Age

Your risk increases, as you get older – being a male over 45 years or a female over 55 years old.

Personal history

Have you had a heart attack, stroke, or coronary bypass?

Having heart disease in the past increases your risk for having another heart attack or stroke.

Family history

Having  a parent or sibling who has had a stroke, heart attack, or known coronary artery disease (CAD) increases your risk.  You are at greater risk if these occurred in a brother or father less than 55 yrs old or a sister or mother less than 65 yrs old.

Smoking

Smokers have 2 to 4 times increased risk of coronary heart disease than nonsmokers.

Smoking raises your pulse and blood pressure, making the heart work harder.

Maintain a smoke free lifestyle

There are many options to help transplant patients stop smoking.

• Smoking cessation classes
• The Wisconsin Tobacco Quit Line 1-877-270-7867 (STOP).
• Hypnosis
• Nicotine patches, sprays, inhalers, lozenges, or gum
• Medicines

           Buproprion

           (Wellbutrin/Zyban) or

           Varenicline (Chantix)

• Talk to your transplant team and your primary care doctor about treatment strategies.
• Avoid exposure to second hand smoke.

High blood pressure

High blood pressure is common after transplant. Certain anti-rejection medicines can cause your blood pressure to go up. 

Having high blood pressure makes your heart work harder. 

Systolic (top number)

130 or less

Diastolic (bottom number) 80 or less.

• Know your blood pressure/  Check your blood pressure daily at home and record the readings.
• Talk to your transplant team or your local doctor if you notice your blood pressure is not at goal most days.

Ways to lower blood pressure

• Maintain a healthy weight.
• Exercise regularly.
• Reduce your salt and alcohol intake.

Some patients need to take medicine to keep blood pressures in the goal range.  If you need medicines, be sure to take them on a regular basis.

Abnormal cholesterol levels

Total cholesterol

Triglycerides (a form of fat)

HDL (“Good” cholesterol)

LDL: (“Bad” cholesterol)

Anti-rejection drugs can cause high cholesterol levels.

When a patient develops high cholesterol and/or triglyceride (fat) levels, blood vessels can become clogged, which affects the flow of blood.  This slowing of blood flow can lead to a heart attack or stroke.

As your total cholesterol rises, so does your risk of heart disesase.  Having an HDL or “good” cholesterol less than 40 also significantly increases your risk. 

In general

Total Cholesterol

< 200 mg/dL

Triglycerides

< 150 mg/dL

HDL

≥ 40 mg/dL

LDL

< 100 mg/dL

Goals can vary from patient to patient based on risk factors.  Talk to your healthcare team about your goals.

Ways to improve your cholesterol

• Stop smoking.
• Exercise.
• Lose excess weight
• If you have diabetes keep blood sugar levels in the goal range.
• Decrease intake of alcohol, saturated fats, and cholesterol. 

Some patients may need medicine to control cholesterol levels.  Most of these medicines are safe for transplant patients, but be sure to discuss any new medicine with your transplant team.

Diabetes

Increased blood sugar levels 

Certain anti-rejection medicines can make your blood sugar levels increase, leading to diabetes. 

Having diabetes greatly increases your risk of heart disease.  Your risk is very high if you often have blood sugar levels that are not in the goal range.

Patients with diabetes

Aim for blood sugar levels of  70 to 140.

If you do not have diabetes fasting blood sugar levels should be 100 or less.

• Weight loss and exercise can help lower your blood sugar levels.
• Check blood sugar levels on a regular basis.
• Some patients may need oral medicine or insulin to control blood sugar levels.  Most of these medicines are safe for transplant patients, but be sure to report any new medicines to your transplant team.  If these medicines are needed, be sure to take them on a regular basis.  

Obesity

More weight means more work for your heart.  This can also lead to high blood pressure and diabetes.

Talk with your healthcare team about your goal weight.

In general aim for a waist circumference of less than 35 inches for women and 40 inches for men.

By losing even as few as 10 pounds, you can lower your heart disease risk.

• Reduce the amount of calories, fat, and sugar you eat.
• Increase your daily activity.
• Record your food intake.
• Discover what triggers your appetite.
• Eat slowly.
• Eat breakfast and do not skip meals.
• Eat more fruits and vegetables.
• Watch your portions.
• Choose foods high in fiber.
• Remember that liquid calories do count.
• See a dietician to for more tips. 

Not being active

Lack of regular activity increases your risk for abnormal blood sugar levels, high blood pressure, and high cholesterol, all of which can increase your risk of heart disease.   

150 minutes of physical activity each week.

• Start a program of aerobic exercise
• Walk more.
• Use the stairs.
• Park in the farthest space in the lot.
• If you have conditions that make it difficult for you to get physical activity, talk with your transplant team or your local doctor for recommendations.