This is the second of a three-part series on heart disease in honor of American Heart Month.
Heart disease refers to multiple conditions involving the heart and vascular system, usually referred to as cardiovascular disease by medical professionals. Since heart disease is one of the most common health problems in the United States, it’s important to know about risk factor modification and lifestyle changes needed to reduce the risk of cardiovascular events.
“An ounce of prevention is worth a pound of cure”.
One unique aspect of heart disease is that there is both primary and secondary prevention.
Primary prevention means undertaking measures to prevent developing heart disease. Primary prevention requires taking preventive measures at a very early age. Blockage in the heart arteries, also known as plaque, but unlike plaque build-up on teeth, begins in late adolescence; the age at which cholesterol and scar tissue deposits may begin to form in the walls of heart arteries. Establishing heart healthy habits in childhood and carrying them through adolescence into adulthood can have considerable impact.
Secondary prevention refers to taking measures to reduce heart risk, even if one has already developed some degree of heart disease. For example, if a person has evidence of early plaque formation, or even blockage obstructing blood flow in the heart arteries, there are measures to help such as:
- lowering blood pressure
- losing weight
- lowering cholesterol
- quitting smoking
- increasing activity levels
It is possible to reduce or shrink the amount of plaque in the arteries and/or slow the progression of plaque buildup. Cardiac risk reduction measures can also reduce the likelihood of needing invasive procedures like a stent or bypass surgery to treat blockage in the heart arteries.
“How can I make the changes needed to improve my health?”
This is one of the most frequent questions from patients to their health care providers. Over many years of practice, I’ve learned that people tend to be more motivated by feeling and functioning better, rather than by fear of a potential adverse event. Motivating people with fear doesn’t succeed in changing lifestyle or habits. Rather, the desire to feel better and function better is a better way to get motivated to be heart healthy.
For example, simple measures like walking at a medium-to-brisk pace for at least 30 minutes three times per week can result in better conditioning, and weight loss of 10 to15 pounds over a period of 2 to 3 months.
The combination of exercise, and the resultant weight loss, leads to more energy, better sleep, and an overall better sense of well-being. The newfound energy and well-being motivates healthier living, and a positive feedback loop of healthy living is established. Simple heart healthy lifestyle tips listed below can improve your health and well-being, and reduce your risk of developing heart disease or having cardiac events:
- Walk 30 to 60 minutes, three to five times per week. Other forms of exercise are great too. The most important thing is not what you do, but that you do it consistently. If you can find an activity that you really enjoy, it makes it much easier to stay with your regimen.
- Try different things. I had a friend who absolutely hated exercise and did everything to avoid it. He gained weight, his blood pressure and blood sugar went up, he developed gout, and was on multiple medications. His health was going downward and he didn’t feel well. Then, he discovered pickle ball and it changed his life. He became an avid pickle ball player, worked on his game and training, and started competing in tournaments. He lost 25 to 30 pounds, his blood pressure and blood sugar came down, and he got off most of his medications.
- Be consistent. If you can’t find an activity that you like, find something that you can do consistently. If you feel like you’re too stretched for time, combine activities and be a multitasker. I have some patients that walk on the treadmill, or do the elliptical trainer while reading or watching television. They’re able to effectively get their exercise time in without having to give up other activities or disrupt their normal schedule.
Know your numbers
The main numbers to be aware of are your blood pressure, cholesterol, blood sugar (or A1C), and your weight (you can use body mass index (BMI) as a gauge of whether your weight is appropriate for your height. These numbers should be reviewed with your health care provider regularly, at least once a year.
- What should my blood pressure be? Based on the most recent national guidelines, an ideal blood pressure is 120/80 or below.
- What is the ideal cholesterol blood level? Studies show that LDL cholesterol levels are one of the strongest predictors of heart disease. An ideal LDL level for the general population is below 90, and the lower it is, the lower the risk of heart disease. Once people have been diagnosed with heart disease, lowering the LDL level to 50-70 significantly reduces the risk of heart events and improves vascular health.
- Weight: The ideal body mass index (BMI) is 18-25. You can calculate this easily by entering your gender, height, and weight into an online BMI calculator and it will generate your BMI number.
- Blood Sugar/A1C: Fasting blood sugar should be below 100. A1C is measured as a percentage and should be below 5.7%. The A1C measurement is more useful than a single blood sugar measurement because it indicates the trend in blood sugars over a period of 60 to 90 days.
There are a number of ways to prevent the onset of cardiovascular disease or to reduce its impact if you’ve already been diagnosed with the disease. Work with your health care providers to take the steps you need to live a healthier life.
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