Page Updated: Jan-17-2011

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Heart Disease Prevention - Reducing Your Risk

By the National Institutes of Health

You can reduce your risk of having a heart attack—even if you already have coronary heart disease (CHD) or have had a previous heart attack. The key is to take steps for prevention and control of your heart disease risk factors.

Six Key Steps for the Prevention of Heart Disease.

Taking these steps will reduce your risk of getting heart disease and having a heart attack:

• Stop smoking is the top priority in Heart Disease Prevention
• Lower high blood pressure
• Reduce high blood cholesterol
• Aim for a healthy weight
• Be physically active each day
• Manage diabetes

Smoking Cigarettes - Top Priority in Heart Disease Prevention

Cigarette smoking greatly increases the risk of fatal and nonfatal heart attacks in both men and women. It also increases the risk of a second heart attack among survivors. Women who smoke and use oral contraceptives have an even greater risk than smoking alone. The good news is that quitting smoking greatly reduces the risk of heart attack. One year after quitting, the risk drop to about one-half that of current smokers and gradually returns to normal in persons without heart disease. Even among persons with heart disease, the risk also drops sharply one year after quitting smoking and it continues to decline over time but the risk does not return to normal.

The virtual Office of the Surgeon General is a Web site of the U.S. Surgeon General. It contains information to help smokers quit. The U.S. Food and Drug Administration has approved five medications to help you stop smoking and lessen the urge to smoke. They are:

• Bupropion SR - available by prescription
• Nicotine gum - available over-the-counter
• Nicotine inhaler - available by prescription
• Nicotine nasal spray - available by prescription
• Nicotine patch - available by prescription and over-the-counter

All of these medicines will more or less double your chances of quitting and quitting for good. You will find details on this information and more at the Virtual Office of the Surgeon General.

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Lower High Blood Pressure

High blood pressure makes the heart work harder. It increases the risk of developing heart disease, as well as kidney disease and stroke.

Also called hypertension, it usually has no symptoms. Once developed, it typically lasts a lifetime.

Blood pressure is recorded as two numbers–the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes). For example, a measurement would be written as 120/80 mm Hg (millimeters of mercury). Normal blood pressure is less than 130 mm Hg systolic and less than 85 mm Hg diastolic. An optimal blood pressure is less than 120 mm Hg systolic and less than 80 mm Hg diastolic. A consistent blood pressure reading of 140/90 mm Hg or higher is considered high blood pressure. If the systolic and diastolic pressures fall into different categories, the higher category is used to classify blood pressure status.

To help prevent or control high blood pressure, you should: lose excess weight; become physically active; follow a heart healthy eating plan, including foods lower in salt and sodium; limit alcohol intake; and, if you are prescribed a medication, take it as directed. The main types of high blood pressure medications are: diuretics, beta-blockers, angiotensin converting enzyme (ACE) inhibitors, angiotensin antagonists, calcium channel blockers, alpha blockers, alpha-beta blockers, nervous system inhibitors, and vasodilators. It’s important that you take medication as prescribed and control your blood pressure to below 140/90 mm Hg.

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Reduce High Blood Cholesterol

The level of cholesterol in the bloodstream greatly affects the risk of developing heart disease. The higher the level of blood cholesterol, the greater the risk for heart disease or heart attack.

Why? When there is too much cholesterol (a fat-like substance) in the blood, it builds up in the walls of arteries. Over time, this buildup causes arteries to become narrowed, and blood flow to the heart is slowed or blocked. If the blood supply to a portion of the heart is completely cut off, a heart attack results.

Various factors affect cholesterol levels: diet, weight, physical activity, age and gender, and heredity.

High blood cholesterol itself does not cause symptoms. You may not know your blood cholesterol level is too high. So, it’s important to have your cholesterol measured. Adults age 20 or older should have their cholesterol checked at least once every 5 years. It best to have a blood test called a lipoprotein profile. This test measures total cholesterol, "good" and "bad" cholesterol, as well as triglycerides, another form of fat in the blood.

High cholesterol is treated with lifestyle changes–a heart healthy eating plan, physical activity, and loss of excess weight–and, if those do not lower it enough, medication. Medications include statins, bile acid sequestrants, nicontinic acid, and fibric acids.

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Aim for a Healthy Weight

A healthy weight is crucial for a long, healthy life. In 1999, almost 108 million-or 61 percent of-adults in the United States were overweight or obese. Being overweight or obese increases your risk of heart attack. And, it increases your risk of developing high blood cholesterol, high blood pressure, and diabetes-each of which also increases your chance of having a heart attack. If you are overweight, even a small weight loss-just 10 percent of your current weight-will help to lower your risk of developing those diseases.

Two of the measures that assess whether or not a person is overweight are body mass index (BMI) and waist circumference. BMI is a measure of weight relative to height. To check your BMI, choose this online calculator. Waist circumference measures abdominal fat. The risk for developing heart and other diseases increases with a waist measurement of more than 40 inches in men and more than 35 inches in women.

To be at their best, adults need to avoid gaining weight and many need to lose weight. Losing weight and keeping it off depends on a change of lifestyle that combines sensible eating with regular physical activity, not a temporary effort to drop pounds quickly. If you need to lose excess weight, talk with your health care provider about developing an action plan, which includes a hearty-healthy, low-calorie, nutritious eating plan and physical activity.

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Be Physically Active Each Day

Being physically active reduces the risk of heart-related problems, including heart attack. Physical activity can improve cholesterol levels, help control high blood pressure and diabetes, and manage weight. It also increases physical fitness, promotes psychological well-being and self-esteem, and reduces depression and anxiety.

Those who have already had a heart attack also benefit greatly from being physically active. Many hospitals have a cardiac (or heart) rehabilitation program. A health care provider can offer advice about a suitable program.

To protect your heart, you only need to do 30 minutes of a moderate-intensity activity on most and, preferably, all days of the week. If 30 minutes is too much at one time, you can break it up into periods of at least 10 minutes each.

If you have been inactive, you should start slowly to increase your physical activity.

If you have coronary heart disease, check with you health care provider before starting a physical activity program. This is especially important if you are over age 55, have been inactive, or have diabetes or another medical problem. Your health care provider can give you advice on how rigorous the exerciseshould be.

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Manage Diabetes

Diabetes mellitus affects more than 16 million Americans. It damages blood vessels, including the coronary arteries of the heart. Up to 75 percent of those with diabetes develop heart and blood vessel diseases. Diabetes also can lead to stroke, kidney failure, and other problems.

Diabetes occurs when the body is not able to use sugar as it should for growth and energy. The body gets sugar when it changes food into glucose (a form of sugar). A hormone called insulin is needed for the glucose to be taken up and used by the body.

Symptoms of diabetes include: increased thirst and urination, weight loss, and blurred vision, hunger, fatigue, frequent infections, and slow healing of wounds or sores.

There are two main types of diabetes: insulin-dependent, or type 1, and noninsulin-dependent, or type 2. Type 1 usually appears suddenly and most commonly in those under age 30. Type 2 diabetes occurs gradually and most often in those over age 40. Up to 95 percent of those with diabetes have type 2. You’re more likely to develop type 2 if you are overweight or obese, especially with extra weight around the middle, over age 40, have high blood pressure, or have a family history of diabetes. Diabetes is particularly prevalent among African Americans, Asians, and Native Americans.

Because of the link with heart disease, it’s important for those with diabetes to prevent or control heart disease and its risk factors. Besides diabetes, major risk factors for heart disease include smoking, high blood pressure, high blood cholesterol, physical inactivity, and overweight and obesity.

Fortunately, new research shows that the same steps that reduce the risk of heart disease also lower the chance of developing type 2 diabetes. And, for those who already have diabetes, those steps, along with taking any prescribed medication, also can delay or prevent the development of complications of diabetes, such as eye disease and nerve damage.

According to the research, a 7 percent loss of body weight and 150 minutes of moderate-intensity physical activity a week can reduce the chance of developing diabetes by 58 percent in those who are at high risk. The lifestyle changes cut the risk of developing type 2 diabetes regardless of age, ethnicity, gender, or weight.

To reduce the risk of developing diabetes, as well as heart disease, you should:

• Follow a heart healthy eating plan, which is low in saturated fat and cholesterol, and moderate in total fat.
• Aim for a healthy weight.
• Be physically active each day–try to do 30 minutes of moderate-intensity physical activity such as brisk walking on most and, preferably, all days of the week.
• Don't smoke.
• Prevent or control high blood pressure.
• Prevent or control high blood cholesterol.

If you already have diabetes, you can delay its progression, or prevent or slow the development of heart, blood vessel, and other complications by following the steps given above and these:

• Eat your meals and snacks at around the same times each day.
• Check with your doctor about physical activities that are best for you.
• Take your diabetes medicine at the same times each day.
• Check your blood sugar every day. Each time you check your blood sugar, write the number in your record book. Call your doctor if your numbers are too high or too low for 2 to 3 days.
• Check your feet every day for cuts, blisters, sores, swelling, redness, or sore toenails.
• Brush and floss your teeth and gums every day.
• Take any prescribed medication for other conditions, such as coronary heart disease.
• Check with your doctor about taking aspirin each day if you have heart disease.

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Heart Health Related Topics

Heart Factors We Can Change

Tobacco smoke
Smokers have twice the risk of heart attack than nonsmokers.4

High blood cholesterol
As blood cholesterol rises, so does the risk of heart disease. 3,4

High blood pressure
High blood pressure increases the heart’s workload, causing the heart to thicken and become stiffer. 4

Physical inactivity
Exercise most days of the week helps prevent heart disease. The more vigorous the activity, the greater your benefits. 3,4

Obesity and overweight
People who have excess body fat are more likely to develop heart
disease and stroke even if they have no other risk factors. 3,4

strong>Individual coping styles
Research has shown there is a link between heart disease risk and stress, happiness, negativity, and socioeconomic status. 3,6-10

Alcohol consumption
Drinking too much alcohol can raise blood pressure. However, the risk of heart disease in people who drink moderate amounts of alcohol
(an average of one drink for women or two drinks for men per day) is lower than in nondrinkers. 3,4

Heart Factors We Can't Change

Risk Factors for Heart Attack

• Do you smoke?
• Is your blood pressure 140/90 mm Hg or higher, OR you have been told by your doctor that your blood pressure is too high?
• Has your doctor told you that your total cholesterol level is 200 mg/dL or higher or your HDL (good cholesterol) is less than 40mg/dl?
• Has your father or brother had a heart attack before age 55 OR your mother or sister had one before age 65?
• Do you have diabetes OR a fasting blood sugar of 126mg/dl or higher, OR do you need medicine to control your blood sugar?
• Are you a man over 45 years of age?
• Are you a woman over 55 years old?
• Do you have a body mass index(BMI) score of 25 or more?
• Do you get less than a total of 30 minutes of physical activity on most days?
• Has a doctor told you that you have angina (chest pains), or have you had a heart attack?

If the answered "yes" to any of these questions, is yes, there exists an increased risk of having a heart attack. Source: Heart Disease in Women