In dealing with coronary heart disease, the first step is to recognize that your doctor is on your team; his goal is to provide you with the treatment, medications, and lifestyle advice to fit your needs.

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Despite remarkable improvements in treatment and a growing awareness of prevention strategies, coronary heart disease (CHD) remains the leading cause of death in the U.S. However, the mortality rate for CHD is declining, and people are living longer and with a greater quality of life with this condition.

So how do some coronary heart disease patients thrive after their diagnosis, while others struggle? It usually starts with adjusting your mental outlook and taking steps to preserve your health. This means eating right, exercising, taking your medications correctly, and remaining optimistic about your condition.

Coronary Heart Disease Basics

CHD occurs when a waxy buildup of cholesterol, fats, and waste products form a plaque along the inner walls of the arteries in the heart (the coronary arteries). This process is called atherosclerosis and it occurs over time.

Too much plaque can narrow arteries, restricting blood flow to the heart muscle. Plaque’s greater danger is that it can rupture, spilling its contents into an artery. Platelets in the blood rush to the site of the rupture to help contain it. But the result can be a blood clot that completely blocks blood flow to the heart. This is a heart attack.

Heart Health Starts in the Brain

A diagnosis of coronary heart disease can be emotionally devastating, especially if CHD is discovered after a heart attack. It’s quite common for someone to become anxious or depressed after a heart attack or after a procedure, such as coronary artery bypass grafting (CABG) or stenting to open a blocked artery.

If you start having feelings of hopelessness or excessive worry, or you find yourself withdrawing from friends, family, and activities you once enjoyed, share your feelings with your doctor. Just talking about them can help. Your doctor may advise you to seek out a support group or find a therapist who is experienced in working with heart patients.

The key is not to let your diagnosis define you and keep you from enjoying life. You may need to change your lifestyle and curtail some activities, based on your health. But Dr. Cho notes that the most successful CHD patients are those who adopt a positive outlook.

“Attitude is so important to recovery,” she says. “Patients who become depressed after their illness have poor outcomes and actually die faster. It is important to talk or find someone to talk to if you are depressed and feel like you need help. Patients become embarrassed and discouraged after their illness and subsequently get into a bad cycle.”

Avoiding Stumbling Blocks

You can help avoid that cycle by becoming more educated about your condition. You may have ideas about what it will be like living with coronary heart disease that aren’t based in reality. Or, you may know someone with serious heart disease and assume that his or her experience is the same that you will have. But each person’s condition and medical history are unique.

It’s common to be in denial about your health and, therefore, refuse to change your lifestyle or take your medications as prescribed by your doctor. And in some cases, inaccurate ideas about the number of medications needed or fears about the potential side effects of heart medications, such as statins, get in the way of effective medical therapy. But your doctor’s ultimate goal is to eliminate heart attacks and strokes, so that you can live longer and with a higher quality of life. Once you as the patient accept that goal, your doctor can help you deal with the rest.

The Doctor-Patient Partnership

Management of your coronary heart disease is usually more successful if you have a good relationship with your cardiologist and other doctors. Keep up with your appointments, ask questions, and follow your doctor’s advice consistently. After a heart attack, you’ll see your cardiologist in a month, then at three months, six months, and then annually, unless your health changes.

It’s also vital that you take your medications as prescribed. If you have problems paying for them or you have side effects, talk with your doctors. They are on your side and share the same goals, so you have to allow them to help you.

Originally published in 2017, this post is regularly updated.