Reduce your risk of coronary vascular disease

Dr. Susan Locke shows how to become heart-healthy with these few simple steps . . .

Coronary vascular disease (CVD) includes coronary heart disease, stroke and peripheral vascular disease. It’s the leading cause of death in the U.S., killing more than 900,000 annually. Mortality rates have decreased by about 25% over the last 30 years due to improved medical therapies and risk factor reduction.

You can’t change your genes, but you can change modifiable risk factors such as smoking, hypertension, diet, dyslipidemia, physical inactivity, obesity and diabetes. Here are our top tips:

Quit smoking. One year after quitting, the risk of a myocardial infarction (MI) and death from coronary heart disease is reduced by half. After several years, the risk for both MI and stroke approaches that of nonsmokers. In terms of your heart, it’s never too late to quit.

Treat high blood pressure. Hypertension is defined by a systolic (top number) pressure >140 and diastolic (bottom number) pressure >90. What’s important to know is that even small decreases in blood pressure can reduce CVD. Therefore, there is benefit to treating even mild hypertension. Prehypertension is defined as a BP of 120-139/80-89. Therapeutic lifestyle changes can cause a significant reduction in the hypertension development rate.

Modify your diet. Of the possible changes, limiting how much saturated and trans fats you eat is the most important step you can take to reduce your blood cholesterol and lower your risk of CVD. Polyunsaturated and monounsaturated fats decrease the risk of CHD. So reading food labels is important. Commit to a diet rich in whole grains, fruits, vegetables, fiber and omega-3 fatty acids (found in fish or fish-oil supplements), which can help reduce your risk of CVD. Small to moderate amounts of alcohol (defined as one drink/day for women and two drinks/day for men) may lower the risk for CVD. However, the beneficial effects must be weighed against the possible increased risk of other diseases including several types of cancer.

Treat abnormal lipids or fats in your blood (dyslipidemia). Lowering cholesterol and triglycerides reduces the risk of CVD. The ideal levels depend upon what other risk factors you have. The more of these risk factors you have, the lower cholesterol levels you should have. A reasonable goal for LDL (bad) cholesterol is <130 if you have  one risk factor and an LDL <100 if you have two or more risk factors. Treatment should start with lifestyle modifications of diet and exercise as well as medication if CVD is already present or if there are multiple risk factors.

Exercise. Thirty minutes of moderate intensity exercise on five or more days a week yields a 50% reduction in mortality for CHD.

Effects of obesity and diabetes. Obesity can cause increased blood pressure, insulin resistance and glucose intolerance (diabetic precursors), elevated LDL and triglycerides, and lowered HDL cholesterol, therefore increasing your risk for CVD. If you are diabetic, tight control of blood sugar and reduction of other risk factors is necessary to reduce mortality.

So get heart healthy! Stop smoking, exercise, drink in moderation, maintain a normal weight, change your diet, and control your blood pressure. You won’t regret it!

Susan Locke, MD, is Healthnetwork Foundation’s medical director.

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