Heart Health Step-by-Step

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Nearly a half-million women die of cardiovascular disease every year, but they don't have to—the condition is largely preventable and treatable. Here's how to reduce your lifestyle hazards as well as your medical and genetic risks:

Lifestyle factors
Risk: Sedentary lifestyle.
Rx: 30 to 60 minutes of moderate-intensity aerobic activity (e.g., brisk walking), meaning you can carry on a conversation as you work out. To lose weight, the American Heart Association (AHA) guidelines recommend 60 to 90 minutes on most, and preferably all, days of the week. Activity can be broken up into 15-minute chunks throughout the day.

Risk: A body mass index (BMI) of 25 or higher. Plug your height and weight into this calculator, or use this equation:

BMI=[weight divided by (height x height)] x 703

Rx: Regular exercise (see above) and a healthy diet, including two servings of fish per week, one serving of nuts or legumes daily, five to nine servings of fresh fruits and vegetables daily, and one to two servings of whole grains daily. No more than one drink per day. Limit intake of saturated fat, and nix trans fats like hydrogenated oil or vegetable shortening.

Risk: Smoking (it triples the risk of heart attacks in women).
Rx: Quit; ask your doc about new smoking-cessation programs and medications. And ban smoking at home and work, too. (An hour in a smoky bar has the same effect as smoking two or three cigarettes yourself.)

Medical factors
Risk: Cholesterol level (total, over 200; bad [LDL], over 100; good [HDL], under 50 for women).
Rx: Regular exercise. A healthy diet. Cholesterol-lowering medications called statins (Lipitor, Zocor, Crestor), which lower bad cholesterol. Niacin (vitamin B3), which raises good cholesterol.

Risk: Hypertension (blood pressure higher than 140 over 90) or prehypertension (blood pressure higher than 130 over 80, especially systolic pressure—the first number); it increases risk by 25 percent.
Rx: Regular exercise. A healthy diet. Weight loss. A prescription drug (vasodilator) that opens blood vessels for improved blood flow. Diuretics to reduce water and salt retention. Low-dose aspirin therapy may also be recommended by your doctor.

Risk: Triglyceride (fat) level over 150.
Rx: Fibrates (triglyceride-lowering drugs such as Clofibrate).
Fish oil. Niacin.

Risk: Diabetes (it increases the chances of heart disease five to seven times in women).
Rx: Routine checkups. Control weight, high cholesterol, and high blood pressure. Avoid inactivity.

Risk: Inflammation (a defensive response of the immune system, implicated in the buildup of fat in arteries).
Rx: Intermediate-risk patients may benefit from having their blood tested for C-reactive protein (CRP), which increases with inflammation; it may help in predicting a heart attack or stroke and in directing therapy.

Inherited factors
Risk: Family history of cardiovascular disease. If either (or both) of your parents had a heart attack—or symptoms of or treatments for heart disease—under the age of 55 (father) or 65 (mother), your chances of a similar incident at that age increase 25% to 50%.
Rx: Inform doctors of family history. Get regular checkups. Avoid inactivity. Control other risk factors, such as weight, blood pressure, and cholesterol.

Risk: An apple-shaped body (a waist measurement greater than 35 inches).
Rx: Exercise and diet.

Risk: Type A personality (angry) or Type D (depressed).
Rx: Exercise (try yoga). Seven hours or more of sleep a night. Socializing. Hobbies. Therapy. Avoid stressful situations like driving in rush hour traffic.