February is Heart Health Month! Are You at Risk?

February highlights heart health focusing on the prevention of heart disease.  Heart disease continues to be the number 1 killer of both men and women in the United States, accounting for about 30% of total deaths per year.

No one single factor "causes" heart disease, however, predictive risk factors that can help identify individuals at the highest risk for a cardiac event, including heart attack, stroke, or atherosclerosis. Some of our risk factors are inherited or can result from aging, however, most risk factors are a result of our lifestyle choices.

There are some risk factors that are inherited. These include being male and over 45 years old. Being male doesn't cause heart disease but increases cardiac risk at an earlier age than females. Females have an elevated risk for heart disease after age 55. In addition, being African American increases risk for high blood pressure and stroke, while Caucasians are at a higher risk for heart attacks. Family history is also important in assessing heart disease risk, especially of a parent had a cardiac event before the age of 40 years old.

The good news is that most of our risk factors are daily choices that we make!

What Are the Risk Factors for Heart Disease That I Can Control?

1. Tobacco Use: Smoking cigarettes or using smokeless tobacco products cause vasoconstriction of blood vessels, contributing to hypertension or high blood pressure. It also lowers the levels of oxygen that reach our cells and also contributes to lung disease. Smoking is a choice that increases heart disease risk.

2. Uncontrolled Hypertension:  High blood pressure is associated with increased occurrence of cardiac events.  The good news is that hypertension can be controlled with one or more of the following treatments, including lowering sodium intake to 1500 mg per day, weight management, exercise, stress management techniques, and sometimes prescription medications.  As a Registered Dietitian, I recommend the least invasive strategies first such as a therapeutic nutrition program as well as an exercise regimen.  If elevated blood pressure continues to persist, it may be time to consider a more aggressive approach, such as medication.  The most important factor to consider with your health care professional is the most effective way to control your blood pressure.

3. Elevated Blood Cholesterol:  Like the other risk factors, high cholesterol does not cause heart disease, but it is a significant risk factor and predictor of future disease. More than100 million Americans have increased cholesterol, or roughly half of the US population. Cholesterol can only be assessed by obtaining a blood sample, typically at your doctor's office or clinic. Total blood cholesterol levels should be less than 200 mg/dL. Individuals with cholesterol levels more than 240 mg/dL are at twice the risk of a heart attack. The most effective ways to lower blood cholesterol levels to maintain calorie control (not consuming more calories than you need to maintain a healthy weight), decreasing added sugar consumption, and controlling fat intake. It is important to note that we make cholesterol in the body. In fact, approximately one third of the cholesterol found in our blood is contributed to our liver's ability to produce its own cholesterol from fatty acids. Some individuals are highly "efficient" cholesterol producers and produce more cholesterol in the liver than what is normally expected. Like hypertension, it is important to control hyperlipidemia or fats in the blood and sometimes it is necessary to include the use of statin medications, a classification of medications that help to help lower cholesterol. Your best option to decrease your cholesterol should be discussed with your health care provider. Generally, a combination of treatments is most effective.

4. Physical Inactivity: It has been said that "Sitting is the new smoking”, Exercise is very important to the prevention of heart disease. It has been shown to be a vasodilator and helps to open up blood vessels, lowers blood pressure, lowers stress levels, lowers cholesterol, and contributes to the maintenance of a healthy weight. All types of exercise are beneficial and should be included in a healthy regimen including aerobic activity such as walking, strength training such as light weight lifting, and flexibility and stretching. There is really no downside to exercise.

5. Being overweight or obese: Having an elevated weight or BMI greater than 25 is an indicator of being overweight or obese. Excess body weight is also a risk factor for the development of heart disease, especially if it is centered around the trunk of the body, imagine an "apple" shape versus a "pear" shaped individual. Typically, individuals with a "big belly" are at higher risk than those with a "big bottom. Exercise, diet, and stress management can all be helpful in achieving a healthy weight.

6. Having Diabetes: Diabetes mellitus or having “elevated sugar” also increases the chances of having a cardiac event. Type 2 Diabetes Mellitus or adult onset is typically associated with high BMI, obesity, low levels of physical activity, increased insulin resistance, and poor carbohydrate metabolism. Controlling blood sugar levels, exercise, and weight management are all priorities in helping to manage this risk factor.

7. Uncontrolled Stress: Stress is a factor in everyone's life. Some people handle stress better than others. There are many effective strategies to deal with stress including yoga, meditation, and exercise. Poor ways of dealing with stress including "eating your feelings", internalizing feelings, and self-medicating with drugs or alcohol. Sometimes counseling or therapy may be helpful.

8. Alcohol Usage: Moderation for alcohol means 1 drink per day or less for a female and 2 drinks per day or less for a male. Alcohol intake above a moderate level increases cardiac risk, particularly increased hypertension leading to higher risk for stroke. Alcohol also is a significant calorie source and can increase body weight and body fat.

Managing your risk factors for heart disease is the most important thing you can do to prevent this devastating disease. The best part is that your heart health can be managed by your daily choices!