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While many people who suffer a heart attack are able to experience a full and active life after recovering, it often takes time to get back on your feet. And given the risk of another heart attack — about 1 in 5 of those age 45 and older have a second one within five years of their first — it’s important to prioritize your health and stay proactive about prevention efforts.

Medications Used After a Heart Attack

Recovery looks different for each person, with treatment dependent upon a variety of factors including the type of heart attack you had, its severity, and your overall health history. In most cases, a combination of lifestyle changes and medication is necessary to manage the risk of another heart attack. Here’s an overview of what to expect.

A heart attack occurs when blood flow to the heart is reduced or blocked as the result of a blockage in a coronary artery. There are two main types of heart attacks, categorized by the extent of the blockage:

An ST-elevation myocardial infarction, commonly referred to as a “STEMI” heart attack, is caused by a complete blockage.

A non-ST-elevation myocardial infarction, commonly referred to as an “NSTEMI” heart attack, is caused by a partial blockage.

Coronary artery disease, the most common type of heart disease, is the cause of most heart attacks. In this condition, accumulation of plaque causes the coronary arteries to become hardened or blocked.

Too often, people learn that they have coronary artery disease after having a heart attack. To detect cardiovascular issues at an early stage, consult with your doctor about your risk for heart disease. Your doctor may use a cardiac risk calculator to assess your chances of developing heart disease based on your personal health history.

Remember that your risk can be managed. The purpose of calculating it is to help you take important preventative steps. While some drivers of heart disease like age and genetics aren’t modifiable, you have control over many others, including high blood pressure, high cholesterol, smoking, and physical inactivity.

Presentation of heart attack symptoms can vary significantly from one person to another. In fact, not everyone who has a heart attack develops symptoms. When they do occur, they can range from mild to severe, developing suddenly or over the course of days or weeks. 

If you think you might be having a heart attack, seek medical care right away. Chest pain or pressure is the most common symptom for both men and women, but watch for the following signs as well.

There is some variation between men and women in the presentation of a heart attack. The symptoms marked with an asterisk (*) are more common in women.

The timeline for heart attack recovery ranges from two weeks to three months. Treatment typically includes lifestyle changes, medication, and cardiac rehabilitation. Surgical procedures may be necessary to treat more severe cases.

It’s important to actively participate in your health after a heart attack. Recovery care and prevention should be a collaborative effort between you and your care team. Stay on track with your appointments. The American Heart Association recommends visiting your doctor for a follow-up appointment within six weeks of your heart attack.

Many people find enrolling in a cardiac rehabilitation program to be beneficial for heart attack recovery. These programs offer access to expert healthcare professionals who can support you in making changes to your routine and managing stress. Speak with your doctor about whether cardiac rehabilitation is a good fit for your needs. 

Your doctor may advise you to change health habits after a heart attack. For many people that includes: 

Avoiding cigarette smoke and limiting your alcohol intake

Medications prescribed after a heart attack

The primary goal of post-heart attack care is to reduce the risk of another heart attack. A variety of medications may be prescribed to:

Prevent complications such as arrhythmias, blood clots, and heart failure

These are the most commonly prescribed medication classes.

Anticoagulants reduce the blood’s ability to form new clots and prevent existing clots from growing. Commonly prescribed anticoagulants include:

Warfarin (Coumadin®, Jantoven®), which prevents the liver from processing vitamin K into proteins that help form blood clots.

Direct oral anticoagulants (DOACs) such as apixaban (Eliquis®), betrixaban (Bevyxxa®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®), which directly block the blood’s ability to form clots.

Like anticoagulants, antiplatelets prevent blood clots from forming. They accomplish this specifically by preventing blood platelets from sticking together. Commonly prescribed antiplatelets include:

Frequently used to lower blood pressure, ACE inhibitors block production of a hormone called angiotensin II, which causes blood vessels to narrow, so that more blood can flow through. Commonly prescribed ACE inhibitors include:

Angiotensin II receptor blockers (ARBs) also protect blood vessels from the hormone angiotensin II to lower blood pressure. Commonly prescribed ARBs include:

Beta blockers cause the heart to beat more slowly and less forcefully, lowering your blood pressure. They also help improve overall blood flow by opening up your veins and arteries.

Commonly prescribed beta blockers include:

Beta blockers typically aren’t recommended for those with asthma, as they can trigger severe asthma attacks.

Never stop taking a beta blocker without first consulting with your doctor. Abruptly stopping the use of these medications can increase the risk of heart attack.

Alpha-beta blockers combine alpha and beta blockers to decrease constriction of blood vessels and help the heart work less forcefully.

Commonly prescribed alpha-beta blockers include:

Also used to lower blood pressure, calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels. This opens up narrowed blood vessels and eases the heart’s workload.

Commonly prescribed calcium channel blockers include:

Diltiazem (Cardizem CD®, Cardizem SR®, Dilacor XR®, Tiazac®)

Verapamil (Calan SR®, Covera HS®, Isoptin SR®, Verelan®)

The most common cholesterol-lowering medication, statins act on the liver to prevent cholesterol from forming. Commonly prescribed statins include:

If statins aren’t the best option for you or your cholesterol levels need to decrease further, your doctor may prescribe a non-statin cholesterol medication such as ezetimibe (Zetia®) or alirocumab (Praluent®).

Ezetimibe is a cholesterol absorption inhibitor. It lowers your cholesterol by reducing the small intestine’s absorption of cholesterol.

Alirocumab belongs to a newer class of injectable cholesterol-lowering medications called PCSK9 inhibitors. These medications act on proteins produced by the liver that are linked to high cholesterol levels.

Pharmacy Care After a Heart Attack

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Medications Used After a Stroke

After an initial stroke, 1 in 4 individuals will have another within five years. Medications play an important role in preventing another stroke and treating stroke-related complications, often in tandem with lifestyle changes.

There’s no one-size-fits-all treatment plan. Your doctor may prescribe one or more medications based on the underlying cause of your stroke as well as its impact on your physical and mental health.

Here’s what to know about stroke causes and medications commonly prescribed during recovery.

A stroke disrupts the flow of blood and oxygen to the brain, potentially damaging brain tissue. This can lead to impaired speech, impaired cognitive function, memory loss, numbness, and paralysis.

Strokes can be life-threatening, so it’s important to seek immediate medical care if you exhibit signs of a stroke such as the following:

Sudden numbness or weakness in the face, arm, or leg

Sudden confusion or difficulty speaking or understanding speech

Sudden severe headache without another cause

There are two types of strokes, with different underlying causes:

An ischemic stroke occurs when blood flow to the brain is blocked, often due to a blood clot or the accumulation of plaque in blood vessels. It is the more common type of stroke. Associated health risk factors include high cholesterol, atrial fibrillation, and diabetes.

A hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures, damaging brain cells as a result. Associated health risk factors include high blood pressure and aneurysms.

Additionally, a transient ischemic attack (TIA) — sometimes referred to as a ministroke — occurs when there is temporarily reduced or blocked blood supply to the brain, often as the result of a blood clot. Unlike ischemic and hemorrhagic strokes, a TIA does not result in permanent damage.

Many of the leading risk factors for a stroke are modifiable, including:

Aftercare may include management of these risk factors.

There are a variety of medication classes used during stroke recovery, including the following.

Since high blood pressure is a leading cause of hemorrhagic strokes, stroke recovery may involve the use of several types of blood pressure medications.

Beta blockers cause the heart to beat more slowly and less forcefully, lowering blood pressure. Commonly prescribed beta blockers include atenolol (Tenormin®), bisoprolol (Zebeta®), metoprolol tartrate (Lopressor®), metoprolol succinate (Toprol-XL®), acebutolol (Sectral®), and propranolol (Inderal®).

ACE inhibitors lower blood pressure by blocking production of a hormone called angiotensin II, which causes blood vessels to narrow. Commonly prescribed ACE inhibitors include benazepril (Lotensin®), enalapril (Vasotec®), fosinopril (Monopril®), lisinopril (Prinivil®, Zestril®), and ramipril (Altace®).

Calcium channel blockers prevent calcium from entering the smooth muscle cells of the heart and blood vessels so that the heart beats with less force. Commonly prescribed calcium channel blockers include amlodipine (Norvasc®), diltiazem (Cardizem CD®, Tiazac®), nifedipine (Procardia XL®), and verapamil (Calan SR®, Verelan®).

Diuretics lower blood pressure by helping the body get rid of excess sodium and water, reducing the volume of fluid in blood vessels. Commonly prescribed diuretics include chlorthalidone (Thalitone®, Tenoretic®, and Clorpres®), hydrochlorothiazide (HydroDiuril®, Microzide®, and Esidrix®), and indapamide (Lozol®).

Read Common Types of Blood Pressure Medications to learn more about these medications and potential side effects.

Anticoagulants interrupt the body’s natural blood clotting process to prevent new clots from forming and existing ones from growing. The following types of anticoagulants may be prescribed after an initial ischemic stroke.

Warfarin (Coumadin® and Jantoven®) prevents your liver from producing proteins that help form blood clots. It is taken orally as tablets. It has been associated with excessive bleeding in some individuals. Inform your doctor if you have a bleeding disorder so that they can prescribe an alternative.

Direct-acting oral anticoagulants (DOACs) directly block the blood’s ability to form new clots. Commonly prescribed DOACs include apixaban (Eliquis®), dabigatran (Pradaxa®), edoxaban (Savaysa®), and rivaroxaban (Xarelto®).

Read How Anticoagulants Prevent Blood Clots From Forming to learn more about these medications and potential side effects.

Like anticoagulants, antiplatelets prevent blood clotting and may be used during recovery from an ischemic stroke. They prevent platelets from coalescing, targeting a particular step in the formation of blood clots. Clopidogrel (Plavix®) is a commonly prescribed antiplatelet during stroke recovery.

Aspirin may also be used for antiplatelet therapy. If you are taking aspirin, avoid taking other nonsteroidal anti-inflammatories (NSAIDs) like ibuprofen and naproxen, as they may interfere with aspirin’s antiplatelet effect.

Atrial fibrillation, or Afib, is a rapid heart rate caused by irregularities in the heart’s upper chambers. It can lead to the accumulation of blood and the formation of blood clots, increasing an individual’s risk for stroke. (Having other conditions such as high blood pressure, diabetes, or heart failure in addition to Afib may further increase your risk for a stroke.)

There are several medications that may be used to control heart rate and prevent a secondary stroke, including beta blockers, calcium channel blockers, and an antiarrhythmic called digoxin (Digox®, Lanoxin®, Digitek®).

Since high cholesterol may be associated with an increased risk for an ischemic stroke or ministroke, statins — a type of cholesterol-lowering medication — may be prescribed during stroke recovery. Statins act on the liver to reduce the amount of cholesterol produced by your body, in turn preventing plaque accumulation.

Commonly prescribed statins include atorvastatin (Lipitor®), fluvastatin (Lescol®), lovastatin (Mevacor®, Altoprev®), pravastatin (Pravachol®), rosuvastatin calcium (Crestor®), and simvastatin (Zocor®).

Read How to Manage High Cholesterol: Diet, Medications, and More to learn more about these medications and potential side effects.

If you have diabetes, your doctor may revisit your diabetes treatment plan after an ischemic stroke. Individuals with type 1 diabetes require insulin every day to maintain healthy blood sugar levels. Treatment for type 2 diabetes is more varied and may involve insulin, oral medications such as metform, or a combination of both.

A stroke may lead to the loss of bone density. This can increase an individual’s risk for osteoporosis, a condition that weakens bones. After a stroke, your doctor may recommend increasing your intake of calcium and vitamin D — the most important nutrients for bone strength and health — depending on your symptoms.

Treatment for osteoporosis may also include medications such as bisphosphonates, which prevent the loss of bone mass. Commonly prescribed bisphosphonates include alendronate (Fosamax®, Binosto®), ibandronate (Boniva®), risedronate (Actonel®, Atelvia®), and zoledronic acid (Reclast®).

Many individuals experience depression after a stroke, both as a response to the emotional challenges of stroke recovery and due to stroke-induced biochemical changes in the brain.

Medication may be necessary to manage symptoms of depression. There are many types of antidepressants, including:

Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine (Prozac®), sertraline (Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®)

Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta®), venlafaxine (Effexor®), and desvenlafaxine (Pristiq®)

Atypical antidepressants such as trazodone, mirtazapine (Remeron®), and bupropion (Wellbutrin®)

A psychiatrist can recommend the best option based on your particular symptoms of depression, your overall health history, and other medications you’re taking.

Recovery from a stroke is often a gradual process. In addition to taking medication and practicing a healthy lifestyle, your doctor may also recommend speech therapy, physical therapy, and/or occupational therapy.

It’s important to take care of your emotional and mental health. Speak with your healthcare provider about resources that can support your recovery and help you adjust to the changes a stroke may bring. Individual psychotherapy or support groups can be helpful tools.

At Alto, we make it as simple as possible to follow the treatment plan your doctor recommends. We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to ensure your medications are as affordable as possible. And our team of pharmacists is available to chat whenever questions come up about side effects or how to take your medication properly.

Reach out any time through in-app messaging or by phone at 1-800-874-5881.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

To automate a manual, error-prone pharmacy workflow, we turned to event streaming. Here’s what we learned from one of the first Kafka use cases at Alto.

How We Used Kafka to Build an Event-Driven Automation Pipeline and Scale Our Pharmacy

Imagine this: You're at the doctor’s office, and your doctor just wrote you a new prescription. Minutes later, before you even check out with the receptionist, you already have a notification from Alto Pharmacy on your phone that your prescription is ready. All you have to do is pick the date and time that works best for your free courier delivery.

This is the future we’re building at Alto: a future where a prescription can be transcribed, billed, and verified by a pharmacist in five minutes, flat. To get there without dramatically increasing Alto’s head count, we need to automate much of the process, starting with the first step: transcribing, or intaking, a prescription.

As a pharmacy, we receive prescriptions in many different forms. Some are sent electronically, in a structured format, but others are handwritten, phoned in, or even faxed. To represent all of these forms in a single table, we previously required every incoming prescription to be transcribed by an Alto team member, who would answer questions like:

Whom is this prescription for? Is this customer already in our system?

Where did this prescription come from? Who wrote it?

What is the relevant prescription information (medication to dispense, quantity, days supply, directions, etc.)?

This manual process is both time-consuming and prone to human error, which, if uncaught, could impact our ability to process the prescription downstream. Furthermore, at our busiest times, it could take up to two hours for a team member to get through the pending intake queue — unacceptable if we hope to have prescriptions ready to schedule before people even leave their doctor’s office. 

Automating intake required close collaboration between three teams:

Data Science, who built the decision-making algorithms 

Data Engineering, who served up the results of those algorithms

Product Engineering, who used those results to automatically intake prescriptions 

To allow the teams to operate in parallel without toe-stepping — and in the language most suitable for each (the Data Science and Data teams prefer Python, while product engineers work mainly in Ruby) — we separated the code into two environments: 

1. Data Prod Interface (DPI), where the code for generating automation results lives

2. Wunderbar (our proprietary pharmacy operations platform), where the code for requesting and using those automation results lives

The key question: to establish robust communication between these two environments, should we use an API-based approach, or an event-driven one? Each has its pros and cons. 

Legacy approach everyone at Alto is familiar with

Existing enforcement of strong types and data

Difficult to scale with increased data & requests

Requires ongoing authorization / authentication

Infrastructure relevant to other business areas

Automatic retries, reprocessing, and queueing

Our existing infrastructure currently utilizes a hefty API-based structure, so there was a natural tendency to go down this path, but we knew that beginning to migrate services towards an event-based architecture with Kafka at its heart would help us in the long term.

Kafka is a framework implementation developed by LinkedIn, now open-source with the Apache Software Foundation. It aims to provide a unified, high-throughput, and low-latency platform for handling real-time data feeds. 

Alto uses Amazon Web Services as our cloud provider, and luckily, they offer an out-of-the-box managed solution for Kafka, MSK. To configure Kafka with our system, our infrastructure team worked with AWS to set up managed instances to comply with our business requirements. Our Infrastructure team will share more details about this work in an upcoming blog post. 

Kafka offers many benefits. The asynchronous nature of the message system allows for retries, reprocessing, and queueing as well as easy recovery from outages. In addition, the infrastructure work done for setting up the managed cluster would be a one-off workstream. When complete, we’d be able to re-use the same setup and configurations across various business needs to streamline other projects that leverage Kafka. 

Setting up for success: defining a strict contract

One element we had to get right from the start was the data contract. As we send messages between DPI and Wunderbar, we need to ensure messages are produced with the correct schema, so that downstream consumers know what to expect.

Protocol Buffers, or Protos, is an open-source, cross-platform data format used to serialize structured data. Developed by Google, Protos allow you to define how you structure your data once and then use generated code to easily write and read the structured data in a variety of different languages. 

At Alto, we’ve been using Protos for the past few years to speed up development with auto-generated code and ensure data continuity between our Ruby on Rails backend and JavaScript / React / React Native frontend. Protos may seem antithetical to JavaScript and Ruby since they’re both dynamically typed languages, but in practice, they have saved us countless hours of debugging and back-and-forth Slack messages. 

For this project, we turned again to Protos to define the schema for messages produced by DPI and Wunderbar. We defined IntakeAutomationRequest and IntakeAutomationResult messages in Go and generated the types (Sorbet, Flow, etc.), which both DPI and Wunderbar now refer to when producing or consuming messages.

Because Wunderbar is already configured to run on AWS and houses our existing intake logic, it was easy enough to send a prescription to DPI for automation. Where we would normally create a task for an operations team member to manually transcribe the prescription, we instead produce a message to our “request automation” Kafka topic using the ruby-kafka library.

Our consumer, instantiated in an executable that runs on a dedicated worker, consumes messages from a “receive automation” Kafka topic. First, the consumer verifies that a given message corresponds to a prescription we previously sent to DPI. Then, it persists any automation results included in that message. If the automation results are sufficient, we skip intake altogether. Otherwise, we create an intake task to be handled by an operations team member.

Because this project was among our early use cases for Kafka, we wanted to be prepared for the worst-case scenario: we produce a message requesting automation results, and for whatever reason—maybe DPI is down—we don’t hear back. For us, we defined a reasonable time frame as fifteen minutes, in order to avoid building up a large backlog of work that would have to be offloaded back onto our operations team.
To this end, we store metadata about the automation lifecycle in an intake_automation_results table, which includes timestamps representing when we sent a message to DPI and when we received a response back. A cron job runs every minute to check that table for rows where received_at is blank, and sent_at was more than fifteen minutes ago. If this occurs, we flag the prescription to be manually intaken by an operations team member.

The diagram below illustrates our intake automation architecture.

Intake automation is now live at Alto. We’re seeing prescriptions fly through in just a few minutes — during which time our automation creates a user profile if one doesn’t already exist, links the new prescription to that profile, and finds and bills the user’s insurance; a pharmacist reviews the prescription for clinical accuracy; and the user receives a text message to schedule their delivery. This single flow, prior to intake automation, once took up to four hours to complete!

Going from zero to one is quite a feat, and it wouldn’t have been possible without an event-based approach. Now that intake automation has laid the groundwork, we know that Kafka will only continue to provide exponential value to Alto as we grow and migrate more of our services to this event-based architecture. 

Interested in learning more about engineering at Alto? Follow us on LinkedIn.

While gestational diabetes can be an upsetting diagnosis to receive, it is very manageable.  With an effective treatment plan you can manage your blood sugar levels and have a healthy pregnancy.

Gestational Diabetes: Signs, Causes, and Treatment

Gestational diabetes is a type of diabetes diagnosed during pregnancy. It affects approximately 10% of pregnancies, and millions of women, in the U.S. every year. Like all types of diabetes, the condition involves complications with the body’s production of insulin, a hormone that converts sugar into energy. If untreated, it can lead to high levels of blood glucose, which can lead to complications for both you and your baby.

While gestational diabetes can be an upsetting diagnosis to receive, it is very manageable.  With an effective treatment plan, including a healthy diet, exercise, and, if needed, medication, you can manage your blood sugar levels and have a healthy pregnancy.  

During your pregnancy, hormone level changes can affect how your body processes sugar. The placenta — an organ in your uterus that forms by week 12 of the pregnancy to deliver nutrients to your baby — produces a variety of hormones. Gestational diabetes occurs when some of these hormones, specifically estrogen, cortisol, and human placental lactogen, interfere with insulin function, causing blood sugar levels to rise.

Gestational diabetes typically develops in the middle of pregnancy, and most doctors test for it between weeks 24 and 28. There often aren’t any noticeable symptoms, and some of the key signs of gestational diabetes overlap with other changes that occur during pregnancy like being thirstier or hungrier and urinating more frequently than usual.

Most women who develop gestational diabetes are over 25. In addition, you are more likely to develop gestational diabetes if you:

Were overweight before you became pregnant

Are Black, Hispanic/Latino, Native American, Asian American, or Pacific Islander

Have prediabetes, a condition in which blood sugar levels are elevated but still below the official threshold for a diabetes diagnosis

Have had gestational diabetes during a previous pregnancy or gave birth to a baby over nine pounds

Have polycystic ovary syndrome (PCOS) or another health condition linked to problems with insulin

Have high blood pressure, high cholesterol, heart disease, or other medical complications

If any of these risk factors apply to you, you should consult with your doctor early on in your pregnancy to assess your risk and determine which preventative measures to take, if needed.

Your doctor will screen for gestational diabetes between weeks 24 and 28 of your pregnancy with a glucose tolerance test (or earlier if you have one or more of the key risk factors). During this test, you will drink a sweet beverage that contains 50 grams of glucose to raise your blood sugar. An hour later, your blood glucose levels will be checked to see how your body responded to the sugar in the drink.

If your blood sugar is higher than a certain threshold after the one-hour glucose tolerance test, your doctor will order additional testing. The most common follow-up is a three-hour glucose tolerance test. For this test, you will fast for eight hours and have your fasting blood sugar measured. You will then drink a beverage that contains 100 grams of sugar. Afterwards, your blood glucose will be tested one, two, and three hours later.

Your doctor may screen you again for gestational diabetes if your results are normal but you are at high risk.

Potential complications of gestational diabetes

Without prompt treatment, high blood sugar levels in a pregnant woman can affect the health of both her and her baby. For instance, unmanaged gestational diabetes can increase the baby’s blood sugar levels, which in turn increases its weight. A woman carrying an overweight baby may have to deliver it via a C-Section, which involves a longer recovery from childbirth.

Another complication that can potentially affect a pregnant woman as a result of gestational diabetes is preeclampsia, a condition characterized by high blood pressure and damage to the liver, kidneys, or other organs.

Despite these potential health risks, gestational diabetes is highly manageable. Your doctor can advise you on appropriate steps to keep your blood sugar levels in a normal range so that you can experience a healthy pregnancy. However, it’s critical to take action as soon as possible if you receive a diagnosis.

Eating healthy foods and exercising regularly play a big role in managing your blood sugar levels and controlling your gestational diabetes. Your doctor will advise you on specific dietary considerations.

In general, swapping sugary snacks for sources of natural sugar such as fruits and carrots and adding vegetables and whole grains to your diet can help keep you and your baby healthy. Portion control is also important, and it is often recommended to eat three small meals throughout the day along with several snacks.

Staying active is also key. Try to aim for about thirty minutes of moderate activity several days throughout the week. Opt for gentle workouts like swimming, or try a yoga class specifically tailored to pregnant women. Not only will this help manage your blood sugar levels, but it has the added bonus of helping you avoid fatigue and backaches during pregnancy.

Your doctor may advise you to check your blood sugar levels several times throughout the day using a blood glucose meter. The American Diabetes Association suggests the following blood sugar targets for pregnant women:

Two hours after a meal: 120 mg/dl or less

Depending on your specific blood sugar levels, your doctor may advise you to take insulin. If taking insulin, it’s important to pay regular attention to your blood sugar as insulin therapy can lead to hypoglycemia, or dangerously low blood sugar. Hypoglycemia often happens as a result of not eating enough or exercising too much.

Common hypoglycemia symptoms include shakiness, anxiety, feeling lightheaded, hunger, nausea, headaches, and seizures. The only way to confirm that you are experiencing hypoglycemia is to check your blood sugar with a blood glucose meter or a continuous glucose monitor (CGM). 

Your doctor can help you develop your blood sugar targets and identify specific numbers to watch for when checking for hypoglycemia. However, if you are experiencing signs of low blood sugar and unable to check blood sugar levels, treat symptoms with high-sugar foods or drinks.

Getting tested for diabetes after pregnancy

For most women with the condition, gestational diabetes typically goes away soon after delivery. However, 5-10% of women with gestational diabetes develop type 2 diabetes after giving birth. And about 50% of the new mothers whose blood sugar levels return to normal after delivery will develop type 2 diabetes later in life.

If you have had gestational diabetes, it’s important to regularly monitor your blood sugar and continue with exercise and a healthy diet after giving birth to avoid health complications. You should also get screened again for diabetes 6 to 12 weeks after giving birth, and then every 1 to 3 years.

We’re here to support your gestational diabetes treatment

Alto is here to help you manage your gestational diabetes, by consolidating medications into streamlined monthly deliveries, setting up automatic refills, and offering free same-day delivery. And if insulin therapy is a part of your treatment plan, our pharmacists are available to walk you through your first doses and discuss any symptoms or side effects.

Learn how we can support your gestational diabetes treatment plan by contacting us via phone at 1-800-874-5881 or in-app messaging.

Here’s what you should know about the link between mental health and heart disease, including heart-healthy ways to navigate emotional lows and manage stress.

How Mental Health Affects Heart Health

Prioritizing mental health doesn’t only improve your moods and relationships, it can potentially lower your risk for heart attack or stroke, too. Heart disease, the leading cause of death in the United States, is deeply intertwined with some of the most widespread mental health disorders, including depression, anxiety, and PTSD. 

In fact, the connection goes both ways: mental health affects heart health, and cardiovascular disease can contribute to mental health disorders. Here’s what you should know about the link between mental health and heart disease, including heart-healthy ways to navigate emotional lows and manage stress.

Heart disease might seem like a purely physical issue, but mental health affects heart health. Up to 40% of people affected by heart disease also fulfill the diagnostic criteria for major depressive disorder, one of the most common mental health disorders and the most frequently diagnosed type of depression in the U.S. At the same time, people with depression face a higher risk for heart disease.

Statistics like these go to show that our mind and body will always influence each other. The connection is both behavioral and physiological: our thoughts and emotions shape our habits and routines — like how well we sleep, how often we exercise, and how we cope with stress — in addition to impacting heart rate, blood flow, and cortisol levels. And, in turn, our physical health has the power to impact our emotional and social well-being.

Mental Health Disorders and Risk Factors for Heart Disease

According to the CDC, more than half of all Americans will be diagnosed with some type of mental health disorder in their lifetime. And since mental health affects heart health, the prevalence of mental health disorders in the U.S. also means that millions of Americans are at higher risk for heart disease.

The primary drivers of heart disease include both uncontrollable factors like age and family history and ones that we can either modify or treat, including smoking, physical inactivity, high cholesterol, and high blood pressure. The correlation between mental health and heart disease stems in part from the overlap between behaviors associated with mental health disorders and risk factors for heart disease. For example, anxiety and depression are both linked to smoking and less active lifestyles.

On top of these key physical risks, there are additional factors for heart disease that relate to your mental well-being, including sleeping habits, alcohol use, diet, and even how happy you feel at work. Given the link between mental health and heart disease, any efforts you make on the self-care front, like prioritizing rest or exploring where you find professional and personal fulfillment, can only help to boost heart health.

Beyond Behavior: Physiological Effects of Mental Health Disorders

The link between mental health and heart disease doesn’t only occur indirectly through behaviors that lead to higher risk. Research has found that mental health disorders cause changes in the body that overlap with risk factors for heart disease, including:

Gradually, these physiological effects can lead to calcium accumulation in the arteries and the development of heart disease. 

A variety of mental health disorders influence a person’s risk for heart disease, from anxiety to PTSD and chronic stress, but the heart-head connection is particularly strong with depression. Not only are people with depression more likely to develop heart disease, they also face a worse prognosis. Depression can intensify fatigue and contribute to isolation after serious cardiac events, complicating recovery from surgery, heart attacks, and strokes. In addition, heart disease patients with depression may face a higher risk for premature death as well as longer or more frequent hospitalizations. 

Research has also found that while having both heart disease and anxiety doubles a patient’s risk of fatality, the combination of depression and heart disease triples it. It’s important for people with heart disease to proactively address symptoms of depression if they appear, regardless of whether they’ve dealt with depression before.

Because of the heavy emotional toll of a heart attack, depression is even more common after this type of serious cardiac event than with heart disease overall. The National Institute of Mental Health reports that up to 65% of cardiovascular disease patients who’ve had a heart attack experience depression.

After a heart attack you may have new or deeper feelings of anxiety given the uncertainty of your future. Stepping back from regular roles and responsibilities at work or with family while you recover can bring up complicated feelings and impact your sense of identity. 

And if lifestyle habits contributed to your heart attack risk, you may feel a sense of guilt as well. These are all understandable, natural reactions. The important thing is to keep moving forward by taking ownership of your health, which may include seeking mental health treatment. Remember, there’s no shame in getting the support you need, and, in fact, doing so is vital to your physical recovery. 

What’s Good for the Heart is Good for the Mind

The good news is that taking care of your mental health often looks exactly the same as taking care of your heart. Lifestyle changes that help manage heart disease, like following a balanced diet, drinking less, and getting those steps in, can also alleviate symptoms of depression and other mental health disorders.

Plus, happy thoughts are literally good for the heart. Some research suggests that patients with positive outlooks are more likely to make vital lifestyle changes following a heart attack, while gratitude is linked to lower levels of inflammation and better overall heart health. Of course, it’s more difficult to practice gratitude when you’re experiencing the isolation of clinical depression, so if you’re dealing with symptoms, remember that seeking help is taking charge of your well-being — and your heart.

The next time you’re feeling stressed or anxious, center your mind and keep your heart beating strong with these proactive strategies:

Explore visualization strategies to mentally picture a positive outcome to a challenge you’re facing.

Consider taking something off your plate at work or at home.

Exceptional Pharmacy Care Every Step of the Way

Heart disease and mental health challenges can feel isolating, but Alto’s expert pharmacists are always on call to help you navigate your health journey. Whether you’re taking medication for heart disease, a mental health disorder, or both, we’re happy to answer any questions you have and deliver your medications right to your doorstep. Call 1-800-874-5881 or reach out via in-app messaging at any time.

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