ADOPTING HEALTHFUL HABITS AND WORKING WITH YOUR DOCTOR to manage chronic conditions that increase your risk for heart disease can keep you from being among the thousands of Americans who will die of heart attacks this year.

“The most important risk factors for heart disease also are the most correctable, and you can significantly reduce them by lifestyle changes, taking medication or both,” says Clyde Yancy, M.D., an associate professor of medicine/cardiology at the University of Texas Southwestern Medical School in Dallas, and spokesman for the American Heart Association (AHA).

Taking the following steps can significantly reduce your risk for heart disease and may reduce its progression.

Prevention Essentials

• Maintain healthful cholesterol levels. High cholesterol is one of the major risk factors for heart disease. Your risk for a heart attack more than doubles if your level reaches 240 mg/dl. You can lower your cholesterol through diet and exercise and by taking cholesterol-lowering medications called statins.
• Control high blood pressure. People with high blood pressure are two to three times more likely to develop congestive heart failure than people with normal blood pressure. Work with your doctor to keep yours within healthy levels through diet, exercise and medication, if needed.
• Manage diabetes. Diabetics are two to four times more likely than other people to have a heart attack. Check your blood sugar levels and work to keep them within healthful limits through diet, exercise and medications.
• Attain and maintain a healthful weight. Obesity increases cholesterol, blood pressure and the risk for diabetes — all high risk factors for heart disease.
• Take aspirin. Studies show taking a single 81 mg. “baby” aspirin every day reduces the risk for a heart attack by 30 to 50 percent.

  “Ask your doctor if you should take aspirin on a daily basis,” says Yancy. “Unless you have stomach problems or you’re allergic to aspirin, the answer will probably be yes.”

• Quit smoking. Smoking damages the heart by raising blood pressure, damaging blood vessels and promoting the buildup of fatty plaque in arteries. Quitting smoking is the best thing you can do to prevent a heart attack.
• Exercise as many days as you can. Studies show exercise reduces the risk for a heart attack by up to 50 percent — more than the best cholesterol-lowering drug. And it doesn’t take much: just a few hours a week, according to the AHA.

Dietary Directions

• Eat more fish, less red meat. Meat’s saturated fat clogs arteries. But fatty fish such as salmon and mackerel are rich in omega-3 fatty acids that help your heart maintain a steady rhythm. Having even one fish serving a week could reduce your risk for death from a heart attack by 52 percent. The AHA recommends people with heart disease eat fish at least once a week.
• Start your day with fruit juice. Orange juice contains folic acid, which helps lower levels of homocysteine, a heart attack risk factor. Grape juice is loaded with flavonoids and resveratrol, both potent antioxidants that may discourage red blood cells from clumping together and blocking an artery.
• Get more than five a day. Aim for eating at least five to nine servings of fruits and vegetables every day.
• Eat the right fats. Monounsaturated fats, such as olive oil and canola oil, and omega-3 fats from fish are heart-healthy. Saturated fat (found in butter, red meat and cheese) and trans fats (found in margarine, commercial baked goods and fried fast foods) increase your risk for heart disease.
• Eat high-fiber foods. Studies show that the more fiber you eat, the less likely you are to have a heart attack. Load up on whole-grain breads and cereals that contain whole wheat, wheat bran and oats.
• Avoid margarine and butter. “The trans fatty acids in margarine and the saturated fat in butter both clog your arteries,” says Yancy. “Instead, try one of the spreads that contain cholesterol- lowering sterols. They can lower your cholesterol up to 14 percent.”
• Try some flaxseed. Flaxseed is a potent source of heart-healthy omega-3 fatty acids. Studies show eating flaxseed can reduce the development of heart disease by keeping red blood cells from clumping together and forming clots that can block arteries. Sprinkle some on cereal, yogurt, steamed vegetables or salad.
• Ask your doctor about alcohol. For many people, drinking 1 to 3 oz. of alcohol a day reduces the risk for a heart attack.

  “People with high blood pressure and certain other diseases should avoid alcohol, however, so ask your doctor before starting this regimen,” says Yancy.

• Consider vitamins. Ask your doctor if you should take a multivitamin supplement with antioxidants. Research has found people who take multivitamins may reduce their risk for heart disease by 24 percent.

Manage Your Mental Health

• Manage stress. Stress increases your risk for heart disease and accelerates its progression by raising blood pressure. Find ways to reduce your stress on a daily basis.
• Attend to your spiritual life. People who meet with a faith community live longer and are less likely to have a heart attack.
• Spend time with others. Strong connections to family, friends and others in your community reduce anxiety and depression — two factors that increase your risk for a heart attack.
• Count to 10. Losing your temper can double your risk for a heart attack within the next two hours.

  “Managing your anger and lowering your anger threshold can reduce your risk for heart attack,” says Yancy.

Barbara Floria spoke with Clyde Yancy, M.D., an associate professor of medicine/cardiology at the University of Texas Southwestern Medical School in Dallas, and spokesman for the American Heart Association (AHA). For more information, visit www.americanheart.org.

Heart Disease by the Numbers
Several medical tests can predict your risk for heart disease. Compare your test results with those below and work with your doctor to bring your results in line with the optimal targets given below.

• Cholesterol, total: <200 mg/dl
• Cholesterol, LDL: <130 mg/dl
• Cholesterol, HDL: > 35 mg/dl
• Blood pressure: < 120/80 mm/Hg
• Diabetes: fasting blood sugar < 110, HgA1c<6%
• Electrocardiogram (ECG, EKG): normal rhythm, no evidence of hypertrophy
• Echocardiogram: no evidence of enlargement of any chamber or thickening of any chamber wall
• Stress test: No evidence of abnormal cardiovascular function with a maximal effort; ability to exercise an appropriate amount during the test
• Weight: within 5 percent of ideal body weight
• Homocysteine: < 10
• C-reactive protein: <1.0
• Brain naturetic peptide: < 100

Source: Before it Happens to You: A Breakthrough Program for Reversing or Preventing Heart Disease by Jonathan Sacker Bernstein, M.D., Da Capo Press, 2004, $26.

© Health Ink & Vitality. Information is the opinion of the sourced authors and organizations. Personal decisions regarding health, diet, and exercise should be made only after consultation with the reader's own medical advisers. This material may not be reproduced for redistribution without written permission from Health Ink & Vitality.