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When it comes to heart disease, you might think you’re either destined to get it or not. But the truth is, heart disease is largely preventable—by some estimates, up to 60 percent of cases can be prevented—if you follow a healthy, balanced lifestyle and take the right medications.
“There’s been a revolution in preventive cardiology,” says Richard Stein, M.D., spokesperson for the American Heart Association and director of preventive cardiology at Beth Israel Medical Center in New York City. “It’s a whole new game and to win the new game, you have to know and follow the new rules.”
Rule number one is to know your cholesterol, blood pressure, and blood sugar levels, for starters. That way you can lower the elevated levels with lifestyle adjustments, as well as medications, if need be. If you smoke cigarettes—a habit that can double to quadruple your risk of developing heart disease—the solution is simple: Quit.
Other everyday factors—including what you eat, how much physical activity you get, and how you handle stress—can also affect your chances of developing heart disease.
According to the latest American Heart Association guidelines, your best bet is to reduce your intake of saturated fats (to less than 7 percent of total calories) and trans fats (to less than 1 percent of total calories); have lots of vegetables, fruits and whole grains; include lowfat dairy products; consume lean protein and fish, especially oily fish (such as salmon, trout and herring, which are high in omega-3 fatty acids) at least twice a week; and minimize consumption of sugary foods and drinks. Consuming alcohol in moderation (defined as one drink per day for women, two for men) can also benefit your heart.
These recommendations are very similar to the Mediterranean diet, Dr. Stein points out, and “people seem to live longer with the Mediterranean diet.”
Indeed, a study at Wageningen University in the Netherlands found that adults between the ages of 70 and 90 who stuck to a Mediterranean diet as part of a healthful lifestyle had a 50 percent lower rate of all-cause mortality. And the Mediterranean diet—which is rich in fruits, vegetables, whole grains and heart-protective monounsaturated fats like olive oil—has been found to have favorable effects on blood lipid levels, blood pressure, insulin resistance (a precursor to diabetes), metabolic syndrome, antioxidant levels and other crucial aspects of health.
“Exercise is the single best proactive thing you can do,” Dr. Stein says. While the official American Heart Association recommendation is to aim for at least 30 minutes of physical activity daily, more is better, he says: “To get your [heart disease] risk as low as possible, it’s best to expend 2,000 calories through moderate to vigorous exercise per week—this is the equivalent of four to five hours of exercise for most people.”
Fortunately, sticking with a heart-healthy diet and exercising regularly can help you control your weight, which is important because being overweight increases your risk of developing heart disease. “You want your body mass index (BMI) to be under 25,” says Gerald Fletcher, M.D., a preventive cardiologist at the Mayo Clinic in Jacksonville, FL, “but you can still have a normal BMI and have abdominal obesity. That needs to be looked at very carefully because you’re at increased risk [for heart disease].”
It’s also important to get plenty of sleep—most adults need seven to nine hours—for the sake of your heart, Dr. Stein says. A recent study at the Columbia University College of Physicians and Surgeons in New York City linked short sleep duration—five hours or less per night—with an increased risk of developing high blood pressure. Meanwhile, other research has linked sleeping less than the optimal amount with a higher BMI and an increased risk of obesity.
Here’s another smart move: taking care of your emotional well-being. Research increasingly suggests that depression, anger and stress can all take a toll on your heart health.
In a study at the Karolinska Institute in Sweden, researchers found that adults between 25 and 50 who were diagnosed with depression had an increased risk of developing heart disease later in life. “Being depressed is such a major risk factor for having early heart attacks and heart disease,” Dr. Stein says. “We’ve just begun to appreciate how powerful a predictor it is—it’s on par with high blood pressure and smoking.”
One reason for this link may be that depression is associated with greater activation and stickiness of platelets, which can increase your risk of clotting. When you’re depressed, your body also secretes more of the stress hormone cortisol, which raises the risk of developing atherosclerosis. Plus, research suggests that psychosocial stress is a more common trigger for sudden cardiac arrest in women, while physical exertion is a more common trigger for men.
Fortunately, exercise has been proven to be useful as both a stress management tool and as a treatment for depression. Learning meditation or the relaxation response may help. And if you’re feeling depressed, be sure to talk to your doctor. He or she can screen you for depression and, if needed, prescribe antidepressants and/or psychotherapy.
Sources: Journal of the American Medical Association, Sept. 2004; Nutrition Review, Feb. 2006; Nutrition, May 2006; Hypertension, May 2006; Sleep, Oct. 2005; American Journal of Preventive Medicine, Dec. 2005.
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