7 Habits for a Healthy Heart

Worldwide, heart disease and strokes are the leading causes of death. They’re also the leading killers of Americans, accounting for one out of every three deaths in the United States. But there’s good news, too. About 80 percent of all cases of cardiovascular disease are preventable. You can lower your risk markedly by making some changes to your lifestyle including doing some things that are easy, simple and even enjoyable. (Two of our favorites? Drink red wine and get a dog.) Here’s what you need to know about heart health, along with some of the best ways to improve and protect yours.

Take Control

Good news. There are many things that you can do to lower your heart disease risk. 

In 2010, a committee of experts with the American Heart Association came up with a strategic plan to reduce cardiovascular disease in the United States. The committee pored over the scientific literature and identified seven of the most important behaviorspeople can follow to protect their cardiovascular health.

  1. Exercise
  2. Eat right
  3. Lower blood pressure
  4. Lower your cholesterol
  5. Know your blood sugar
  6. Maintain a healthy weight
  7. Don’t smoke

“What accrues to people who maintain that package of seven things at more optimal levels is really quite amazing – it’s sort of like the fountain of youth,” said Dr. Donald Lloyd-Jones, a cardiologist at the Northwestern University Feinberg School of Medicine and the chairman of the heart association committee. “They are much healthier and they have a substantially better quality of life.” So what are the major things you can do?

Regular exercise improves nearly every aspect of your health.

Dr. Michael Emery, a sports cardiologist, tells his patients that there is one magic pill that can improve nearly every aspect of your health and well-being, and especially your cardiovascular health. “It’s just that you can’t swallow it, you have to earn it,” said Dr. Emery, an assistant professor of clinical medicine at the Indiana University School of Medicine.

That magic pill is exercise.

Scientists have long known about its ability to protect heart health. Some of the first hints came in the 1950s when studies showed that the conductors of London’s double-decker buses had lower rates of coronary heart disease than the drivers, and that English mail carriers had less heart disease than sedentary telephone operators at the same company. Since then large studies have consistently found a strong and inverse relationship between physical activity and heart disease. Clinical trials have also shed light on the precise reasons exercise strengthens the heart:

  • It enhances the cardiorespiratory system.
  • It increases HDL cholesterol.
  • It lowers triglycerides, a type of fat that circulates in the blood.
  • It reduces blood pressure and heart rate.
  • It lowers inflammation and improves blood sugar control.
  • It increases insulin sensitivity.

Best of all, exercise is the type of medicine that appears to produce benefits no matter how small the dose.

Get Your Blood Pressure Checked

Make sure your heart isn’t working harder than it should be.

High blood pressure, also known as hypertension, puts mechanical stress on the walls of your arteries, causing them to narrow and stiffen. The stress can increase the development of plaque and ultimately cause your heart muscle to get weaker and thicker over time. It can also cause blood vessels in your brain to rupture, leading to a stroke. Ideally your blood pressure should be no higher than 120/80. The top number is your “systolic” pressure, the pressure when your heart is contracting, and the lower number is your “diastolic” pressure, when your heart is at rest. Keeping those numbers in check is critical. Hypertension is a leading cause of heart attacks, and the single-most important risk factor for strokes. Almost a third of the adult population in the United States has the condition but about 20 percent of them don’t know it.

You’re especially vulnerable to hypertension if you:

  • Are older. The prevalence of the disease increases sharply with age, from 7.3 percent of people between 18 and 39 to as high as 65 percent of people 60 and over.
  • Are black. About 40 percent of black adults have the condition, compared with 28 percent of non-Hispanic whites, 25 percent of Asian Americans and 26 percent of Hispanic adults.
  • Have diabetes. Two thirds of adults with Type 2 diabetes have hypertension.
  • Have other, complicating conditions, such as sleep apnea, kidney disease, obesity, high levels of stress and heavy alcohol consumption. When your blood pressure climbs above 120/80, you may have pre-hypertension. If your blood pressure reaches or exceeds 140/90, then you have full-blown hypertension. Blood pressure fluctuates throughout the day. It can rise or fall in response to caffeine, stress, alcohol or even the last meal you ate. So you need to measure it on at least two or more occasions to get an accurate idea of your average blood pressure. If your numbers are consistently high then the importance of getting your blood pressure down into the normal range can’t be overstated.
HOW TO LOWER YOUR BLOOD PRESSURE

If you have hypertension, here are some things you can do to improve your numbers:

  • Lose weight. The famous, long-running Framingham Heart Study found thatex cess weight accounted for roughly 26 percent of all cases of hypertension in men and 28 percent of cases in women. Being overweight increases the amount of work your heart has to do to pump blood throughout your body.
  • Moderate your alcohol intake. Overconsumption can increase blood pressure. So try to consume no more than two drinks a day if you’re a man and one drink a day if you’re a woman.
  • Exercise. Not surprising, right? A meta-analysis of randomized controlled trials published in the Journal of the American Heart Association found that both aerobic exercise and resistance training significantly lower systolic and diastolic blood pressure.
  • Watch your salt and your sugar intake. The World Health Organization recommends keeping your salt intake to no more than five grams per day to reduce hypertension. The average intake in many countries is double that amount. Studies have found that a high sugar intake is also linked to hypertension.
A Heart Healthy Diet

Don’t get confused by conflicting studies on the best foods to eat — keep things simple with a straightforward system.

UNDERSTANDING THE RESEARCH

Nutrition and its effects on heart health tends to ignite heated debate. The problem is that many of the claims about which foods and diets are best for you are based on weak evidence. But there is a way to simplify things that cuts through all the noise and confusion, said Dr. Dariush Mozaffarian, a cardiologist and dean of the Tufts Friedman School of Nutrition Science and Policy. Dr. Mozaffarian has published numerous studies on foods and cardiovascular risk and has singled out foods that are backed by hard data from rigorous clinical trials. Ultimately he has found that most foods can be separated into three categories:

  1. Those that are good for your heart.
  2. Those that are bad for you.
  3. Those that are essentially neutral.

Foods that you should seek out and eat often:

  • Plant life, such as nuts, seeds, legumes, whole grains, beans and avocados.
  • Fruits and vegetables with no added sugar or preservatives.
  • Seafood, including shellfish and especially oily fish like wild salmon, sardines and mackerel. (Mercury levels can be high in some kinds of fish, so learn which types are of particular concern.)
  • Fermented foods, like yogurt, kimchi and tempeh.
  • Healthy fats like olive oil.

You’ll see that the “good” category contains a lot of  plant-based foods. “These are foods that contain bioactive phytochemicals that are there to help protect a plant’s new life,” Dr. Mozaffarian said. “They have things that our bodies need as we age. We need their anti-inflammatory, pro-health phytochemicals and nutrients.” This first category also contains some other foods that have been shown in compelling studies to be strongly beneficial, like fish, which contains omega-3 fatty acids, and yogurt, which has probiotics that support gut health.

Foods to avoid:

  • Foods with added sugar, such as soft drinks, fruit juices and candy.
  • Refined carbohydrates such as breakfast cereals, granola, white bread, bagels, crackers and pasta.
  • Processed meats, such as deli meats, salami, hot dogs and ham.
  • Packaged foods that are loaded with salt, sugar, trans fats, preservatives and other additives and artificial ingredients. Some examples are frozen entrees, potato chips, chicken nuggets, granola bars, microwaveable meals, canned soups, instant noodles and boxed snacks.
Maintain a Healthy Bodyweight

It’s not just excess fat, but the type of excess fat that contributes to your heart risks.

ANOTHER REASON TO REDUCE YOUR POUNDS

Excess body fat isn’t just dead weight. Fat cells release many substances that increase inflammation, promote insulin resistance and contribute to atherosclerosis, the hardening of arteries. So it should be no surprise that obesity is among the leading causes of cardiovascular morbidity and mortality. That is especially the case for people who have a lot of visceral fat, the type that accumulates deep inside your abdomen around your internal organs. Visceral fat is much more dangerous than subcutaneous fat, the kind that resides just below your skin (you can pinch your subcutaneous fat with your fingers). It’s not entirely clear why but visceral fat is far more toxic to your body and especially to your cardiovascular system. An easy way to get a sense of the amount of visceral fat you carry and your risk is by measuring your waist circumference. According to Harvard Medical School, here’s how to interpret your waist circumference to determine if you’re in the healthy range.

For Women

  • Low Risk:  31.5 inches or less
  • Intermediate Risk:  31.6 to 34.9 inches
  • High Risk:  35 inches or greater

For Men

  • Low Risk:  37 inches or less
  • Intermediate Risk:  37.1 to 39.9 inches
  • High Risk:  40 inches or greater
WHY B.M.I. DOESN’T ALWAYS WORK

Another barometer you can use to determine your amount of visceral fat is your body mass index, or B.M.I. This calculation estimates your body fat based on your height and weight. You can determine your number by using the N.I.H.’s B.M.I. calculator.

The American Heart Association defines an optimal B.M.I. as one that is below 25, which is the threshold for being overweight. But keep in mind that B.M.I. is a blunt instrument. People who have a lot of muscle mass, for example, might have a B.M.I. over 25 even if they have a low body fat percentage. And people who are thin but carrying a lot of visceral fat might have a B.M.I. under 25 even though they are technically high risk.

Having a normal B.M.I. is a good starting point but it doesn’t necessarily mean you’re in the clear. Dr. Gina Lundberg, an assistant professor of medicine at Emory University School of Medicine and clinical director of the Emory Women’s Heart Center, said she has patients who are “skinny fat”: They have a normal B.M.I. but their blood pressure is high, they have low muscle tone and their cholesterol and other heart disease risk factors are out of whack. Dr. Lundberg said that having a normal B.M.I. does not mean you don’t have to be health conscious. “Just because someone looks healthy on the outside does not necessarily mean that they’re healthy,” she added. “They still have to go to the doctor, have an examination and be evaluated.”

Avoid Tobacco

Smoking and the use of tobacco products isn’t just bad for your lungs, it’s bad for your heart, too. 

JUST DON’T SMOKE

This one should be a no-brainer. But it can’t be stressed too highly because it’s still an extremely common cause of heart disease. In fact, the American Heart Association found that many top experts rank smoking and use of tobacco products as the most important cardiovascular risk factor. The rate of tobacco use in the United States peaked more than a half century ago, when almost one in two adults were smokers. Decades of public health efforts have helped lower that number significantly. But today roughly 36.5 million Americans – equivalent to about 15 percent of the population – continue to smoke. That is still a lot of people.

It’s the reason smoking remains the single largest preventable cause of death and disease in the country. Nationwide, it causes about one in every five deaths annually. If you’re among those who smoke or use tobacco, even occasionally, then cutting the habit could drastically improve your health. Smoking causes emphysema, cancer, gum disease, and harms nearly every organ in your body. And it’s particularly toxic to the heart. Tobacco smoke damages blood vessels. It increases blood pressure, lowers your HDL cholesterol and causes peripheral artery disease and atherosclerosis. Smokers have double the risk of having a heart attack, and triple the risk of having a stroke compared with nonsmokers. E-cigarettes have also been linked in preliminary research to increased cardiovascular risks.

Quitting will immediately lower your risk. Studies have found that smokers who have heart disease experience a 50 percent reduction in subsequent heart attacks or sudden cardiac death when they quit.

Honorable Mentions

Working to prevent heart disease doesn’t mean focusing only on the big things. There are plenty of other things you can do – some small, some fun, some weird, and some mundane – that can boost your cardiovascular health.

GET A PET

Several years ago a panel of heart experts reviewed decades of data on the cardiovascular benefits of owning pets. They concluded that there was evidence from both large observational studies and small clinical trials that owning pets, and dogs in particular, could lower your risk of heart disease. Why? It could be a lot of things. For one, people who own dogs are more likely to get outside and take walks. But studies have also found that dog and cat owners tend to form such strong bonds with their pets that being around them lowers their heart rates and blunts the owners’ responses to stressful events.

REDUCE STRESS

Stress is normal. It’s a part of life and can even be good for you in small doses. Exercise for example is a type of short-term stress that improves health. But chronic stress, especially the mental and emotional kind, can take a toll on your heart. It can depress your immune system, increase your risk of high blood pressure, and eventually contribute to heart attacks and strokes. While stress is unavoidable in modern life, it doesn’t have to make you sick.

OPTIMIZE YOUR SLEEP

Do you snore? Do you find yourself tired and fatigued throughout the day? Do you have difficulty concentrating, irritability and decreased alertness? Do you find you can’t get through the day without a steady stream of caffeine? These are some of the signs that you might have a sleep disorder, an issue that afflicts an estimated one-third of the country. A sleep disorder can not only impair your quality of life, but significantly impact your cardiovascular health. Sleep apnea in particular – a condition in which a person experiences pauses in breathing at night – is strongly linked to heart disease.According to Harvard Medical School, untreated sleep apnea can increase your risk of dying from heart disease nearly fivefold.

Dr. Lundberg at Emory said that the importance of getting a good night’s sleep to protect your heart is often overlooked. “If you wake up not feeling refreshed or your partner says they hear you snoring, that needs to be evaluated at the doctor,” she said. “It could be causing serious heart problems.”

MEDITATE

In recent decades, many studies have looked at the effects of meditation on cardiovascular risk factors. While the research is not definitive, there is some evidence that meditation can lower blood pressure and blunt the body’s response to stress.The best part about meditation is that it’s easy to learn and has no side effects. It can also help with many other aspects of health (including sleep). So why not give it a try?

Source – nytimes.com

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