ANGINA/REDUCING THE RISK FACTORS: AVOIDING CIGARETTE SMOKE
Your heart’s efficacy will improve if you can keep your coronary arteries as wide open as possible. Crucial to that aim is to avoid cigarette smoke—your own and other people’s. Exposure to cigarette smoke narrows all the small arteries in the skin, pushing up the blood pressure, and causing the coronary arteries to shut down. If they are already narrowed as a result of atheroma, then narrowing them further at the same time as increasing the work of the heart is both insane and suicidal.
Stopping smoking completely is essential; it is no use “cutting down” or “trying to stop.” The only answer, if you are a smoker, is to say to yourself that you are, from this moment on, a nonsmoker. If you can’t do that, then it doesn’t matter how good you are at taking the rest of the advice—you are lost.
Keeping away from other people’s smoke is vital, too. Despite the claims of the tobacco companies to the contrary, there is plenty of evidence that other people’s smoking gets nicotine into the bloodstream of nonsmokers. Nicotine breaks down in the body to a poisonous substance called cotinine. The measuring of cotinine in the blood helps researchers judge the level of exposure, since people inhale cigarette smoke differently, making the number of cigarettes smoked per day an inaccurate measure. Nonsmokers who work in smoky atmospheres have measurable levels of cotinine in their blood. The more their colleagues or customers smoke, the higher their own blood cotinine levels are. The same applies to your home. The babies of parents who smoke have cotinine in their blood; and the higher the level, the more likely they are to be admitted to hospital with lung disease. For every twenty cigarettes smoked around them, non-smokers passively smoke the equivalent of one cigarette.
So if you have angina, avoid cigarette smoke at all costs. In today’s social climate, you shouldn’t feel embarrassed to ask smokers nearby to stop smoking or to go elsewhere to do so. In your home, a small, discreet nonsmoking sign on the window can deter visitors from lighting up, but if they know you have angina, then a quiet word of explanation why they should not smoke in the house should be perfectly acceptable.
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