Decreasing Your Risk for Heart Disease
Of all deaths in the U.S. in 2002, 38% were caused by cardiovascular disease, which has been the number one killer in the U.S. nearly every year since 1900. Over 38% of Americans with one or more types of cardiovascular disease are ages 65 or older. In order to lead a healthier, longer life, it is important to recognize the risk factors for heart disease that you can and cannot change, and eliminate those which you can control. Some risk factors for heart disease that can be controlled are high blood pressure and blood cholesterol, tobacco use, diabetes, physical inactivity, obesity, excessive alcohol intake, and possibly stress. Some risk factors cannot be controlled: increasing age, sex, heredity, and race.
METHODS TO DECREASE HEART DISEASE RISK
Lower your blood pressure. High blood pressure (hypertension) causes the heart to enlarge and weaken over time, and increases the risk of heart attack, congestive heart failure, kidney failure, and stroke. When hypertension exists alongside of obesity, high blood cholesterol, diabetes, and cigarette smoking, the risk of heart attack or stroke greatly increases. Because hypertension, defined as readings of 140/90 mm Hg or greater that remain high for an extended time, usually has no symptoms, the only way to obtain a diagnosis is to have it measured at least every two years. If it is high, limiting sodium and alcohol intake, losing weight if overweight, increasing physical activity, and taking medication if recommended by your physician are ways to lower your blood pressure.
Lower your cholesterol levels. Rising blood cholesterol levels increase the risk of coronary heart disease. When coupled with other risk factors such as high blood pressure and cigarette smoking, this risk grows even higher. Cholesterol levels are also affected by age, sex, heredity, and diet. There are two main types of cholesterol: low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol. LDL cholesterol contributes to the build-up of plaque and, subsequently, increases your risk of coronary heart disease and heart attack; HDL cholesterol clears cholesterol out of your system, lowering your risk of heart disease. Cholesterol levels should be checked regularly, especially if you have a history of high cholesterol or if it runs in your family. Total cholesterol levels of less than 200 mg/dL are desirable, with 240 mg/dL and above high. LDL cholesterol levels of less than 100 mg/dL are optimal, 130-159 mg/dL are borderline high, and 190 mg/dL and above are very high. HDL cholesterol levels less than 40 mg/dL place you at major risk for heart disease, but 60 mg/dL and above is protective against it. Low levels of HDL appear to be a stronger risk factor for women than for men. New research shows that using a statin or cholesterol-lowering drug can reduce your cholesterol levels and also lower C-reactive protein levels, which have been linked to inflammation in the arteries, thus further decreasing heart disease progression. You should check with your doctor to see if such drug therapy is an appropriate choice for you in preventing and/or controlling heart disease.
Stop smoking. Your risk of suffering from a heart attack more than doubles if you are a smoker; smoking is a woman’s single biggest risk factor for heart attack. You are more likely to die within an hour after a heart attack if you are a smoker. Exposure to secondhand smoke or passive smoking may place you at increased risk for heart disease.
Prevent diabetes. Diabetes dramatically increases the risk of developing cardiovascular disease—even when glucose levels are under control—and a large percentage of persons with diabetes die of some form of heart or blood vessel disease. Persons with diabetes must monitor and control as many risk factors for heart disease as possible. Routine exercise and eating healthful food may lower your risk for diabetes.
Lose weight. Even if no other risk factors are present, those who are overweight are more likely to develop heart disease and stroke, as being obese places increased strain on the heart and raises blood pressure, blood cholesterol, and triglyceride levels, lowers HDL cholesterol levels, and increases your risk of developing diabetes. If you are overweight, it is important to eat healthful foods and exercise. In some patients, moderate-to-vigorous exercise or modest levels of low-intensity exercise (if done on a regular, long-term basis) can help control blood cholesterol, diabetes, obesity, and blood pressure, preventing heart and blood vessel disease.
Limit alcohol intake. Consuming high amounts of alcohol can raise blood pressure, cause heart failure, lead to stroke, produce irregular heartbeats, contribute to high triglycerides and cancer, and lead to alcoholism and obesity.
Reduce stress. No current data support specific recommendations about stress reduction as a proven therapy for cardiovascular disease, but evidence suggests a relationship between the risk of cardiovascular disease and environmental and psychosocial factors. Research has shown that risk factors for heart disease such as high blood pressure and cholesterol levels, smoking, physical inactivity, and overeating, may be affected by acute and chronic stress, but it is unknown whether stress acts as an independent risk factor. It is important to relax and to deal with situations you find stressful in a healthful manner to avoid developing other risk behaviors.
RISK FACTORS THAT CANNOT BE CHANGED
Advancing age and sex. Cardiovascular disease risk increases with advancing age. Men are at a greater risk of heart attack and have them earlier in life than women. Although the death rate for women from heart disease increases after menopause, it is not as great as the death rate for men; however, older women who suffer from heart attacks are more likely than men to die within a few weeks.
Heredity and race. Most persons with a strong history of heart disease in their families have one or more other risk factor. You are more likely to develop heart disease if a parent suffered from it. Race also plays a role; African-American persons have more severe hypertension than white persons, so they have a greater risk of heart disease.
Sources: American Heart Association; New England Journal of Medicine (Jan. 6, 2005).