A strong and healthy heart is the foundation of a healthy life. In fact, the heart is often synonymous with life itself. February is American Heart Month, a time to bring attention to the keys to good heart health and the ways we can reduce risk of heart disease.
Statistically, heart disease is the single biggest threat to our health. Heart disease is the number one cause of death for both women and men in the United States. In fact, one person dies of heart disease every 36 seconds in the United States, totaling more than 650,000 deaths per year. Heart disease brings about a tremendous economic cost, as well. According to the U.S. Centers for Disease Control and Prevention (CDC), heart disease accounts for $219 billion in negative economic impact (for years 2014-15). This includes cost of related health care expenses and lost economic productivity due to death and disability.
These statistics are sobering. Yet, in many cases heart disease can be prevented altogether or its onset can be delayed until later in life. While some instances of heart disease are caused by heredity, most are shaped by lifestyle choices and environmental factors. Let’s take a look at the common forms of heart disease, as well as some simple things we can all do to reduce our risk of heart disease and live a longer and healthier life.
Forms of Heart Disease
The term “heart disease” is a general term that may refer to several specific conditions. Some of the more common heart conditions include:
- Coronary Artery Disease: Coronary Artery Disease (CAD) is the most common form of heart disease and is often the root cause of heart attacks and other heart problems. CAD occurs when plaque – deposits of cholesterol and other substances – build up in the coronary arteries that supply blood to the heart. When blood flow to the heart is impeded over a long period of time, the heart will weaken, increasing the risk of heart failure. If blood flow to the heart is completely cut off, a heart attack will result. CAD can also cause blood clots, which may lead to stroke.
- Heart Attack: Someone has a heart attack every 45 seconds in the United States. Also known as a myocardial infarction, a heart attack occurs when a portion of the heart suddenly receives inadequate blood flow. The longer the heart goes without the required amount of blood flow, the greater the damage that will be done to the heart muscle.
Each year, close to 800,000 Americans suffer a heart attack. Nearly 25 percent of these are “repeat” heart attacks – that is to say, the person has had at least one heart attack in the past.
Everyone should be able to recognize the signs of a heart attack:
- Chest pain or discomfort
- Pain or discomfort in the jaw, neck or back
- Feeling weak, light-headed or faint (this is more common in women)
- Pain or discomfort in arms or shoulder
- Shortness of breath
IMPORTANT: If you or someone around you suddenly begins to experience one or more of these symptoms, call 911 immediately. The sooner you seek and receive medical attention, the greater your odds of recovering from a heart attack.
- Angina: Angina is chest pain caused by reduced blood flow to the heart.
- Arrhythmia: Arrhythmia occurs when the heart beats irregularly. Arrhythmia increases the risk of blood clots and stroke.
- Atherosclerosis: This condition is characterized by the narrowing of the arteries as a result of plaque buildup.
- Peripheral Arterial Disease (PAD): When the arteries that supply blood to the arms and legs narrow or stiffen as a result of atherosclerosis, the blood and oxygen flow to the limbs can be diminished or even blocked. This can lead to numbness, tingling and pain in the legs and arms.
- Cardiomyopathy: This condition results from the stiffening or enlargement of the heart muscle, which can cause inadequate blood pumping. Cardiomyopathy can result from many factors, including genetic ones. Uncontrolled high blood pressure is a key risk factor for this condition.
- Heart failure: Heart failure – also called congestive heart failure (due to the buildup of fluids in the lungs, limbs and liver) – results from the gradual weakening of the heart muscle. The heart is still beating but no longer pumps blood correctly.
Good Choices Help Reduce Risk
Many of the various heart conditions described above can be prevented or mitigated by making healthy choices. Three of the biggest risk factors for heart disease are high blood pressure, high blood cholesterol and smoking. Nearly half of all Americans (47%) has at least one of the risk factors.
“Healthy decisions can have a positive impact on major heart health risk factors, such as high cholesterol, high blood pressure and diabetes,” explains Dr. Scott Ewing, a cardiologist. “Additionally, making good decisions such as not smoking, drinking alcohol only in moderation, maintaining a healthy diet and getting enough exercise all help protect your heart and improve your overall health.”
Here’s a look at some of these common risk factors and steps everyone can take to improve heart health:
High blood pressure, also called hypertension, is often referred to as a “silent killer” – it usually produces no noticeable symptoms, but left untreated, can result in severe damage to the heart. About half of all adults in the United States have hypertension and of those, only one out of four have their blood pressure under control. In 2018, hypertension was the primary or contributing cause of death in nearly a half million Americans.
A blood pressure reading measures the force of blood against the arteries and includes two numbers:
- Systolic (upper number): when the heart beats
- Diastolic (lower number): when the heart is resting, in between beats
Blood pressure is categorized in the following ways:
- Normal: Less than 120/80 mm Hg;
- Elevated: Systolic between 120-129 and diastolic less than 80;
- Stage 1 Hypertension: Systolic between 130-139 or diastolic between 80-89;
- Stage 2 Hypertension: Systolic at least 140 or diastolic at least 90;
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120
Elevated blood pressure can damage the arteries over time. It also makes the heart work harder to pump blood, causing extra strain and possible damage to the heart. High blood pressure often develops gradually with age, its root cause unknown. However, there are known risk factors that contribute to high blood pressure, including:
- Too much salt consumption
- Too little potassium consumption
- Excessive alcohol consumption
- Tobacco use
As with high cholesterol, if diet and exercise are insufficient to bring blood pressure into a normal range, your physician may prescribe medication.
All adults should have their blood pressure checked by a medical professional periodically:
- Men and women, age 18-39: every three to five years
- Men and women, age 40 and older: every year
Cholesterol is a waxy, naturally-occurring substance in our bloodstream. Our bodies need some cholesterol to help build healthy cells and aid in the digestive process. Our bodies naturally produce all the cholesterol we need, but we also consume additional cholesterol through food, such as meat, dairy, eggs and foods containing trans-fats.
Cholesterol is transported through the bloodstream by lipoproteins. There are two types of lipoproteins, low-density (LDL) and high-density (HDL). LDL is often referred to as “bad cholesterol” and HDL as “good cholesterol.”
LDL cholesterol is bad for us because it contributes to the buildup of plaque in the arteries, which can lead to coronary artery disease, angina and heart attack.
Conversely, the higher your HDL, the better. The HDL lipoproteins transport cholesterol and fat through the blood and to the liver, so they can be eliminated from the body.
Triglycerides, a type of fat found in the blood, can also be harmful to cardiovascular health if levels are too high.
A cholesterol screening, which is a simple blood test that measures cholesterol and triglyceride levels, will determine if your levels are in the normal range. Everyone should receive cholesterol screenings periodically:
- Children between the ages of 9-11
- Young adults between the ages of 17-21
- Adults every 4-6 years, if no history of heart disease
- Adults with a history of heart disease should visit with their physician about how often to be screened.
If your LDL levels are elevated, you can often bring them down by making dietary adjustments. Eating less saturated fat, the type of fat found in meat and dairy, can help improve cholesterol levels. Trans fats, also known as partially hydrogenated vegetable oil, are found in many processed baked goods, such as cookies and doughnuts, as well as some fried foods. Trans fats are considered to be the worst type of fat to consume, as they raise LDL cholesterol while reducing HDL levels. People should avoid consuming trans fats in all cases.
In addition to dietary adjustments, HDL levels can be elevated through regular exercise, which has numerous heart health benefits. If diet and exercise alone are insufficient to bring cholesterol levels into a healthy range, your physician may prescribe a medication known as a statin. Statins are commonly prescribed to reduce cholesterol levels and improve heart health.
Diabetes is a major risk factor for heart disease and causes other serious health problems. Diabetes is a disorder of the metabolism, meaning the body is not properly using the food it is consuming. Under normal circumstances, our liver breaks down carbohydrates into glucose, also known as blood sugar. The liver releases the glucose into the blood stream. Meanwhile, the pancreas, a gland located near the stomach, produces insulin, which is a hormone that helps the body’s cells absorb the sugar in the blood. Our cells then use the glucose for energy. If a person’s cells are unable to absorb enough glucose, blood sugar levels rise. This can lead to diabetes.
Your doctor can check your blood sugar level with a simple blood test, and there are several things that can be done to lower it if it’s too high. Some foods should be avoided or eaten only in moderation. This includes certain carbohydrates, such as white flour products like bread and pasta, as well as white rice. Sugary drinks, including soda and fruit drinks, can also cause blood sugar levels to spike. Getting regular exercise and remaining hydrated are important keys to keeping blood sugar levels in check.
All adults should have their blood sugar levels checked periodically:
- Men and women age 45 and older, every three years
- Men and women ages 19-44, if overweight or obese
- Women who have had gestational diabetes
Maintain a Healthy Weight
Maintaining a weight within a healthy, normal range is one of the most important things everyone can do for their overall health, including heart health. Being overweight can contribute to hypertension, elevated cholesterol and diabetes. Extra pounds on your frame will result in the heart working harder to pump blood throughout the body and causes strain on the joints, which in turn can make it more difficult to exercise.
A Healthy, Balanced Diet
“What we eat has a direct impact on cholesterol level, blood pressure and blood sugar, three of the primary indicators for heart disease risk,” explains Dr. Sam Nassar, a cardiologist. “And of course, what and how much we eat also affects our weight.”
When thinking about foods that comprise a heart-friendly diet, think about what to eat, what to avoid and what to only consume in moderation.
Good for you:
- Fresh fruits and vegetables
- Whole grains
- Unsalted nuts
- Lean meat
- Water: we should all get at least 64 oz per day
Foods to avoid:
- Any foods containing trans-fat, which increase the bad, LDL cholesterol and reduce the good, HDL cholesterol.
- Soft drinks and fruit punch; they are loaded with sugar and have no nutritional value. This is especially important for children, as sugary drinks are a major contributor to childhood obesity.
Only in moderation
A lot of the foods we like tend to be high in sugar, salt, fat or all three. In general, eat these only occasionally, if at all:
- Fried foods
- Processed meats, such as hot dogs
- Anything that is high in sugar or salt
- Alcoholic beverages
Many foods that we may not think of as salty or sweet sometimes contain excessively high amounts of sodium and sugar, including bread, frozen dinners, sauces and packaged snacks. Make a habit of reading nutrition labels to get an accurate assessment of how much salt and sugar you are really consuming.
Adults older than 21 should consume alcohol only in moderation. That means a maximum of one drink for women and two for men in one day. Excessive alcohol consumption contributes to high blood pressure and weight gain.
It’s Not Just What; It’s How Much
Too much of anything isn’t good, and that is especially true of food. It’s quite possible to eat healthy foods but still consume too many calories, contributing to weight gain. Be mindful of serving sizes. A portion of meat should be four ounces, about the size of your palm. A serving of whole wheat pasta has some positive health benefits, but remember that a serving is one cup, dry.
“The serving sizes you see in restaurants are not normal,” warns Dr. Laura Baker, a primary care physician. “We tend be overserved food in our society and we must make a conscious effort to recognize what a normal, healthy serving size actually is.”
Read the labels to know how much a serving is and how many calories it contains – then use a measuring cup and a kitchen scale to make sure you and your family don’t prepare and consume excess calories.
Exercise helps the heart in two important ways. Cardio exercise such as walking, bicycling, running and swimming causes the heart rate to increase. As the heart beats faster to pump blood, the heart muscle is strengthened.
The second way exercise helps, of course, is that it burns calories, helping achieve and maintain a healthy weight. “All of us should get at least 30 minutes of exercise a day, five or more days a week,” says Dr. Paresh Patel, a primary care physician. “A brisk walk is a great way to get burn some calories and give your heart a valuable workout. Exercise will help you feel better, also!”
IMPORTANT NOTE: Before beginning any exercise routine, visit with your physician first to ensure that exercise is safe for you. Exercising with an undetected, underlying health condition can result in serious injury, illness or death.
Stress probably does not get enough attention for the role it plays in our physical health, including heart health. “No matter your age or what you do for a living, everyone experiences stress at different times in their lives,” explains Dr. Mark Bernhard, a primary care physician. “When stress is not managed correctly, it can negatively impact our overall health, by contributing to high blood pressure and other problems. In addition, some people try to cope with stress by turning to unhealthy habits, such as smoking or excessive drinking.”
Getting a good night’s sleep and exercising are two of the most important keys to reducing stress.
Smoking is one of the very worst things you can do to your heart. Smoking causes arteries to narrow and elevates blood pressure. It contributes to unhealthy cholesterol and triglyceride levels and can lead to diabetes. It also causes cancer and a host of other serious illnesses.
If you smoke, make an appointment to see your doctor and develop a plan to quit.
Healthy Heart = Healthy You
When you take care of your heart, it is more likely to take care of you for a long time to come. If you have not recently seen your health care provider or think you may be due for a cholesterol or blood sugar screening, get in touch with us and make an appointment today!
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