Heart attack SURVIVOR? What’s NEXT?

Five strategies for rebuilding health, longevity, and reclaiming your life

Every year, more than 800,000 people in the United States suffer a heart attack. To make matters worse, nearly 20 percent will have a second heart attack within the next five years.

Fortunately, there are FIVE key strategies you can use to rebuild your health… and AVOID A DEADLY REPEAT of the traumatizing ordeal.

Plus, by putting them into practice, you will BOOST your longevity and RECLAIM the life you had before the heart attack. (Or, even, create a better one!)

The first strategy involves prioritizing something you may have put on the back-burner years ago.

Here’s what I mean…

Bring this “ignored part” of your health to the FRONT burner

Researchers recently discovered something quite remarkable (and perhaps a little surprising) about your likelihood of having a second heart attack…

It isn’t just about your weight… your blood pressure… your family history… your smoking habits… your exercise levels… or even whether or not your arteries are filled with plaque.

It turns out, your mental health plays a HUGE role in your survival rate moving foward.2

In a recent study at Emory University in Atlanta, Georgia, researchers analyzed health data on 283 heart attack survivors between the ages of 18 and 61.

They asked survivors about any psychological distress they felt—such as depression, anxiety, anger, or stress.

Next, the researchers sorted the heart attack survivors into three groups—mild, moderate, or high distress—based on their response.

It turns out, compared to those with mild distress, survivors who said they suffered from high distress after their initial heart attack were more than TWICE AS LIKELY to:

  • Suffer another heart attack (or stroke)
  • Become hospitalized for heart failure
  • Die from cardiovascular causes

High-distress survivors also exhibited worrisome levels of two inflammatory markers (interleukin-6 and monocyte chemoattract protein-1), which are known to raise cardiovascular disease risk.

The gift of self-care

This research clearly exhibits the importance of prioritizing your mental health, especially if you’ve recently suffered a heart attack.

One excellent (and free!) technique to try is controlled breathing.

In one recent study conducted by researchers with the University of Missouri, the majority of people who practiced 15 minutes of controlled breathing, five times a week, experienced a significant five-point reduction in their blood pressure.3

Plus, practicing deep, controlled breathing reduces stress and anxiety, which can lessen the risk of experiencing a second heart attack.4

Here are five types of controlled-breathing exercises performed by participants in the Missouri study:

  1. Bellow breathing: Take deep breaths that fill your lungs, followed by deep exhales.
  2. Rapid exhalations: Inhale deeply through your nose. Then exhale, in quick bursts, through your nose 10 to 15 times.
  3. Alternate nostril breathing: Close your right nostril and inhale through your left. Then close your left nostril and exhale through your right.
  4. Bumblebee breathing:Plug your ears and breathe in and out through your nose while humming like a bee.
  5. “OM” singing:Breathe in normally and say “om” while exhaling.

Transcendental meditation (TM) is another good stress-relieving technique to try. It involves silently repeating a personal “mantra” to achieve a state of inner peace. (A quick internet search can give you more detailed instruction for how to practice it.)

In fact, research shows TM is particularly helpful for people who already have heart problems…

In one study, men and women with coronary heart disease who practiced TM had a 48 percent lower risk of suffering a heart attack or stroke over a five-year follow-up. They also had an impressive 48 percent lower all-cause mortality risk!5

Of course, there are countless other ways to reduce stress. And it’s a very individualized decision. Just make sure to stay away from prescription antidepressant drugs, as emerging research links them to a whole slew of heart problems… and even EARLY DEATH! (See page 7 to learn more.)

Now, let’s move on to the second strategy you can use to reduce your risk of suffering a heart attack…

Navigating the road to recovery

It shouldn’t come as any big surprise that getting regular exercise after a heart attack can dramatically improve your survival rate.

In fact, following this recommendation at ANY point in your life is just about as close as you can get to a “magic bullet” for your health…

In a Swedish study, researchers asked more than 22,000 heart attack survivors about their activity levels at two follow-up visits. 6 (The first visit was at six to 10 weeks after the event. And the second visit was nearly a year after the event.)

Next, the researchers sorted the survivors into four groups based on their activity levels. Then, they noted the relationship to certain outcomes.

It turns out:

  • Those with “increased activity” between the two follow-up visits had a 59 percent lower risk of dying over the next four years compared to people classified as “constantly inactive” during both follow-up visits.
  • The “constantly active” group had a 71 percent lower risk of dying than the “inactive” group.

But even heart attack survivors who scaled back their workouts appeared to improve their odds of survival…

Those who reported “reduced activity” between their first and second follow-up visit had a 44 percent lower risk of death compared to survivors who were constantly “inactive.”

Meaning even a little bit of activity is FAR BETTER than doing nothing when it comes to preventing a second heart attack.

And remember, it’s important to ease your way back into your pre-heart attack routine. Here are my general recommendations when it comes to resuming activity after a heart attack:

  1. Re-start your exercise regimen at 10 percent of what you did prior to suffering a heart attack. Train at this capacity for four weeks.
  2. For the next 12 weeks, increase your activity levels by 5 percent each week.
  3. Over the next three weeks, add 10 percent more activity until you feel like you’ve reached your “normal” pre-heart attack activity level.

Of course, you should always speak with your treating physician to decide on a workout plan that’s best for you following a heart attack. It’s likely they’ll create a personalized plan tailored to your needs (and ability)—or have you perform cardiac rehab with a team of specialists.

Now, let’s move on to the third and fourth strategies you can use to prevent a second heart attack…

Replace dangerous drugs with heart-supportive supplements

Without question, most mainstream cardiologists prescribe cholesterol-lowering statin drugs to their heart attack survivors. And lots of survivors now even take a “polypill” that combines a statin with low-dose aspirin.7

But I encourage you to rethink that prescription.

That’s because research shows statins and aspirin don’t lower your risk of suffering—or dying from—a heart attack.8,9 Plus, both come with a slew of dangerous side effects!10

Instead, I suggest sticking with a few tried-and-true supplements, including:

  1. CoQ10 (400 mg daily). This is a powerful antioxidant that even the famed Cleveland Clinic says could reduce your risk of suffering a second heart attack.11
  2. Glutamine (5,000 mg daily). This is an amino acid that stimulates blood flow and supports circulation by generating nitric oxide. Plus, emerging science shows it plays a “FUNDAMENTAL role” in supporting cardiovascular health.12
  3. Vitamin E (800 mg daily), D (250 mcg daily), and fish oil (3,000 mg daily). Everyone who has ever suffered a heart attack should take these three heart-saving heroes… pronto! When it comes to vitamin E, just make sure you avoid synthetic versions (with a “dl” prefix before the listed tocopherols). Instead, look for one with just a “d” prefix that has the full range of tocopherols (alpha, beta, gamma, and delta). And when it comes to fish oil, make sure your supplement contains 3,000 mg of both EPA and DHA, as your body needs both forms.
  4. Potassium and magnesium. Every heart attack survivor should also take steps to optimize their potassium and magnesium levels, as these two minerals help lower blood pressure, relax blood vessels, and improve circulation. See page 3 for guidance and dosage recommendations for potassium. When it comes to magnesium, I always recommend one of two forms that are best-absorbed by the body: magnesium orotate (32 mg per day) or taurate (125 mg per day).

Now, let’s go over the last strategy you can use to rebuild your health—and your life—after a heart attack…

Get serious about your nutrition plan

A wealth of scientific evidence shows that adopting a Mediterranean-style diet can help get your cardiovascular health back on track, even after suffering a heart attack.

This simple, wholesome type of diet features high-fat, low-carb foods—like lean protein, fresh produce, and nuts. You should also take special care to include lots of heart-healthy garlic, fatty fish like salmon, and macadamia nut oil in your cooking. (For a recipe to kick you off, check out the sidebar on page 5.)

And remember, when it comes to heart health, herbs and spices are a secret weapon in the kitchen, too. As I reported in the September issue of Logical Health Alternatives, researchers found using them in cooking can lower blood pressure in just four weeks!13

Well, there you have it: FIVE simple strategies for improving survival after a heart attack… and rebuilding your life.

Add more heart-healthy foods to the menu

It may be hard to know where to start when it comes to redesigning your diet after a heart attack. So, here’s an easy, heart-healthy dish that makes use of canned salmon, garlic, and macadamia nut oil. I suggest making it over the weekend so you can enjoy delicious leftovers all week long.

Can you pass the push-up test?

I’ve always been a vocal proponent of natural, resistance-training workouts—like planking and push-ups. They’re great for your core muscle strength… and your heart!

In fact, a new Harvard University study found that men who can perform at least 40 push-ups in one attempt are 96 percent less likely to suffer from heart disease and other related heart problems over the next 10 years compared to those who can only complete 10 or less.13

Plus, a man’s push-up performance was more strongly associated with cardiovascular disease risk than his performance on the treadmill… a finding that admittedly surprised the researchers.

So, when your doctor says you’re ready, make sure to add some push-ups to your workout. As always, rebuild your strength slowly—and gradually work toward your fitness goals.

Salmon-Stuffed Cabbage

Ingredients: Grab 1-pound of canned salmon, 3 garlic cloves (peeled), 1/2 cup chopped fresh parsley, 1/2 cup watercress leaves, 1-1/2 tablespoons extra virgin olive oil, 1/4 teaspoon cayenne pepper, coarse sea salt (to taste), 1-1/2 tablespoons macadamia nut oil, 1 large onion (peeled and chopped), freshly ground black pepper (to taste), 1/4 cup chicken broth, and alfalfa sprouts (for garnish).

Directions: Bring a large pot of salted water to a boil over high heat. Meanwhile, select eight, large, nearly perfect cabbage leaves. Using a paring knife, remove their thickest vein. Blanch the leaves in the boiling water until softened, about 1 minute. Remove and drain on paper towels.

Combine the salmon, garlic, parsley, watercress, olive oil, cayenne, and a large pinch of salt in a food processor. Pulse until minced and well-combined—but not puréed. Spoon a portion of the salmon mixture on the lower third of each cabbage leaf, fold in the sides, and roll up. (Be careful not to overstuff or roll too tightly.)

Heat the macadamia nut oil in a large skillet over medium-high heat. Add the onion and sauté until it softens, about 5 minutes. Season with salt and pepper. Add the chicken broth and cook for another 5 minutes.

Carefully add the cabbage rolls, seam-side down, in a single layer and cover the skillet. Adjust the heat to a simmer and cook, turning once, until the rolls are firm, 10 to 15 minutes. (You may need to add a bit more broth.) Place two cabbage rolls on each plate, drizzle with some pan juices, garnish with alfalfa sprouts, and serve.

You can find many more heart-healthy recipes in my book, The A-List Diet, available under the “books” tab on my website, www.DrPescatore.com.


  1. “Proactive steps can reduce chances of second heart attack.” American Heart Association News, 4/4/19. (heart.org/en/news/2019/04/04/proactive-steps-can-reduce-chances-of-second-heart-attack)
  2. “Mental Health May Play Big Role in Recovery After a Heart Attack.” American College of Cardiology, 5/6/21. (acc.org/about-acc/press-releases/2021/05/05/18/17/mental-health-may-play-big-role-in-recovery-after-a-heart-attack)
  3. “Can Yoga Lower Your Blood Pressure?” University of Missouri School of Medicine, 10/18/19. (medicine.missouri.edu/news/can-yoga-lower-your-blood-pressure)
  4. “The Effectiveness of Diaphragmatic Breathing Relaxation Training for Reducing Anxiety.” Perspectives in Psychiatric Care, 20016; 54(4):329-226. doi.org/10.1111/ppc.12184
  5. “Stress Reduction in the Secondary Prevention of Cardiovascular Disease.” Circulation: Cardiovascular Quality and Outcomes, 2012; 5:750–758. Nov doi.org/10.1161/CIRCOUTCOMES.112.967406
  6. “Increased Physical Activity Post–Myocardial Infarction Is Related to Reduced Mortality: Results From the SWEDEHEART Registry.” Journal of the American Heart Association, 2018;7:e010108. doi.org/10.1161/JAHA.118.010108
  7. “All-in-One ‘Polypill’ Gets Heart Patients Taking Their Meds.” U.S. News & World Report, 8/29/22. (usnews.com/news/health-news/articles/2022-08-29/all-in-one-polypill-gets-heart-patients-taking-their-meds)
  8. “Aspirin No Longer Recommended to Prevent First Heart Attack, Stroke.” WebMD, 4/27/22. (webmd.com/heart-disease/news/20220427/aspirin-no-longer-recommended-prevent-heart-attack-stroke)
  9. “No connection between the level of exposition to statins in the population and the incidence/mortality of acute myocardial infarction: An ecological study based on Sweden’s municipalities,” Journal of Negative Results in Biomedicine 2011; 10(6). doi.org/10.1186/1477-5751-10-6
  10. “ASPREE: No Benefit of Aspirin in Primary Prevention.” Medscape Medical News, 09/16/2018. (medscape.com/viewarticle/902056)
  11. “CoQ10: What are the Heart Health Benefits?” Cleveland Heart Lab, 9/9/15. (clevelandheartlab.com/blog/horizons-coq10-what-are-the-heart-health-benefits)
  12. “The Emerging Role of l-Glutamine in Cardiovascular Health and Disease.” Nutrients, 2019 Sep 4;11(9):2092. doi.org/10.3390/nu11092092. PMID: 31487814; PMCID: PMC6769761.
  13. “Four weeks of spice consumption lowers plasma proinflammatory cytokines and alters the function of monocytes in adults at risk of cardiometabolic disease: secondary outcome analysis in a 3-period, randomized, crossover, controlled feeding trial.” The American Journal of Clinical Nutrition, 2022; 115(1):61-72. doi.org/10.1093/ajcn/nqab331
  14. “Men who can do 40 push-ups far less likely to develop heart disease.” Study Finds, 2/26/22. (studyfinds.org/men-more-than-40-push-ups-heart-disease/)