Take steps to protect your heart.

Heart disease describes a variety of disorders and conditions that affect the heart. It is the leading cause of death for both women and men in the United States, but it can be prevented.

Some risk factors are beyond you control, like your:

Age
Your risk increases the older you get.

Family history
If you have a male relative with heart disease before the age of 55, or a female relative with heart disease before the age of 65, you may have an increased risk. The more knowledge you have about your family’s medical history, the better.

Ethnicity
African Americans, Mexican Americans, American Indians, native Hawaiians and South Asian Americans have an increased risk of heart disease.

But you can significantly lower your risk of heart disease by managing or reducing the risk factors you can control through healthy lifestyle changes. Ohio State’s Heart and Vascular Center is committed to improving your health by helping you take steps to prevent heart disease before problems arise.

5 Numbers for a Healthy Heart

5 Numbers You Need to Know for a Healthy Heart Infographic

What is Heart Disease?

The Five Numbers You Need to Know for Heart Health

Martha Gulati, MD, cardiologist at Ohio State’s Heart and Vascular Center, explains the five key numbers every person should know to understand their risk of heart disease.

What is Heart Disease?

Tom Ryan, MD, Director of Ohio State’s Heart and Vascular Center, explains what heart disease, what the common signs and symptoms are of heart disease and when to seek care with a physician.

Cholesterol and Blood Pressure

When the arteries in your heart become narrowed or clogged by cholesterol and fat deposits, they can‘t supply enough blood to the heart. High blood pressure, or hypertension, makes your heart pump harder than it should to send blood throughout your body. You can reduce your risk of heart disease and stroke by gaining control over your cholesterol and blood pressure.

What is cholesterol?

Cholesterol is a waxy substance that can be found in all parts of your body. It aids in the production of cell membranes, some hormones and Vitamin D. The cholesterol in your blood comes from two sources: the foods you eat and your liver. However, your liver makes all of the cholesterol your body needs.

Cholesterol and other fats are transported in your blood stream in the form of round particles called lipoproteins. The two most commonly known lipoproteins are:

  • Low-density lipoproteins (LDL)
  • High-density lipoproteins (HDL)

LDL is commonly called the "bad" cholesterol. It‘s a type of fat in the blood that contains the most cholesterol, so you want your LDL to be low. 

HDL is known as the "good" cholesterol. It‘s a type of fat in the blood that helps to remove cholesterol from the blood. Since "good" cholesterol prevents the fatty buildup and formation of plaque, you want your HDL to be high. Your total cholesterol is a combination of LDL, HDL and other lipids (fats).

What is a healthy cholesterol level?

High cholesterol is a significant risk factor in heart disease. Cholesterol is specific to each individual and a full lipid profile is an important part of your medical history.

In general, ideal levels are as follows:

  • LDL – less than 100 milligrams per deciliter (mg/dl)
  • HDL – greater than 40 milligrams per deciliter (mg/dl) for men, greater than 50 mg/dL for women
  • Triglycerides – less than 150 mg/dL
  • A total cholesterol level below 200 mg/dL is considered desirable

If you already have coronary artery disease or an increased number of risk factors for heart disease, your physician may determine that your LDL cholesterol level must be lower than 100 and may even need to be lower than 70.

Recent studies have shown that those who are at highest risk for a heart attack should lower their LDL cholesterol level to less than 100. An LDL cholesterol level of 70 or less may be the best for those people at the very highest level of risk. Always consult your physician for a diagnosis.

How to Control Your Cholesterol

It is important to work with your doctor on a plan to control your cholesterol. Some general tips include:

  • Eat a diet low in saturated fat, cholesterol and calories
  • Maintain a healthy weight
  • Stop smoking
  • Exercise for at least 30 minutes three times a week

What is blood pressure?

Blood pressure is the force of blood pushing against artery walls. Blood pressure results from two forces: one is created by the heart as it pumps blood into the arteries, and the other is the force of the arteries as they resist the blood flow.

Two numbers are recorded when measuring blood pressure. The top number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body. The bottom number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and filling with blood.

What is a healthy blood pressure level?

The National Heart, Lung and Blood Institute guidelines define normal blood pressure as less than 120/80.

A single elevated blood pressure measurement is not necessarily an indication of a problem. Your physician will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of hypertension (high blood pressure) and initiating treatment.

How to Control Your Blood Pressure

You can control high blood pressure by:

  • Choosing foods that are lower in fat, higher in fiber and lower in sodium
  • Maintaining a healthy weight
  • Limiting serving sizes
  • Increasing exercise
  • Reducing or omitting alcoholic beverages

Some people must take daily medication to control hypertension. If you have hypertension, you should routinely have your blood pressure checked and be under the care of a physician.

Diabetes

Diabetes is a risk factor for heart disease. High blood glucose (sugar) levels over time can lead to increased deposits of fatty materials on the insides of your blood vessel walls. These deposits may affect your blood flow, which increases the chance of clogging and hardening of your blood vessels and leads to heart disease.

What is diabetes?

Diabetes is a metabolic disorder characterized by a failure to secrete enough insulin. Insulin is a hormone that lowers the level of glucose in the blood. In some cases, the cells don’t respond appropriately to the insulin that is produced. Because insulin is needed by your body to convert glucose into energy, these failures result in abnormally high levels of glucose accumulating in the blood. Diabetes may be a result of other conditions such as genetic syndromes, chemicals, drugs, poor nutrition, infections, viruses or other illnesses.

The three main types of diabetes – type 1, type 2, and gestational – are all defined as metabolic disorders that affect the way the body uses digested food to make glucose, the main source of fuel for your body.

What are normal blood glucose (sugar) levels?

  • Blood sugar levels over 200 mg/dL (mg/dL = milligrams of glucose per deciliter of blood) or under 60 mg/dL are considered unhealthy.
  • High blood sugar levels (above 200 mg/dL) may be a sign of inadequate levels of insulin caused by diabetes medication, overeating, lack of exercise or other factors.
  • Low blood sugar levels (below 60 mg/dL) may be caused by taking too much insulin, skipping or postponing a meal, over-exercising, excessive alcohol consumption or other factors.

A good blood glucose level is between 60 mg/dL and 120 mg/dL.

The Link Between Diabetes and Heart Disease

People with diabetes are twice as likely to have cardiovascular disease (heart and blood vessel disease) or stroke, with this risk being even greater for women who have diabetes. People with diabetes also often develop these conditions at an earlier age. Many people with diabetes have risk factors that increase their chances of developing cardiovascular disease. Those risk factors include:

  • High cholesterol
  • High blood pressure
  • Obesity
  • Not exercising
  • Smoking

When diabetes causes blockages to develop in the arteries it is called diabetic vascular disease, also known as atherosclerosis (hardening of the arteries). Diabetes can also damage blood vessels elsewhere in your body, leading to eye problems, kidney problems, and poor circulation to your legs and feet.

The best way to prevent heart disease if you have diabetes is to control your diabetes and reduce your risk factors through diet and lifestyle changes. Your physician may also prescribe medication to lower blood pressure, cholesterol and blood sugar levels.

How to Control Your Diabetes

The type of diabetes you have determines what type of treatment will work best for you. No matter what type you have, maintaining a healthy diet, exercising and keeping a healthy weight are all keys to managing your diabetes and reducing your risk factors for heart disease.

Treatment for type 1 and type 2 diabetes primarily involves:

  • Monitoring glucose
  • Insulin replacement therapy
  • Following meal and alcohol guidelines
  • Oral medications

Gestational diabetes occurs in pregnant women, and may be controlled with diet, exercise and attention to weight gain. In some cases, your physician may prescribe medicine or insulin shots to control your glucose levels. If you have had gestational diabetes you are at high risk of developing diabetes in your future, so it is important to be screened regularly for this.

Activity, Diet and Weight

Excess weight and inactivity place you at risk for high blood pressure, high cholesterol and insulin resistance, a precursor of type 2 diabetes. Getting regular aerobic exercise and following a healthy diet go a long way toward the prevention of heart disease.

What is exercise?

Exercise is any physical exertion that enhances or maintains physical fitness and overall health. A complete exercise program should include:

  • Cardiovascular exercise – exercise that strengthens the heart and lungs, increases endurance and burns calories. Examples include walking, running, aerobics, cycling, swimming and dancing.
  • Strength training – exercise that helps you build lean muscle tissue, which raises metabolism and reduces body fat. Any activity where you exert force against resistance qualifies as strength training. The most common form is weightlifting.
  • Flexibility exercises – activity that increases the range of motion of a joint and its surrounding tissue. Examples include stretching and some forms of yoga and Pilates.

General Exercise Recommendations

The American Heart Association has set exercise recommendations for the average healthy adult to maintain health and reduce the risk for chronic disease. These guidelines include:

  • Moderately intense cardiovascular exercise for 30 minutes a day, five days a week, or vigorous cardiovascular exercise for 20 minutes a day, 3 days a week
  • Eight to 10 strength-training exercises, eight to 12 repetitions of each exercise twice a week
  • Stretching a minimum of two to three days a week

Benefits of Exercise

Daily physical activity plays a positive role in reducing your risk for heart disease. Benefits from regular exercise or physical activity include:

  • Improved blood circulation throughout the body
  • Keeping weight under control
  • Improved blood cholesterol levels
  • Controlling high blood pressure
  • Preventing bone loss
  • Increased energy levels
  • Reduced tension
  • Better sleep habits
  • Improved self-image
  • Reduced stress, anxiety and depression
  • Increased enthusiasm and optimism
  • Increased muscle strength

What is a healthy diet and weight?

The American Heart Association recommends eating a diet that includes vegetables and fruits, whole grains and high-fiber foods, lean meats and poultry, fish, and fat-free or one percent fat dairy products. A diet should also be low in saturated fat, trans fat and cholesterol.

Eating a variety of fruits and vegetables and unrefined whole grains may help you control your weight, your blood pressure and your cholesterol.

By limiting foods and beverages high in calories but low in nutrients, and how much saturated fat, trans fat, cholesterol and sodium you eat, you can reduce your risk of heart disease. Reading food labels helps you choose foods that make up a healthful diet.

The American Heart Association recommends the following:

  • Choose lean meats and poultry without skin, and prepare them without added saturated and trans fat.
  • Select fat-free, one-percent fat and low-fat dairy products.
  • Cut back on foods containing partially hydrogenated vegetable oils to reduce trans fat in your diet.
  • Aim to eat less than 300 milligrams of cholesterol each day.
  • Reduce or eliminate beverages and foods with added sugars.
  • Choose and prepare foods with little or no salt. Try to eat less than 1,500 milligrams of sodium per day.
  • If you drink alcohol, drink in moderation. That means one drink per day if you‘re a woman and two drinks per day if you‘re a man.
  • Follow the AHA recommendations when you eat out, and keep an eye on your portion sizes.

What is obesity?

Obesity is defined as having an excessive amount of body fat. Obesity can be determined based on three key measurements, according to National Heart, Lung and Blood Institute:

  • Body mass index (BMI) – BMI is your weight relative to your height, including considerations such as amount of bone, muscle and fat in your body's composition. If your BMI calculation is 25.0 or higher, you are considered overweight (a BMI over 30 is considered obese). A BMI of 40 or greater is considered morbidly obese and weight-loss surgery [link to weight loss experience] may be an option.
  • Waist circumference – Your waist circumference indicates abdominal fat. A waist circumference over 40 inches in men and over 35 inches in women increases your risk of developing diabetes, the metabolic syndrome and heart disease.
  • Risk factors – People with two or more risk factors for heart disease are at even higher risk for heart disease, when combined with a high BMI or large waist circumference.

Healthy Tips for Losing Weight

Successful weight loss requires a long-term weight management program that is realistic, according to the National Heart, Lung and Blood Institute’s Obesity Education Initiative. To help lose weight and maintain a healthy weight, consider the following:

  • Set realistic goals
  • Set short-term goals that lead to long-term goals
  • Reward yourself
  • Monitor yourself
  • Avoid situations that cause you to overeat
  • Eat slowly

The Center for Wellness and Prevention at Ohio State's Martha Morehouse Medical Plaza features a fitness center that provides a friendly, comfortable environment for exercise. Professional staff is available to answer your questions or provide guidance and encouragement while you exercise.

Alcohol and Tobacco

According to the American Heart Association, drinking too much alcohol can raise the levels of some fats in your blood. It can also lead to high blood pressure, heart disease and an increased calorie intake. Cigarette smoking is also a major cause of coronary artery disease, which leads to heart attack.

Drink sensibly

If you drink alcohol, do so in moderation. This means an average of one to two drinks per day for men and one drink per day for women. (A drink is one 12 oz. beer, 4 oz. of wine, 1.5 oz. of 80-proof spirits, or 1 oz. of 100-proof spirits.) If you do not currently drink alcohol it is recommended you not start. Consult your doctor on the benefits and risks of consuming alcohol in moderation.

Avoid tobacco

You should eliminate all tobacco products to help lower your risk.

Smoking increases blood pressure, decreases HDL (good) cholesterol, decreases exercise tolerance and increases the tendency for blood to clot. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery. Cigarette smoking combined with a family history of heart disease also seems to greatly increase the risk.

As soon as you stop smoking, your body begins to heal itself from the devastating effects of tobacco.

The Ross Heart Hospital‘s Smoking Cessation Clinic offers support for those trying to quit smoking or using smokeless tobacco. The clinic is pharmacist-run and physician supervised, providing consultation and support services to those ready to quit nicotine for good. To make an appointment, please contact 614-293-7677.

Stress

Increased stress can be a factor in developing heart disease.

Keep stress under control

Emotional stress can lead to:

  • High blood pressure
  • Increased susceptibility to substance abuse and illness
  • Less resistance to disease including heart disease
  • Depression

Take steps to reduce or manage the stress in your life:

  • Eat a healthy diet and exercise regularly. A nutritious, well-balanced diet and exercise can keep your body fit and able to resist disease, and exercise is an excellent way to elevate your mood.
  • Talk about stressful situations with someone you trust. Sometimes just talking about your problems and concerns can help put them into perspective and give you insights into ways to deal with them.
  • Stay organized to help manage your time more efficiently.
  • Remember, no one can do it all alone, so ask for help.
  • Use relaxation techniques to calm your mind and body.
  • Get professional help if you need it.
Heart Disease Prevention Resources at Ohio State

Heart Disease Prevention Resources at Ohio State

Successful prevention of cardiovascular disease – whether you've never had a cardiac event before or you've already experienced one – requires a close collaboration between you and your healthcare team. Ohio State offers a variety of programs and other resources to help you manage the risk factors that can lead to heart disease.

Primary Care

Primary prevention begins when your primary care physician refers you to one of our multiple clinic locations. You’ll meet with a multidisciplinary team of specialists who will assess family history, controllable and uncontrollable risk factors, cardiac history, diet and exercise habits and medication profile. The team spends as much time with you as needed to make a complete assessment. If you need a primary care physician, Ohio State has many convenient primary care locations throughout central Ohio.

Preventive Cardiology

If you’ve already experienced a cardiac event, decreasing your chances of having another one involves lifelong behavior changes and learning to manage medication. Positive changes like losing extra weight or quitting smoking can help you see improvements in your overall health. The heart experts of our Preventive Cardiology team can help you set, track and achieve your cardiac health goals. Call 614-293-7677 for more details.

Lipid Management

At Ohio State’s Cardiovascular Risk Reduction and Lipid Clinic, we design individualized care plans to help you meet your cholesterol and lipid management goals. Treatment plans may include a combination of lifestyle modification coaching and management of medications. The clinic specializes in:

  • Exploring barriers to changes in behavior
  • Motivational interviewing to assist you in finding solutions
  • Cardiovascular event risk reduction
  • Helping you with medication intolerance
  • Screening and management of medication intolerances that may worsen conditions
  • Screening for potential drug interactions

For more information, contact Ohio State’s Cardiovascular Risk Reduction and Lipid Clinic at 614-293-7677.

Hypertension Treatment

If you have high blood pressure your Ohio State doctor will guide you through lifestyle changes such as diet and exercise that can help you lower your blood pressure. Your doctor will also probably prescribe daily medication and perform routine blood pressure checks.

Metabolic Syndrome Management

Metabolic syndrome increases your risk for developing more serious conditions such as cardiovascular disease and type 2 diabetes. Therefore, treating metabolic syndrome is important. Treatment at Ohio State may include:

  • Lifestyle management – a program of weight management and exercise
  • Tobacco cessation
  • Limiting alcohol consumption
  • Changes in dietary habits, including eating a heart-healthy diet
  • Medication to help lower blood pressure, improve insulin metabolism, improve cholesterol and increase weight loss
  • Weight-loss surgery (bariatric surgery) to treat morbid obesity in individuals for whom conservative measures have failed

Cardiac Rehabilitation

Cardiac rehabilitation following a heart event significantly reduces the risk of heart problems happening again and has a positive impact on your recovery and return to independence. Cardiac rehab helps you reach your short-term goal of improved function and your long-term goal of preventing progression of heart disease through exercise programs, education and lifestyle coaching. Benefits of our program include:

  • Reduction in likelihood or severity of event recurrence
  • Improved cardiovascular function
  • Increased fitness level
  • Improved, healthier eating habits
  • Increased muscle tone, stamina and activity tolerance
  • Assistance with smoking cessation
  • Less fear or anxiety
  • Faster recovery
  • Improved lipid profile
  • Improved blood glucose control for diabetics

Ohio State’s Cardiac Rehabilitation Program guides you through recovery at two convenient Columbus-area locations, Martha Morehouse Medical Plaza and CarePoint East.

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Fitness Center Memberships and Classes

The Fitness Center at Ohio State’s Center for Wellness and Prevention located on the Ohio State campus, provides a friendly, comfortable environment for exercise. Our professional staff is trained in CPR and an automated external defibrillator (AED) is on-site. Someone is always available to answer questions or provide guidance and encouragement while exercising. Members have access to aerobic and strength training equipment including:

  • Treadmills
  • Biodex machines
  • NuSteps
  • Recumbent bikes
  • Ellipticals
  • Rowing machines
  • Free weights
  • Weight training machines

We also offer many instructor-led fitness class, including:

  • Basic fitness (strength, balance, flexibility)
  • Body sculpting
  • Gentle yoga
  • Yoga level 2
  • Stretching 

For more information about Ohio State’s Center for Wellness and Prevention, call 614-293-2800.

Pulmonary Rehabilitation

Ohio State’s Pulmonary Rehabilitation Program offers expert care for patients with lung disease. Pulmonary rehabilitation can benefit you in several ways:

  • Increasing your understanding of your condition
  • Reducing your shortness of breath with daily activities 
  • Increasing your ability to manage your breathing
  • Improving your quality of life
  • Increasing your independence
  • Keeping you out of the hospital

Our Pulmonary Rehabilitation team provides care through Ohio State’s Center for Wellness and Prevention, located on Ohio State's Columbus campus.

Pulmonary rehabilitation sessions consist of exercise and education. Rehabilitation activities include stretching exercises, weights, treadmill, bicycle, upper body bicycle and NuStep. Sessions take place three days a week for approximately eight weeks. Both morning and afternoon sessions are offered, and each session lasts approximately 2.5 hours.

Enrollment in the Pulmonary Rehabilitation Program is dependent on a physician referral. For more information about the program, call 614-293-2820.

Genetic Testing

Most types of heart disease have underlying genetic components. We offer genetic counseling and genetic testing for people with red flags in their family history.

Genetic testing involves a simple blood test that is used to analyze your DNA for inherited genetic traits. These traits could increase your risk – or your children’s risk – of developing a disease, such as coronary artery disease, aortic aneurysms, cardiomyopathy, arrhythmias (irregular heart beat) and others.

Also, for those patients with congenital heart defects or vascular disease, if you are considering starting a family, genetic testing might help you learn more about the chances of having a child with the same condition.

Ohio State offers multiple clinics that can evaluate you if you have a heart condition that may be genetic or if you have a family history of heart disease that concerns you.

Also, The Ohio State University Wexner Medical Center has created a free online assessment tool – Family Healthlink – that allows you to enter your family medical history. This online program helps determine your risk for cancer and coronary heart disease. The survey only takes 10-15 minutes to complete, and provides a personalized risk assessment form that can be printed and given to your physician for discussion.

Women's Heart Health

Americans often think of heart disease as a man's disease. That myth may contribute to women not getting the preventive care they need and the lifesaving treatment necessary when a heart attack or stroke occurs.

The Women's Cardiovascular Health Clinic at Ohio State's Heart and Vascular Center is one of only a handful of clinics in the country devoted to women's heart health. More than a third of the cardiology experts at Ohio State are women – covering nearly every specialty of heart and vascular care. Our team is led by nationally renowned women’s heart expert, Martha Gulati, MD, director of Preventive Cardiology and Women’s Cardiovascular Health.

At Ohio State, we understand that the symptoms and complications of heart disease are different in women than in men, and our deep experience in treating women’s heart disease means we have unmatched expertise.

Learn more about women’s heart health care at Ohio State.

Smoking Cessation

Cigarette smoking is a major cause of coronary artery disease, which leads to heart attack. As soon as you stop smoking, your body begins to heal itself from the devastating effects of tobacco. Ohio State’s Ross Heart Hospital Smoking Cessation Clinic can help you quit. The program, which is covered by most insurance plans, provides each participant:

  • Initial individual assessments with a pharmacist that include behavioral counseling and pharmacologic treatment as well as assessments for blood pressure, heart rate, weight, medications, past health history and immunizations
  • Follow-up visits whenever a patient wishes to review progress, strategies and medications, and make adjustments as needed

Ohio State's Ross Heart Hospital Smoking Cessation Clinic is located on the first floor of the Ross Heart Hospital. To schedule a patient for an appointment, call our Heart Schedulers at 614-293-ROSS (7677). Or for more information, contact 614-293-0932.

Our Leaders

Our leaders

John Larry

John Larry, MD

Medical Director, Cardiology and Cardiac Rehabilitation, University Hospital East

Dr. Larry is an associate professor of clinical medicine at Ohio State. Dr. Larry has published numerous abstracts and peer-reviewed journal articles. He is a member of multiple professional societies, including the American College of Cardiology, the American Heart Association and the American Society for Echocardiography. Dr. Larry was named one of America’s Best Doctors in 2009. He was also honored in Madison’s Who’s Who in Health Care Professionals in 2009. Dr. Larry’s clinical interests include prevention of cardiac disease, cardiac rehabilitation and echocardiography.

Kavita Sharma

Kavita Sharma, MD

Dr. Sharma is an assistant professor of clinical medicine in the Division of Cardiovascular Medicine at Ohio State. Dr. Sharma is board certified in internal medicine and nuclear cardiology. She is currently an ACCF Question Writing Committee contributor. She won the 2011 Scholarship for the Mayo Clinic Echocardiography Review Course for Boards and Re-certification. She has co-authored several peer-reviewed journal articles and abstracts.

Martha Gulati, MD

Martha Gulati, MD, MS, FACC, FAHA

Director, Preventive Cardiology and Women's Cardiovascular Health

Dr. Gulati is an associate professor of Cardiovascular Medicine at Ohio State as well as the Sarah Ross Soter Chair in Women’s Cardiovascular Health. Dr. Gulati is the principal or co-investigator on several studies examining women’s heart health, fitness and prevention. Dr. Gulati is a co-author of the 2007 guidelines of the American Heart Association for heart disease prevention in women. She has also published numerous articles in peer-reviewed publications and serves as a reviewer for several medical journals.

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