Drs. Binh An P. Phan & David Najman (NorthShore)
Excellent question, and there is no data yet to answer your question. There was a similar drug previously in development which failed because more people died when taking it. It is unknown if that was due to the class of drugs, or if it was specific to the previously studied agent. Towards the end of this year or early next year there will be 2 very large trials assessing the benefits of Niacin in addition to a statin, named "AIM-HI" and "HPS2-THRIVE" which will give us definitive data with Niacin. There will also be more data with anacetrapib around the same time, and although none of these trials are comparing the agents to each other, we will have much more information to answer the question.

Drs. Binh An P. Phan & David Najman (NorthShore)
There is no good answer to your question, as we are unaware of any data to give us this answer. Although exercise may trigger an event, the underlying disease process began long before the actual heart attack. People who engage in more regular exercise and better diet have a slower progression of arterial disease (plaque in the arteries), and also have more of a warning mechanism before an actual heart attack. For those who do not engage in regular activity, they should be very careful shoveling snow today and tomorrow as this places a huge demand on the heart. For those who know their heart is fine, shoveling snow is a great form of exercise and burning calories.

Drs. Binh An P. Phan & David Najman (NorthShore)
Patients who have heart attacks in their 20's and 30's usually have several risk factors. You mentioned high blood pressure, but other concerns which hopefully have been examined are diabetes (glucose), smoking, and cholesterol (not just the total, but the good - HDL, and bad - LDL and TG). Your body mass index if elevated should also be watched, and kept under 25. It is hard to answer the question of your future risk without knowing what was abnormal prior to this point, but the most important factors we listed above should be followed on a regular basis, and the frequency is dependent on how well they are controlled. We would also recommend periodic stress tests to follow your heart, this dependent on how many blockages you had at the time of your heart attack, how severe they were, and if you develop any symptoms.

Drs. Binh An P. Phan & David Najman (NorthShore)
Get on a plane to Florida if you still can, wait until everything melts, then come back. :-)As written 2 questions ago, this is a concern and with each significant snow fall we see many patients coming in with a heart attack. For those who exercise on a regular basis, shoveling is still a greater demand on the heart and body, so as with anyone if you develop any chest discomfort, (can be tightness, squeezing, sharp pain..., there is not 1 specific symptom to watch out for), you should rest, and if it has not gone away for 5 minutes either call 911 or go to the ER.

Drs. Binh An P. Phan & David Najman (NorthShore)
It is our pleasure to answer these questions. It is great that you are exercising on a regular basis, that unfortunately is the minority in this day and age. Avoiding all smoke, screening (and treatment if necessary) for your cholesterol and glucose, and maintaining a body mass index under 25 are all important. Given your blood pressure, limiting your sodium (salt) intake will also help this, the guidelines which just came out yesterday recommend 1500mg/day as a maximum.

Drs. Binh An P. Phan & David Najman (NorthShore)
There are several other options, either with lifestyle, over the counter meds, or other prescription meds. It is dependent on many factors beyond what you typed above, so a generic answer would not suffice. Factors such as diabetes, weight, and the exact numbers of your cholesterols, glucose, and average blood sugars all need to be taken into consideration. We are concerned about you as an individual, if your regular doctor can not answer your questions adequately feel free to come in to see either one of us, Dr. Phan's office is attached to Glenbrook Hospital, Dr Najman's office in Skokie. You can call 847-663-8410 and ask to schedule an appointment with either one of us, please bring all of your blood tests with you, not just the recent ones, and we will gladly address this in more detail.

Drs. Binh An P. Phan & David Najman (NorthShore)
BP is a risk factor for developing arterial disease, both in the heart and throughout the body. The combination of this along with other risk factors is additive in developing vascular disease. Everyone has a genetically determined start point of their cholesterols, good and bad, and guessing on your origin based on your name, there is a preponderance of people with elevated bad cholesterol (ldl) in western asia/middle east, even if someone is skinny and eats well. It is important to look at all of the risk factors together, and with this we assess an individual's risk of having a heart attack. Based on this we decide at what point to recommend just lifestyle changes, or medications to keep you healthy. Dr. Hani Salti's office (847-941-7970) is very close to you (on Milwaukee just south of 60), it would be a good idea to look at you and your families' numbers to hopefully keep you healthy and prevent you from developing heart disease.

Drs. Binh An P. Phan & David Najman (NorthShore)
Ideal BP is a systolic under 120 and a diastolic under 80. A systolic between 120 and 140 is borderline, over 140 is high.

Drs. Binh An P. Phan & David Najman (NorthShore)
It is a substance found in animal tissues and various foods. It is made by the liver and is important as a constituent of cell membranes and a precursor to steroid hormones. An individual's cholesterol is initially determined genetically, but lifestyle (exercise and diet) will effect both the good and the bad cholesterol levels.

Drs. Binh An P. Phan & David Najman (NorthShore)
Absolutely. We could talk about this question for hours, but will limit it to a few salient points. After menopause the hormones which prevent or delay vascular disease go down significantly. That is the main reason why a pre-menopausal woman's risk of heart disease is lower than a man's, but a woman's risk of heart disease is greater than a man's after menopause. Several other changes tend to occur, good cholesterol can go down, bad cholesterol tends to go up, and blood pressure may go up.

Drs. Binh An P. Phan & David Najman (NorthShore)
Arrhythmia refers to any abnormal heart rhythm, slow, fast, regular, or irregular. Some are benign, some are very concerning. The heart has an electrical system built into it, and if this electrical system is disrupted that is when we see arrhythmias.

Drs. Binh An P. Phan & David Najman (NorthShore)
"Heart disease" is a broad topic, and relates to any part of a complex organ. Lidocaine only has effects on the heart's rhythm, and does not have other effects on preventing build up of plaque in the arteries which cause heart attacks.