterol and fluid retention, and he started learning how to make the lifestyle changes that allowed him to help himself. He looks like a new man!” List enthused.

The first month Cape Cod Healthcare’s Heart Failure Clinic was open the team reduced readmission rates for heart failure patients from 21 percent to 8.5 percent. The national average heart failure readmission rate is 21 percent.

With results like these, List will happily keep rolling out the grocery cart and any other resources she can think of to encourage everyone—heart patient or not—that eating right, exercising regularly, maintaining a good weight and not smoking are proven natural remedies.

“It’s a privilege to be so intimately involved in my patients’ care,” she said. “When they first come to the office, I tell them we are going to be friends, and that’s exactly what happens. I enjoy seeing patients benefit as they make healthy lifestyle changes, but I’m truly the one who gets the reward because I enjoy getting to be part of their lives.”