Priorities in Lowering the Risk of Heart Disease

Dr. David Lipschitz
Wed, 11 Feb 2015 21:00:00 -0800
Lifestyle

Heart disease is the leading cause of death in the developed world. Although occurring at a later age, heart disease is just as common in women as in men. Despite this fact, fewer than 1 in 5 women believe that heart disease is a significant health threat even though 1 in 3 deaths in women each year is from heart disease, which is more than from all causes of cancer combined.

While every adult is at high risk for heart disease, there are a series of factors that increase the chances of heart disease substantially. The disease is much more common in men than in women until menopause, after which time the risk is essentially the same. And with each advancing year heart disease becomes more common. A strong family history of heart disease, particularly if symptoms occur under the age of 50, cigarette smoking, elevated cholesterol, high blood pressure, a sedentary lifestyle and obesity, all substantially increase heart disease risk. Heart attacks and other forms of heart disease are much more common in women with diabetes, but for reasons that are ill understood, diabetes does not have a similar impact in men. And anxiety and high levels of stress do not bode well for preventing heart attacks.

For most adults, an assessment of cardiac risk should be done at age 30. Occasionally, markedly elevated cholesterol is identified, necessitating the need for treatment. Blood pressure should be measured at least annually, and if elevated, approaches to bringing the levels to normal is a must. Hypertension may or may not require treatment with medications. Screening for diabetes should be done every five years until age 60 and more frequently thereafter. Whenever a routine physical is done, time should be spent counseling on how to live long, age well and prevent heart disease.
Updated: Thu Feb 12, 2015

Heart disease is the leading cause of death in the developed world. Although occurring at a later age, heart disease is just as common in women as in men. Despite this fact, fewer than 1 in 5 women believe that heart disease is a significant health threat even though 1 in 3 deaths in women each year is from heart disease, which is more than from all causes of cancer combined.

While every adult is at high risk for heart disease, there are a series of factors that increase the chances of heart disease substantially. The disease is much more common in men than in women until menopause, after which time the risk is essentially the same. And with each advancing year heart disease becomes more common. A strong family history of heart disease, particularly if symptoms occur under the age of 50, cigarette smoking, elevated cholesterol, high blood pressure, a sedentary lifestyle and obesity, all substantially increase heart disease risk. Heart attacks and other forms of heart disease are much more common in women with diabetes, but for reasons that are ill understood, diabetes does not have a similar impact in men. And anxiety and high levels of stress do not bode well for preventing heart attacks.

For most adults, an assessment of cardiac risk should be done at age 30. Occasionally, markedly elevated cholesterol is identified, necessitating the need for treatment. Blood pressure should be measured at least annually, and if elevated, approaches to bringing the levels to normal is a must. Hypertension may or may not require treatment with medications. Screening for diabetes should be done every five years until age 60 and more frequently thereafter. Whenever a routine physical is done, time should be spent counseling on how to live long, age well and prevent heart disease.

We are all aware of the critical importance of not smoking, diet, exercise, maintaining an ideal weight and staying as stress free as possible. But as a nation we are not doing as well as we should in meeting these goals. If will power is involved, most of us fall short. It is for this reason that we try and do as much as we can to maintain a healthy lifestyle, without giving up because our lofty goals are not achieved.

We focus far too much on weight loss and our body image. We all want to "get into shape," hopefully to become a slim beautiful woman or a male Adonis. Hating the way we look is disastrous. We need to be proud and pleased with ourselves and, most importantly, have high self-esteem; perhaps the single most important factor in living long, aging well and reducing heart attack risks. I recommend to all my patients that no matter their shape, they look in the mirror and say, "I am gorgeous." And this applies to men, too. You must feel good about yourself, confident in your accomplishments and in the way you look and dress.

Believe it or not, your weight is not an important risk factor in preventing heart disease. In fact, those who are overweight but not obese, live longer than those who are thin or obese.

It is also far more important to be fit and fat than thin and sedentary. Nothing is more important than exercise. And while more is better than less, walking at a reasonable pace for 30 minutes, four or five times weekly, has almost as much benefit as jogging 10 miles daily. And forget all the "too" excuses: I am too tired, too embarrassed, too sick, in too much pain; it's too expensive, too far, too cold or too hot to exercise. No matter what, there is always an exercise that is right for you.

Try as much as possible to eat a balanced diet containing the right fats, proteins, vegetables and starches. Learn how to relax; have love in your life; laugh and have faith in yourself and in others.

These are the keys to reduce your chances of heart disease. It's not rocket science, and no matter your age, the presence or absence of chronic disease and the stresses of life, you can do much to delay heart disease for decades or even forever.