Cardiovascular disease remains the number one killer in the US for both men and women. Not cancer, fatal gun shots, automobile accidents or Alzheimer's disease as you may think. A heart attack or myocardial infarction will hit about a million people in the US this year and will kill about five hundred thousand men and women. The other five hundred thousand men and women will suffer a heart attack and survive but many are incapacitated either emotionally or physically or both. The good news is that heart attacks may be prevented.
Heart attacks don't spare the younger population either. With the rise in levels of obesity and diabetes in young adults of 20 and 30 years of age, this is a cause of great concern and alarm to doctors and official health authorities.
Genetics certainly play a big role in the cardiovascular risk but you can bypass this risk with preventive measures and even some medicines.
It is very important to know your cholesterol and blood pressure numbers to start with. For most people a LDL cholesterol (low density lipoprotein) or as I call it the "Lousy" cholesterol should be under 100 (for diabetics it should be 70) and the HDL cholesterol or as I call it the "Happy" cholesterol should be higher then 60. A good reading for a blood pressure in most people should be 120/80. Please note that patients with a large arm as compared with a regular size arm circumference, should have their blood pressure measured with a large cuff, just as children are measured with a child's cuff. (Yes, even children can have high blood pressure and for a variety of different causes.)
It is also important to know other parameters that can increase the risks for a heart attack such as your glucose (sugar) level, your level of accumulation of fat in the walls of your arteries such as in the carotid arteries, your heart rhythm and the presence (or not) of a heart murmur and others.
Here are some of the most important things you can do:
1) STOP SMOKING - Within a year, a former smoker reduces his heart attack risk by 50%. This is quite impressive.
2) EXERCISE and EAT HEALTHY - Exercise and diet are also fundamental in reducing heart attack risks. Exercising at least 30 minutes a day is associated with a 70% heart attack risk reduction in a year. This exercise could be a brisk walk for example. A good sweat. A brisk walk 10 minutes a day will reduce by 50% a heart attack risk. Not bad at all if you think of it.
Sitting for more than 4 hours in front of a computer or a television is an added risk factor for a cardiovascular event. Prolonged sitting is associated with higher levels of inflammatory markers in the blood, higher body weight, lower levels of HDL, the good (happy) cholesterol indicating than sedentary behavior has it's own bad biology. Take a walk many times during the day, take the stairs instead of the escalator. Instead of going for a snack, go for a 10 min walk. Invite a friend or a family member to walk with you. It will encourage you to walk more.
3) EAT HEALTHY FOODS - Diet is fundamental. You are what you eat. You know you feel heavy and sluggish after a huge meal and you usually end up regretting it right after you finished your last bite. So limit the size of your portion. Fresh produce and other unprocessed foods are best. Vegetables, fruits, grains, nuts (limit the salt please), olive oils, low fat yogurt, fat free milk or soy milk, fish and some lean white poultry meat should be the preference. Try to avoid red meats, fried foods such as French fries, bacon, butter, whole milk, heavy cheeses, and certainly try to avoid refined sugar. You don't need to add sugar to your coffee or tea. It is a matter of acquired taste and you will soon get used to drinking or eating with less or no sugar. Same thing for salt. Try to avoid it.
A good healthy diet that I recommend is a Mediterranean one with the products I mentioned above.
4) SLEEP - Sleeping is very important for your health. It is known that chronic sleep deprivation leads to high blood pressure, weight gain and increase your risk of diabetes.
5) AVOID DEPRESSION, ANGER and HOSTILITY- These feelings have a deleterious effect on cardiovascular health. Beware of these emotions and try to manage or control them as much as possible. You can try to do this alone or enlist the help of family members, friends or with a therapist if you feel you need it.
6) BE HAPPY - Think of good moments and good times, stay positive. Good humor, be happy, smile whenever possible, try to worry less than you normally do.
WHAT TO DO IN THE EVENT OF A HEART ATTACK?
If you believe you are having a heart attack, chew an aspirin (81mg) while waiting for an ambulance. In fact many doctors prescribe a daily baby aspirin (81mg) to everyone 50 years of age and over regardless of symptoms or history of a heart attack. That is unless you have a medical contraindication to aspirin (allergy, active peptic ulcer, dengue fever and others to be discussed with your doctor).
It may not be easy to follow but keeping to these measures may not only reduce the risk of a heart attack but will also make you feel better, healthier and happier.
Albert Levy, MD
