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.

How to Prevent Heart Disease

You can reduce your risk for heart disease through lifestyle choices and taking the steps below:

  • Manage your cholesterol and blood pressure levels
  • Get tested and manage your diabetes
  • Exercise regularly
  • Maintain a healthy weight
  • Avoid smoking 
  • Drink responsibly
  • Keep stress under control

Although heart disease is preventable through modifying lifestyle factors above, some risk factors are beyond your 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.

What is Heart Disease?

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

Preventing Heart Disease

There are several things that can help prevent heart disease or keep a cardiovascular condition from worsening.

Lowering Risk Through Preventive Cardiology

Preventative cardiology involves identifying and understanding the degree of risk a patient faces for cardiac issues, such as heart attack, congestive heart failure or stroke, and then implementing options for decreasing that risk. 

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 Prevent Heart Disease by  Controlling 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 prevent heart disease by controlling your blood pressure

  • 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.

Exercise, 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.

Avoid 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.

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