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Husband with Heart Disease still smokes
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marriedwithdogs posted:
Hi, I would just like to try to get some answers. My husband is only 50 yrs old, he has heart disease, copd and diabetes. Two yrs ago is when we found out and he had 3 stents put into 2 arteries at that time. Since then he has had to go back 4 times to have stents put in, one of his arteries keeps blocking up and he also continues to smoke. He is on 3 heart meds, Effient, Renexa and Niaspan.If he continues to smoke how many stents can be added into his arteries before his cardiologist says this can no longer be done. I am just concerned that at some point he may have to have open heart surgery. Can you give me any advice?
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cardiostarusa1 responded:
Hi:

"He also continues to smoke"

He must quit smoking ASAP!

As reported, smoking increases the circulating levels of catecholamines and free fatty acids, which may contribute to the increased level of total cholesterol and decreased levels of high-density lipoprotein ("good" cholesterol) that are found in habitual cigarette smokers.

The effects on platelets may enhance coagulation (blood clotting). There can be accelerated coronary and peripheral vascular disease, and occurrence of a dreaded stroke and complications from hypertension.

The greatest concern is the acceleration or aggravation of cardiovascular disease. Smoking can promote atherosclerotic vascular disease by contributing to high cholesterol, endothelial injury (damaging the sensitive inner lining of the walls of the arteries), or both.

Complications of hypertension are more severe in those who smoke cigarettes. Smoking can also aggravate hypertension by causing vasoconstriction (tightening of the vessels).

About.com

After You Quit Smoking - The First 2 Days


Quit Smoking Benefits - the Healing Begins...When you quit smoking, the benefits begin within minutes of your last...

At 20 minutes after quitting:

Blood pressure decreases, pulse rate drops...

http://quitsmoking.about.com/cs/afterquitting/a/quitting20minut.htm

USA Today

Just one cigarette can harm DNA, Surgeon General says

12/9/10

"Tobacco smoke damages almost every organ in your body," says Surgeon General Regina Benjamin. In someone with underlying heart disease, she says, "One cigarette can cause a heart attack."

http://www.usatoday.com/yourlife/health/2010-12-09-1Asmoking09_st_N.htm

"How many stents can be added into..."

This varies upon the individual, though what one really wants to avoid is a "full metal jacket", in which the entire length of a native coronary artery or bypass graft is stented.

The bottom line

Coronary stents (bare-metal or drug-eluting) are only a Band-aid or spot-treatment, as it doesn't address the disease process and what drives the progression.

Coronary artery disease (CAD) is a lifelong unpredictable (may/can exhibit periods of stabilization, acceleration and even some regression) condition requiring a continuum of care.

Best of luck to your husband and you down the road of life.

Take care,

CardioStar*

WeMD member (since 8/99)



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Be well-informed

WebMD

Living with Coronary artery disease (CAD)

A chronic disease with no cure. When you have CAD, it is important to take care...

This is especially true if you have had an interventional procedure or....

Recognize the symptoms. Reduce your risk factors. Take your medications. See your doctor for regular check-ups...


http://www.webmd.com/heart-disease/guide/living-with-heart-disease

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Good to know, for the primary/secondary prevention of heart attack/brain attack.

Epidemiologic studies have revealed risk factors atherosclerosis, which includes age, gender, genetics, DIABETES (considered as being the highest risk factor), smoking (includes second/thirdhand), inactivity, obesity, hypertension, high LDL, small, dense LDL, RLP (remnant lipoprotein), high Lp(a), high ApoB, high Lp-PLA2, high triglycerides, HDL2b, LOW HDL (less than 40 mg/dL, an HDL level of 60/65 mg/dL or more is considered protective against coronary artery disease), high homocysteine (now iffy), and high C-reactive protein (CRP/hs-CRP).

.

Quote!

Be a questioning patient. Talk to your doctor and ask questions. Studies show that patients who ask the most questions, and are most assertive, get the best results. Be vigilant and speak up!"

- Charles Inlander, People's Medical Society


.

WebMD/WebMD forums DOES NOT provide medical advice, diagnosis, or treatment.

 
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James Beckerman, MD, FACC responded:
My first recommendation - he should absolutely stop smoking. Smoking and diabetes are likely his greatest risk factors for future blockages and heart attacks. This should be a big priority.

But to answer your question - it's hard to say. It depends on where his stents are located and the details of his coronary artery anatomy otherwise. It's very possible that over his life he may require open heart surgery - which can be an excellent treatment for people with coronary disease, especially if they have diabetes.
 
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cvcman replied to James Beckerman, MD, FACC's response:
I feel sorry for you because to be very blunt, your husband is not too bright or doesnt care too much about himself or his family ! ANYONE knows that smoking is like the number one cause of heart and resp. problems, now he has heart problems and still smokes.....unreal
Its very hard to have sympathy for someone that doesnt care that much about his own health or providing for his family that he just keeps doing something that to be honest is going to kill him !
Again I do feeel sorry for you but not him. He's a big boy and if he is trying to kill himself he is doing a great job. Again sorry to be blunt but im being honest !
 
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marriedwithdogs replied to James Beckerman, MD, FACC's response:
Thank you for your reply, I really appreciate your input!
 
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marriedwithdogs replied to cvcman's response:
I appreciate your honesty, thank you! Sometimes the truth can hurt but still needs to be stated.


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