Ask the doctor: My husband’s stress is so bad I worry he’s going to have a heart attack. Would medication help?

Is there anything you could ask your GP to do to get you through this period? Please don’t tell me all the behavior modifications you should try because you won’t. We need a Band-Aid to get through this time.

dr. Grant replies: I’m afraid there is no such thing as a ‘band-aid/magic pill’ to help your husband through this difficult time. You may be referring to something like Valium (generic name diazepam) also known as a class of drugs called benzodiazepines.

They were first prescribed by American doctors in the 1960s to ‘reduce tension’ and quickly became number one sellers in the Western world.

We now know that long-term use of benzodiazepines has many downsides, and today they are only prescribed for certain conditions.

Physicians’ prescribing habits for controlled substances (drugs that are subject to abuse) are monitored by government agencies around the world.

Moreover, social media tends to modify lifestyles instead of giving patients pills for all kinds of early medical disorders. But that change must come from within the patient. Your efforts may be in vain if the patient is not highly motivated for consistent long-term self-improvement. Stress management depends on several factors.

Instead, I’m asking you to evaluate your husband’s lifestyle and see what you (and other family members/friends) can do to reduce his stress for him. No man is an island.

Starting with his diet and weekly alcohol/cigarette intake (if any). One surefire way to save money is to stop spending it on alcohol/cigarettes/take-out etc.

Where can you both make improvements in your diet? Does he sleep well? You should aim for 7-8 hours of sleep each night, and ideally brisk walking for one hour each day.

Can he reduce his working hours or delegate more? Can you both decide to spend less money this Christmas? Are all available HSE supports provided for his elderly parents? Are there other siblings who can share the burden? It is more about effective time management and ensuring that all available resources are used.

You mentioned your concern about his risk of heart disease. He obviously needs to see a GP for a cardiovascular risk assessment. Factors that contribute to his risk include his current level of physical activity, overall fitness, dietary choices, cigarette/alcohol intake, potential illicit drug use, current stress level, and overall sleep quality.

His body mass index (BMI), body fat percentage, muscle mass, blood pressure and cholesterol profile contribute to his cardiovascular risk assessment. Other things to consider include a strong family history of heart disease (a first-degree relative under the age of 55 with a heart attack) will adversely affect his risk.

Patients with multiple risk factors such as diabetes, metabolic or renal disease, current smoking, morbid obesity, familial high cholesterol, or poorly controlled hypertension should consider screening.

During the shared decision-making process, patients with a higher baseline risk often proceed directly to a heart scan called a CT coronary angiogram. This provides insight into the anatomy of the blood vessels that supply the heart muscle, in order to assess potential heart disease.

No test is 100% definitive, but under the guidance of a cardiologist, you will be directed to the appropriate tests according to the indications.

Other specialized tests such as cardiac perfusion MRI scans or invasive formal coronary angiograms are sometimes indicated for additional reassurance.

Dr Jennifer Grant is a GP with Beacon HealthCheck

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