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Tips to Prevent Heart Disease And Strokes

1. Take responsibility for your health.

Cardiovascular disease is the major cause of death in America, accounting for 34 percent of
deaths, many suddenly and almost all of them premature. This is down from 40 percent just
four decades ago, mainly due to treatment of common risk factors. If you have diabetes, your
risk increases dramatically. The best prevention against heart disease and stroke is to
understand the risks and treatment options. The greatest risk is ignorance or
misinformation. The first step is to take responsibility for your health.

2. Know your risks.

The most influential risk factor for cardiovascular disease is age – the older you are, the
greater your risk. The second is your genetic make-up. Although everyone is excited by the
scientific progress in genomics research, conclusive gene tests are still in their infancy. But,
as I tell our medical students, “A good family history is a poor man’s gene test.” We have long
known that if your parents, grandparents, or other relatives were afflicted with or died of
heart disease, diabetes or stroke, your risk is much greater.

3. Don’t smoke or expose yourself to second-hand smoke.

The evidence is overwhelming that cigarette smoking and second-hand exposure to smoke
increases the risks of heart disease, lung disease, peripheral vascular disease and stroke.

4. Maintain a healthy blood pressure.

High blood pressure, called hypertension, is known as “the silent killer” as it goes without
symptoms in most individuals. High blood pressure causes wear and tear of the delicate
inner lining of your blood vessels. The higher your blood pressure (BP) the greater your risk.
The risk begins to increase from a pressure of 115/70 mmHg and doubles for each 10 mmHg
increase in systolic (the larger number) and 5 mmHg increase in the diastolic (the smaller
number). Heredity and increasing age raise the risks. Measuring blood pressures at home
reflects more accurately your risk than having the blood pressure taken at a physician’s
office. It is worth the investment to get a cuffmeter.

It is best not to rely only on the readings at your doctor’s office as some individuals suffer
from “white coat” hypertension – their BP is up only when they are at the doctor’s office.
Others have “masked” hypertension – higher when not in the doctor’s office. Prognosis is
best related to home BP. But for home blood pressure readings, you should not use finger or
wrist units – only regular upper arm units.

5. Monitor your cholesterol (blood lipids).

Abnormal or high blood lipids (fats) are a major contributor to cardiovascular disease. Your
blood lipids include the LDL (bad cholesterol; remember as “Lousy cholesterol”), HDL (good
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” 7. exercise alone cannot control or reduce your weight – you must also modify your diet.” It is important to know that research data are often lacking for alternative medications. Plus.S. https://www. After all. wouldn’t we? The obesity rate in Americans is alarming. tea.0. remember as “Healthy cholesterol”) and triglycerides. Portion sizes and the amount of sugars in the American diet have dramatically increased over the past few Page 2 . There is a great interest in alternative medicine and understandably so. If you are at risk. Fad diets do not work. Abdominal obesity is the major risk.nhlbi. contributing to a near epidemic of diabetes. If any of them did. medication is almost always necessary to lower the LDL or to raise your HDL. 6. it can only decrease total blood cholesterol by about 10 percent. in general. The lack of exercise is contributing to the obesity epidemic in Americans. the better your prognosis. many take alternative medicines because of the way they are marketed. The problem with diet is that. It is good advice to “drink slim” (water. your risk is the same as someone who already had a heart attack. If you have diabetes. but a lot more from cholesterol produced by the liver and excreted into the digestive tract) and. The lower your LDL and the higher your HDL. finally.Tips to Prevent Heart Disease And Strokes cholesterol. Exercise does more than burn calories. none of which are regulated by the U. you might need diet as therapy. If higher. the amount absorbed from the intestinal tract (some from what you eat. nobody in their right mind would take arsenic simply because it is “natural. age – your cholesterol increases with age.nih. we all would be on THAT one. coffee). drug therapy is usually needed. exercise is one of the best treatments for depression and anxiety. 8. and those two miles of walking do not have to be done all at once. Use portion control before you start eating and push away from the table before you are “full. Limit your calories. it also activates genes that are beneficial to health in other ways. The mere fact that a substance is “natural” does not prove its health benefit. Pick your pills wisely. If you have a strong family history or elevated Lp(a) (a rare abnormal cholesterol that increases the risk). Obesity is caused by consuming more calories than your body burns. supplements and vitamins. because patients want to be empowered to take responsibility for their own health. Studies indicate that walking two miles a day is optimal for overall health. the daily amount of exercise has been decreasing. The amount of cholesterol in your blood is determined mainly by three factors: the amount produced by the liver (this is largely genetic). which is a cardiovascular disease. At the same time. However. Make exercise a daily habit. The ideal ratio of total cholesterol divided by HDL cholesterol is 3. Food and Drug Administration (FDA). However.

The situation can be especially confusing when scientific studies yield different or even contradicting results. Also. laughing. The only constant is change. 10. An overwhelming number of research studies that make it into scientific publications are poorly designed or yield data that are not representative. adequate sleep. to date none have been shown to decrease the risk of cardiovascular disease. Stay informed: Science changes constantly. if severe. try to avoid situations and people who make you anxious or angry. such as regular exercise. due to a lack of a sufficient number of participants. Stress contributes to cardiovascular disease and.g. when in fact they are not. striving for a good marriage. can cause a heart attack or sudden death. volunteering or attending religious services..nhlbi. Keep in mind that many studies are financed or sponsored by individuals or companies with a vested interest in gaining favorable results. such as fish oils and niacin (vitamin B). Watching TV generally does not relieve. There are some rare exceptions. This is especially true in medicine as new techniques and new insights develop constantly. There are plenty of options that help reduce stress. 9. Although some vitamins have been shown to possibly help some conditions. Do not believe every piece of “scientific information” you find in the media or advertisements.nih. e. It is also important to note that high doses of some vitamins may interfere or counteract the beneficial effects of some prescription drugs.Tips to Prevent Heart Disease And Strokes Do we ever prescribe alternative medicines? On occasion we do! The major risk with many alternative medications is that the patient thinks they are doing something to improve health. Reduce stress. but can aggravate Page 3 . and this happens quite often. Signs and Symptoms of Heart Disease https://www.

angina often occurs during routine daily activities. burning chest pain. https://www. The severity of angina varies. abdomen. A common symptom of CHD is Page 4 . only half of women who have heart attacks have chest pain.Tips to Prevent Heart Disease And Strokes Heart Disease Signs and Symptoms The illustration shows the major signs and symptoms of coronary heart disease. rather than while exercising.nhlbi. such as shopping or cooking. or back. In women who have coronary microvascular disease. Women can also have these angina symptoms. angina tends to worsen with physical activity and go away with rest. Women are more likely than men to have angina while they're resting or sleeping. Mental stress also is more likely to trigger angina pain in women than in men. But women also tend to describe a sharp. angina often feels like pressure or squeezing in the chest. throat. The pain may get worse or occur more often as the buildup of plaque continues to narrow the coronary (heart) arteries. Women are more likely to have pain in the neck.nih. However. Signs and Symptoms Coronary Heart Disease Complications Heart Attack The most common heart attack symptom in men and women is chest pain or discomfort. This feeling may extend to the arms. In men. In men. jaw. Angina is chest pain or discomfort that occurs when your heart muscle doesn't get enough oxygen-rich blood.

vomiting. indigestion. the heart can beat too fast. Some people describe arrhythmias as fluttering or thumping feelings or skipped beats in their chests.nhlbi. Men are more likely than women to break out in a cold sweat and to report pain in the left arm during a heart attack. Other heart attack symptoms are light-headedness and dizziness. Arrhythmias or cardiogenic shock also may occur. For example. legs.  Tests show no signs of blockages in the coronary arteries. which occur more often in women than men. Cardiogenic shock is a condition in which a suddenly weakened heart isn't able to pump enough blood to meet the body's needs. https://www. jaw. It means that your heart can't cope with the demands of everyday activities. Heart Failure Heart failure is a condition in which your heart can't pump enough blood to meet your body's needs. or with an irregular rhythm.  EKG (electrocardiogram) results don't look the same as the EKG results for a person having a heart Page 5 . too slow. these symptoms tend to occur suddenly in people who have no history of heart disease. Tips to Prevent Heart Disease And Strokes Women are more likely than men to report back or neck pain. Signs and Symptoms of Broken Heart Syndrome The most common signs and symptoms of broken heart syndrome are chest pain and shortness of breath. in people who have broken heart syndrome:  Symptoms occur suddenly after having extreme emotional or physical stress.nih. and veins in the neck. Heart failure also can cause swelling in the feet. Some arrhythmias can cause your heart to suddenly stop beating. nausea (feeling sick to the stomach). In this disorder. During an arrhythmia. ankles. or problems breathing. neck. Heart failure causes shortness of breath and fatigue that tends to increase with physical exertion. SCA causes loss of consciousness and death if it's not treated right away.)  Blood tests show no signs or mild signs of heart damage. the back. Heart attacks also can cause upper body discomfort in one or both arms. (An EKG is a test that records the heart's electrical activity. abdomen. Some of the signs and symptoms of broken heart syndrome differ from those of heart attack. Heart failure doesn't mean that your heart has stopped or is about to stop working. extreme fatigue (tiredness). Arrhythmia An arrhythmia is a problem with the rate or rhythm of the heartbeat. This condition is called sudden cardiac arrest (SCA). heartburn. These feelings are called palpitations. or upper part of the stomach.

painless test that detects and records the heart's electrical activity. Plaque- narrowed coronary (heart) arteries can't supply enough oxygen-rich blood to meet your heart's needs. As part of some stress tests. How is Heart Disease Diagnosed? Your doctor will diagnose coronary heart disease (CHD) based on your medical and family histories. Stress Testing During stress testing. When your heart is working hard and beating fast. These imaging stress tests can show how well blood is flowing in your heart and how well your heart pumps blood when it beats. he or she may recommend one or more of the following tests. A stress test can show possible signs and symptoms of CHD. you may be given medicines to increase your heart rate. it needs more blood and oxygen. https://www. If your doctor thinks you have CHD.nhlbi. a physical exam. other factors also can prevent you from exercising long enough (for example. An EKG can show signs of heart damage due to CHD and signs of a previous or current heart attack. No single test can diagnose CHD. your risk factors. and the results from tests and Page 6 .  Recovery time is quick. lung diseases. The test shows how fast the heart is beating and its rhythm (steady or irregular). Tips to Prevent Heart Disease And Strokes  Tests show ballooning and unusual movement of the lower left heart chamber (left ventricle). If you can't exercise.nih. such as:  Abnormal changes in your heart rate or blood pressure  Shortness of breath or chest pain  Abnormal changes in your heart rhythm or your heart's electrical activity If you can't exercise for as long as what is considered normal for someone your age. An EKG also records the strength and timing of electrical signals as they pass through the heart. anemia. EKG (Electrocardiogram) An EKG is a simple. usually within days or weeks (compared with the recovery time of a month or more for a heart attack). your heart may not be getting enough oxygen-rich blood. or poor general fitness). pictures are taken of your heart while you exercise and while you rest. However. you exercise to make your heart work hard and beat fast while heart tests are done.

gov/health/health-topics/topics/hdw/signs Page 7 .nih. Blood Tests Blood tests check the levels of certain fats. The tube is threaded into your coronary arteries. sugar. areas of heart muscle that aren't contracting normally. Abnormal levels may be a sign that you're at risk for CHD. The test provides information about the size and shape of your heart and how well your heart chambers and valves are working. groin (upper thigh). Special x rays are taken while the dye is flowing through your coronary arteries. and the dye is released into your bloodstream. During a heart attack. Blood tests also help detect anemia. and previous injury to the heart muscle caused by poor blood flow. The dye lets your doctor study the flow of blood through your heart and blood vessels. Coronary Angiography and Cardiac Catheterization Your doctor may recommend coronary angiography (an-jee-OG-rah-fee) if other tests or factors suggest you have CHD. A thin. the test doesn't detect coronary microvascular disease (MVD). heart muscle cells die and release proteins into the bloodstream. talk with your doctor about whether you might have coronary MVD. as well as lung disorders and other causes of symptoms not related to CHD. lungs. This is because coronary MVD doesn't cause blockages in the large coronary arteries. High levels of these proteins are a sign of a recent heart attack. and proteins in your blood. This test uses dye and special x rays to look inside your coronary arteries. It gives your doctor information about how well blood is flowing through your coronary arteries. https://www. Your doctor may ask you to fill out a questionnaire called the Duke Activity Status Index.Tips to Prevent Heart Disease And Strokes Echocardiography Echocardiography (echo) uses sound waves to create a moving picture of your heart. flexible tube called a catheter is put into a blood vessel in your arm. your doctor will use a procedure called cardiac catheterization (KATH-eh-ter-ih-ZA-shun). such as your heart. This questionnaire measures how easily you can do routine tasks. Coronary angiography detects blockages in the large coronary arteries. or neck. If so. Blood tests can measure the amount of these proteins in the bloodstream. and blood vessels. you may still have chest pain or other CHD symptoms. cholesterol. To get the dye into your coronary arteries. A chest x ray can reveal signs of heart failure. Chest X Ray A chest x ray creates pictures of the organs and structures inside your chest.nhlbi. Echo also can show areas of poor blood flow to the heart. a risk factor for CHD. Even if the results of your coronary angiography are normal. However.

 Lower the risk of blood clots forming. Tips to Prevent Heart Disease And Strokes Your doctor also may recommend other tests that measure blood flow in the heart.)  Widen or bypass plaque-clogged coronary (heart) arteries. How is Heart Disease Treated Treatment for coronary heart disease (CHD) usually is the same for both women and men. medicines. (Blood clots can cause a heart attack. The test produces both still and moving pictures of your heart and major blood vessels. consider joining a support group. For more information about how to quit smoking. and cardiac rehabilitation (rehab). Cardiac MRI uses radio waves." https://www.nih. Lung. Tests Used To Diagnose Broken Heart Syndrome If your doctor thinks you have broken heart syndrome. and a computer to create pictures of your heart as it beats. echo. Treatment may include lifestyle changes. and cardiac MRI. he or she may recommend coronary angiography. Other tests done during cardiac catheterization can check blood flow in the heart's small arteries and the thickness of the artery walls. Also. These changes may be the only treatment that some people need.  Reduce risk factors in an effort to slow. or reverse the buildup of plaque. Lifestyle Changes Making lifestyle changes can help prevent or treat CHD. and community groups offer classes to help people quit smoking. EKG. Quit Smoking If you smoke or use tobacco.nhlbi. workplaces. Other tests are also used to diagnose this Page 8 .  Prevent CHD complications. such as a cardiac MRI (magnetic resonance imaging) stress test. magnets. try to avoid secondhand smoke. and Blood Institute's (NHLBI's) "Your Guide to a Healthy Heart. Talk with your doctor about programs and products that can help you quit. stop. including blood tests. The goals of treatment are to:  Relieve symptoms. If you find it hard to quit smoking on your own. Smoking can raise your risk for CHD and heart attack and worsen other CHD risk factors. try to quit. go to the Health Topics Smoking and Your Heart article and the National Heart. Many hospitals. medical and surgical procedures.

Also. Research suggests that regularly drinking small to moderate amounts of alcohol may lower the risk of CHD.nhlbi. Solid fats are saturated fat and trans fatty acids. These foods can be fresh. Studies show that following the Dietary Approaches to Stop Hypertension(DASH) eating plan can lower blood pressure. Be Physically Active Regular physical activity can lower many CHD risk factors. In women. processed soy products. Physical activity also can lower your risk for diabetes and raise your HDL cholesterol level. For more information about following a healthy diet. Refined grains come from processing whole grains. or a small amount of hard liquor. A healthy diet includes a variety of vegetables and fruits. poultry without skin. Department of Agriculture'sChooseMyPlate. if you're planning to become pregnant. seafood. A good rule is to try to fill half of your plate with vegetables and fruits. (HDL cholesterol helps remove cholesterol from your arteries.S. A healthy diet also includes whole grains. which results in a loss of nutrients (such as dietary fiber). Also. If you drink alcohol. or dried. frozen. and peas. One drink a day can lower your CHD risk by raising your HDL cholesterol level. even one drink a day may raise the risk of certain types of cancer. beans.Tips to Prevent Heart Disease And Strokes Follow a Healthy Diet A healthy diet is an important part of a healthy lifestyle. beer. you shouldn't drink if you're pregnant. fat-free or low-fat dairy products.nih. high blood pressure. such as lean meats. canned. Women should have no more than one alcoholic drink a day. Web site. or if you have another health condition that could make alcohol use harmful. this isn't a recommendation to start using alcohol. go to the NHLBI's "Your Guide to Lowering Your Blood Pressure With DASH" and the U. and protein foods. like soda. Ask him or her how much and what kinds of physical activity are safe for you. Both resources provide general information about healthy eating. try to limit the amount of solid fats and refined grains that you eat. For Page 9 . If you don't drink. Try to avoid foods and drinks that are high in added sugars. drink water instead of sugary drinks. including high LDL cholesterol. One drink is a glass of wine. Too much alcohol can cause you to gain weight and raise your blood pressure and triglyceride level. Choose and prepare foods with little sodium (salt).) Talk with your doctor before you start a new exercise plan. seeds. do so in moderation. Too much salt can raise your risk for high blood pressure. https://www. and excess weight.

S. A BMI of less than 25 and a waist circumference of 35 inches or less is the goal for preventing and treating CHD. You can use the NHLBI's online BMI calculator to figure out your Page 10 . yoga. try to lose weight. relax. BMI measures your weight in relation to your height and gives an estimate of your total body fat. Medicines You may need medicines to treat CHD if lifestyle changes aren't enough. and cope with problems can improve your emotional and physical health. or overeating—aren't heart healthy. Your health care provider may refer you to a dietitian to help you manage your weight. smoking.nih. He or she may recommend counseling or prescribe medicines to help you manage the condition. Measure your waist just after you breathe out. such as feeling hopeless or not taking interest in daily activities. Cut back your calorie intake and do more physical activity. Stress and Depression Research shows that getting upset or angry can trigger a heart attack. The more active you are. and the NHLBI's "Your Guide to Physical Activity and Your Heart. Medicines can help:  Reduce your heart's workload and relieve CHD symptoms https://www. Physical activity. Tips to Prevent Heart Disease And Strokes People gain health benefits from as little as 60 minutes of moderate-intensity aerobic activity per week. go to the NHLBI'sAim for a Healthy Weight Web site. the more you will benefit. go to the U. some of the ways people cope with stress—such as drinking." Maintain a Healthy Weight Overweight and obesity are risk factors for CHD. For more information about losing weight or maintaining a healthy weight. Also. Eat smaller portions and choose lower calorie foods. If you're overweight or obese." the Health Topics Physical Activity and Your Heart article. Talk with your doctor if you have symptoms of depression. Make sure the tape is snug but doesn't squeeze the flesh. For more information about physical activity. Having supportive people in your life with whom you can share your feelings or concerns can help relieve stress. and relaxation therapy also can help relieve stress. To measure your waist. Department of Health and Human Services' "2008 Physical Activity Guidelines for Americans. Depression also makes it hard to maintain a heart healthy lifestyle. just above your hipbones. Walking is an excellent heart healthy exercise. or your doctor can help you. You may want to consider taking part in a stress management program.nhlbi. Depression can double or triple your risk for CHD. Learning how to manage stress. stand and place a tape measure around your middle.

A thin. Tips to Prevent Heart Disease And Strokes  Decrease your chance of having a heart attack or dying suddenly  Lower your LDL cholesterol. Both angioplasty and CABG are used as treatments. go to the NHLBI's Postmenopausal Hormone Therapy Web site. the balloon is inflated to compress the plaque against the wall of the artery. Take all of your medicines as prescribed.nhlbi. For more information about MHT. Most people who have broken heart syndrome make a full recovery within weeks. including lifestyle changes and medicines. and manage stress hormones. stroke. He or she may be able to provide other options. You and your doctor can discuss which treatment is right for you. blood pressure. Doctors may prescribe medicines to relieve fluid buildup. Women who have broken heart syndrome also may need medicines. is a nonsurgical procedure that opens blocked or narrowed coronary arteries. prevent blood clots.nih. Percutaneous Coronary Intervention Percutaneous coronary intervention (PCI). Menopausal Hormone Therapy Recent studies have shown that menopausal hormone therapy (MHT) doesn't prevent CHD. these studies tested MHT on women who had been postmenopausal for at least several years. If you have side effects or other problems related to your medicines. such as angioplasty (AN-jee-oh-plas- tee) or coronary artery bypass grafting (CABG) Women who have coronary microvascular disease and anemia may benefit from taking medicine to treat the anemia. current findings suggest MHT shouldn't routinely be used to prevent or treat CHD. Some studies have even shown that MHT increases women's risk for CHD. While questions remain. Page 11 . Once in place. Procedures and Surgery You may need a procedure or surgery to treat CHD. During that time. tell your doctor. This restores blood flow through the artery. and other CHD risk factors  Prevent blood clots  Prevent or delay the need for a procedure or surgery. treat blood pressure problems. commonly known as angioplasty (AN-jee-oh-plas-tee). However. they could have already developed CHD. Ask your doctor about other ways to prevent or treat CHD. flexible tube with a balloon or other device on the end is threaded through a blood vessel to the narrowed or blocked coronary artery. Research is ongoing to see whether MHT helps prevent CHD when taken right when menopause starts. and breast cancer.

try to avoid secondhand smoke. A small mesh tube called astent usually is placed in the artery to help keep it open after the procedure. CABG can improve blood flow to your heart. physical and occupational therapists. The cardiac rehab team may include doctors. Your exercise plan will be based on your personal abilities. This part of rehab helps you understand your heart condition and find ways to lower your risk for future heart problems. and interests. nurses. Talk with your doctor about programs and products that can help you quit. This part of rehab helps you learn how to exercise safely. exercise specialists. counseling. needs. Almost everyone who has CHD can benefit from cardiac rehab. For more information. Cardiac rehab is a medically supervised program that can improve the health and well-being of people who have heart problems. Also. CABG. Cardiac Rehabilitation Your doctor may prescribe cardiac rehab for angina or after angioplasty. and improve your stamina. Cardiac rehab has two parts:  Exercise Page 12 . strengthen your muscles. relieve chest pain.nhlbi. https://www. if you smoke. and possibly prevent a heart attack.  Education. Coronary Artery Bypass Grafting CABG is a type of surgery. For example. One step you can take is to adopt a heart healthy lifestyle. Tips to Prevent Heart Disease And Strokes PCI can improve blood flow to your heart and relieve chest pain. go to the Health Topics Coronary Artery Bypass Grafting article. a surgeon removes arteries or veins from other areas in your body and uses them to bypass (that is. dietitians or nutritionists. go to the Health Topics PCI article. How can heart disease be prevented Taking action to control your risk factors can help prevent or delay coronary heart disease (CHD). and psychologists or other mental health specialists. For more information. Smoking can raise your risk for CHD and heart attack and worsen other CHD risk factors. Your risk for CHD increases with the number of CHD risk factors you have. A heart healthy lifestyle should be part of a lifelong approach to healthy living. go around) narrowed or blocked coronary arteries. and training. The rehab team will help you learn how to cope with the stress of adjusting to a new lifestyle and with your fears about the future. or a heart attack. try to quit. During CABG.

If lifestyle changes aren't enough. and Blood Institute's (NHLBI's) "Your Guide to a Healthy Page 13 . you also may need medicines to control your CHD risk factors. Take all of your medicines as prescribed. such as lean meats. which results in a loss of nutrients (such as dietary fiber). go to the Health Topics Smoking and Your Heartarticle and the National Heart. added sugars." Following a healthy diet also is an important part of a healthy lifestyle. and peas. It also includes whole grains. nuts. Solid fats are saturated fat and trans fatty acids. A healthy diet is low in sodium (salt). https://www. and refined grains. go to the Health Topics Physical Activity and Your Heart article and the NHLBI's "Your Guide to Physical Activity and Your Heart. Lung. seeds. Physical activity can improve your fitness level and your health. processed soy products. Talk with your doctor about what types of activity are safe for you. fat-free or low-fat dairy products.nhlbi. Be as physically active as you can. For more information about physical activity. seafood.Tips to Prevent Heart Disease And Strokes For more information about quitting smoking. poultry without skin. The NHLBI's Therapeutic Lifestyle Changes (TLC) and Dietary Approaches to Stop Hypertension (DASH) are two programs that promote healthy eating. Refined grains come from processing whole grains.nih. If you or someone in your family has CHD. If you're overweight or obese." Know your family history of CHD. A healthy diet includes a variety of vegetables and fruits. and protein foods. Controlling your weight helps you control CHD risk factors. be sure to tell your doctor. work with your doctor to create a reasonable weight-loss plan. solid fats. beans.