A heart attack, or myocardial infarction, occurs when the flow of oxygen to the heart stops suddenly. This is usually due to the build-up of fat and cholesterol in the arteries. Each year in the United States, about 735,000 people experience a heart attack. For 30% of them, it isn’t the first time. Once you have one heart attack, the risk for having another heart attack rises; this risk is especially high for 3 to 5 years after the first heart attack. Every heart attack is different, though, and you aren’t just a number. There’s a lot you and your doctor can do to help prevent a second heart attack. Manage your heart attack risk factors. About 86% of people who have a heart attack survive it, but certain lifestyle habits and medical conditions increase the risk of second heart attack, including: Smoking, the most preventable risk factor High blood pressure (hypertension) High cholesterol Lack of physical activity Obesity Drinking alcohol excessively Diabetes Work with your healthcare team to make improvements to your lifestyle habits where needed and maintain good control of other medical conditions. Adopting a heart-healthy diet low in saturated and trans fats is often an important first step in lowering bad cholesterol. Regular exercise can also help lower cholesterol, lower high blood pressure, and help you maintain a healthy weight. Take your medications as prescribed. It may not be possible to decrease your risk factors with lifestyle changes alone. Most heart attack survivors are prescribed some form of medication to help decrease their chances of second heart attack. It’s not unusual to go from taking zero medications before a heart attack to taking six or more afterward. Common medications include: Baby aspirin taken once a day Cholesterol-lowering medication Medication to lower blood pressure Anticoagulant medication that helps prevent blood from clotting if you have a stent Your new medication routine will come with a learning curve, but it’s critical to stick with it. The American Heart Association offers these helpful tips: Organize a list of your medications with dosage information into one chart. Keep a weekly pill box up to date. Schedule reminders on your smart phone. If the cost of medication is a concern, let your doctor know. Alternative medications or prescription savings programs may be available. Commit to cardiac rehabilitation if it’s recommended. Doctors often recommend cardiac rehabilitation after a heart attack. If it isn’t offered to you, ask if it’s available. The foundation of cardiac rehabilitation is a personalized exercise prescription developed by a physiologist and overseen by a cardiologist, with medical monitoring that decreases as your heart health improves. There are usually four phases: Phase 1: Walking as soon as possible after heart attack, often within 24 hours Phase 2: Regular, monitored exercise sessions that use treadmills or exercise bikes and build up duration and intensity Phase 3: Exercise sessions with less monitoring Phase 4: Independent exercise without supervision Surround yourself with support. Just as every heart attack is different, and every person is different, the range of emotions you may feel after a heart attack can be different from someone else’s. Some people are scared. Others take it in stride. Some are angry or anxious about the future. Emotional support isn’t just nice to have. It’s been shown to help physical healing. Look to friends and family to hear you out and help you stay on the right track with your medications and lifestyle changes. Community and religious organizations can also help, especially if they include members who are in your same situation and can empathize. Check out online heart attack support groups, too. About 20% of people experience depression after a heart attack and may need the assistance of a professional therapist. Let your doctor know if you think you might be depressed. Unlike feelings of sadness or loneliness that come and go, depression is characterized by persistent feelings of sadness and hopelessness and a loss of interest in activities you once enjoyed. Managing your risk factors, taking new medications, developing new diet and exercise regimes, and participating in support programs may seem like a full-time job. All of it will get easier over time until it becomes second nature to put your heart health first. Avoiding another heart attack is a reward that’s well worth it.