Reducing Heart Disease
by Charles H. Booras, MD

Revised 7/11/98

A heart attack is still the leading killer of American men and women but, since 1960, the mortality rate from a heart attack has dropped by half. This success is due not only to improved medical treatment of coronary artery disease (CAD), but also to preventative steps people have taken.

We still have a ways to go in order to prevent more deaths due to heart disease. The first step is to recognize the major controllable risk factors for CAD; high cholesterol, smoking, obesity, high blood pressure, diabetes, and being sedentary. Most of these can be countered by relatively simple preventative measures.

  • QUIT SMOKING. This is the single most effective step one can take. 20 - 40% of all CAD deaths are directly attributable to smoking.
  • REDUCE CHOLESTEROL. For every 1% reduction in blood cholesterol, there's a 2 to 3% decline in the risk for heart attack. WOW! That's a pretty good return on your investment.
  • CONTROL HYPERTENSION. A major risk factor for stroke and heart attack. A good target is 135/85 or below.
  • STAY ACTIVE. Dozens of studies show that exercise protects against CAD.
  • MAINTAIN A HEALTHY WEIGHT. One in three Americans is seriously overweight. People who put on weight around the waist (see Waist-to-Hip Ratio) have a higher risk than those who accumulate weight on the hips. Strive for a Body Mass Index (BMI) of 25 or less.
  • BALANCE YOUR NUTRITION. There is no substitute for consuming five servings of fruits and vegetables each day. Other studies have found that eating at least 6 ounces of fish each week can reduce the incidence of a heart attack. Canned Tuna fish was effective also.
  • CONTROL DIABETES. Strive for a HgbA1c of 7.0 or lower.
  • CONSIDER HORMONE THERAPY AFTER MENOPAUSE. This can reduce the risk of CAD by 40 - 50% or more, but is not appropriate for all women. Discuss this with your doctor first.
  • CONSIDER A DRINK A DAY. Light alcohol consumption has a minor beneficial effect for the heart, but larger amounts increase the risk for heart and other medical problems. The limit is 2 ounces a day.
  • CONSIDER ASPIRIN. Low-dose aspirin can lower the risk of heart attack by up to 33%. The dosage ranges from 81- 325mg daily or three days a week. Discuss aspirin therapy with your doctor first.
  • CONSIDER SUPPLEMENTS. Supplements such as Vitamin E, Selenium, and the B-Complex Vitamins (Folic Acid, B6 and B12) seem to have a role in reducing ones risk for heart attack.

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