What 10 Things Can I Do to Decrease My Risk of Heart Disease?
Renee Bullock-Palmer, MD FACC FASNC FASE. Board Certified Cardiologist, Director of Women’s Heart Center and Director of Non-Invasive Cardiac Imaging at Deborah Heart and Lung Hospital Center, Browns Mills, NJ.
Heart disease occurs when coronary arteries supplying blood to the heart muscle become narrowed or blocked by a buildup of fatty deposits. Coronary arteries usually become blocked as cholesterol in the blood is taken up within the walls of the blood vessels of the heart to form a plaque. After a period of time, usually a period of years, if this process continues unabated, the plaque will eventually grow to lead to a blockage of these blood vessels. This reduces myocardial perfusion, which is the amount of blood flowing into the heart muscle. If the blood flow is reduced too much, part of the heart muscle becomes injured, causing a heart attack. The injured part of the heart muscle can become permanently damaged.
There are several risk factors for heart disease. There are modifiable risk factors such as cigarette smoking, unhealthy eating habits, physical inactivity, obesity, diabetes, high blood pressure and high cholesterol levels. There are also non-modifiable risk factors such as family history of heart disease, as well as being older.
Heart disease is the leading cause of death for women in the United States, even greater than all cancers combined. Here are the ten ways you can reduce your risk for heart disease:
- Know your history
Knowing your family history of heart disease is important. Your risk of coronary artery disease (clogged arteries in your heart) is increased if any of your first degree relatives such as your mother, father or sibling have been diagnosed with “clogged arteries” or a heart attack when they were under 55 years old (male relatives) or under 65 years old (female relatives).
- Know your numbers
Important numbers and measurements that every woman should know:
- Fasting blood sugar should be less than 100
- Your blood pressure ideally should be around 120/80
- Know your cholesterol levels. Ideally total cholesterol should be less than 200, LDL (“bad cholesterol”) should be less than 100 ideally and HDL (“good cholesterol”) should be greater than 50. Triglycerides (another type of cholesterol) should be less than 150.
- Know your body mass index (BMI), which is based on weight and height and determines the presence of an ideal weight. Ideally your BMI should be 18.5 to 24.9.
- Know your risk for heart disease
It is important to do the above tests and consult a physician who can inform you of your particular risk for heart disease, and also counsel you on ways to reduce your risk for this disease.
- Visit your physician regularly
Visit your health provider to get yourself checked to know your risk for heart disease. Certainly if you have symptoms of heart disease such as chest discomfort, shortness of breath or fatigue you should seek medical evaluation as soon as possible. The following areas should be checked by your physician:1. Fasting blood glucose
- The American Diabetes Association (ADA) recommends that adults age 45 and older get screened for type 2 diabetes every three years by their health care provider. If you have a higher risk, then you may need to be screened earlier and more frequently.
2. Blood pressure
- For patients without diabetes: Blood pressure should be measured at each regular visit or at least once every 2 years if it is less than 120/80 mmHg. Blood pressure should be measured while seated after 5 min rest in the office.
- For patients with diabetes: Blood pressure should be measured at each regular visit.
3. Cholesterol levels
- Adults (over 19 years old) without diabetes should have a cholesterol test at least every 5 years, including adults with low-risk values. Other patients who are at higher risk will need to have their cholesterol levels checked more frequently.
4. Assess your weight
- Measure BMI routinely at each regular check-up
- Get treated and take your medications
If you are found to be at increased risk from a diagnosis of diabetes, high blood pressure and/or high cholesterol, management of these diseases is important. It is vital to listen to the advice of your doctor and take your medications. If you are diagnosed with heart disease, then getting treated early is very important to decrease your risk of death or further complications of the disease.
- Stop smoking
Smoking significantly increases your risk of heart disease. This is the single best thing anyone could do to minimize their risk of heart disease. There are several different aides available including nicotine patches and gum.
- Revise your diet
Reduce your caloric intake: A deficit of 100 calories per day leads to a 10lb weight loss over a year. (An 8 oz. can of soda on average is 150 to 180 calories, so just eliminating a can of soda a day would lead to over 10lb weight loss in a year!)Simplify your diet by avoiding processed foods. Replace sugary sodas with water and fresh fruit. It is also important to also eat whole grains, nuts, vegetables and fruit, and avoid food containing high fructose corn syrup (HFCS). Think not only about decreasing the quantity of your meals, but improving the quality of your meals.Timing of your meals is also important. You should ideally eat your heaviest meal in the morning and your meals should get smaller as the day progresses and your activity level decreases. Therefore, dinner should be your smallest meal, and breakfast should be your largest meal. If you work at night, then this may be reversed. Avoid junk food such as hamburgers, pizza and fried chicken – just to name a few.Avoid animal fats as much as possible; this includes red meat, pork, processed meats such as bacon, deli meats, etc. Avoid chips and fries. Healthier choices are fruits, vegetables, nuts, dried fruit, chicken, other forms of poultry, and fish. Instead of ice cream, try Greek yogurt.
- Minimize alcohol intake
Decreasing your intake to only moderate consumption may lead to a reduced risk of heart disease. According to the Dietary Guidelines for Americans, moderate alcohol consumption is defined as having less than 1 drink per day for women and less than 2 drinks per day for men.
- Get physically active
Find ways to fit activity into your daily routine. Examples include taking the stairs instead of the escalator or elevator, parking further away, or walking to another bus stop. Aim for at least 150 minutes/week of moderate aerobic exercise. This can be broken down into multiple spurts of activity each day. If you are just starting out, start with just 5 or 10 minutes three times per day and build from there. Stay motivated by wearing a pedometer and tracking your steps. Join a walking group and challenge each other to more and more steps. If you have been sedentary, then it may be a good idea to get yourself checked by your physician before starting an exercise program.If you are overweight, then you should create specific goals for weight loss and maintenance of a healthy weight. Dietary intervention as previously described is important. Limit calories to less than 1800 calories/day (for most females). Here are the American College of Sports Medicine (ACSM) guidelines for physical activity:
- To maintain weight it’s necessary to do between 150-250 minutes of moderate intensity physical activity per week; that translates to between 2.5-4 hours per week.
- If your goal is to lose significant weight, the ACSM says you need to do more than 250 minutes (over four hours) per week of exercise.
- To prevent regaining any weight you lose, evidence suggests you need to do as much exercise as was needed for the weight loss (more than four hours a week).
- Manage your stress
Stress is a natural part of life. The problem is not only the presence of stress in our lives, but more importantly, how we react to stress that affects our risk for heart disease. There are several points to remember: try to minimize stressful situations, set realistic goals, change your view of the particular stressful situation, take control of the situation, prioritize and figure out what is most important to you, and discover new relaxation techniques.