Prevent a Heart Attack Reduce your risk to almost zero by following these six proven steps
Which of the following people is likely to suffer a heart attack?
Chris, 54, is thin, eats a healthy diet, takes a baby aspirin every day, and exercises regularly.
Howard, 66, has diabetes. Until recently, his blood pressure and blood sugar were too high.
Naomi, 79, has already had two heart attacks.
So who's at risk? Surprise—it's all three of them. Howard and Naomi have obvious risk factors, but Chris has to contend with family history—his father had a heart attack in his mid-40s, and died of one at 66. All these people, however, share a common concern about their health: about 1.1 million Americans will suffer a heart attack this year, and some 500,000 will not survive it. Despite the risks, most people don't understand what causes a heart attack. The common view is that it's simply a plumbing problem—cholesterol builds up, clogging arteries like sludge in a pipe. When an artery supplying blood to the heart becomes completely obstructed, portions of the heart, deprived of oxygen, die. The result is a heart attack, right? Not quite, say heart experts. Heart disease involves the gradual buildup of plaque. And plaque is like a pus-filled pimple that grows within the walls of arteries. If one of those lesions pops open, a blood clot forms over the spot to seal it and the clot blocks the artery. Other things can stop your heart, but that's what causes a heart attack. The bigger issue is how to stop it from happening. There's no way to predict where an artery-blocking clot will originate, so prying open a section of an artery with a stent will not necessarily prevent a heart attack. Stents relieve chest pain, but people who have no symptoms are better off adhering to tried-and-true measures to slow plaque growth and prevent the lesions from bursting. Those measures, says Peter Libby, M.D., chief of cardiovascular medicine at Brigham and Women's Hospital in Boston, "are things no one wants to hear: keep your weight down, make physical activity a part of your life, and stop smoking if you smoke." And, of course, keep your blood pressure and cholesterol under control, taking medications if necessary. Few people are following that advice. Twenty-five percent of Americans over age 50 have at least two risk factors, such as high blood-pressure or cholesterol levels, or an elevated blood-sugar level. Only 10 percent of Americans have every risk factor under control. "In the majority of cases when someone has a heart attack, at least two or three risk factors might have been avoided," says Valentin Fuster, M.D., a cardiologist at Mount Sinai School of Medicine in New York City. About 1.1 million of us will have a heart attack this year. In fact, a 50-year-old man with none of the risk factors has only a 5 percent chance over the next 45 years of ever having a heart attack, according to Daniel Levy, M.D., director of the Framingham Heart Study, a federal study of heart disease in Framingham, Massachusetts. But if that man has even one risk factor, such as high cholesterol, his chance of having a heart attack soars to 50 percent. For a woman with no risk factors, the chance of having a heart attack is 8 percent; with just one risk factor, it goes to 38 percent. By focusing on a few key risk factors, most people can significantly reduce their odds of ever having a heart attack. "There's a lot we can do," says Libby. The top six steps: Keep your cholesterol in check Excess cholesterol gets stuck in artery walls. The walls become inflamed with white blood cells of the immune system, and those cells release chemicals that cause plaque. The normal level of so-called bad cholesterol, or LDL cholesterol, is 60 to 130. But if you are at high risk of a heart attack—because you have diabetes, for example—your level should be below 100 and, ideally, no higher than 70. Diet and weight loss are the preferred way to control your cholesterol, say heart-disease experts. If that doesn't work, statins—a class of cholesterol-lowering drugs—can reduce your LDL enough to help prevent heart attacks. Two decades of large and rigorous studies have shown that statins are safe for almost everyone. Lower your blood pressure High blood pressure can damage artery walls, causing them to become stiff and narrow. Ideally your blood pressure should be below 120/80. If you can get it that low with diet and exercise, great; if not, medications may do the job. Studies have shown that blood-pressure medications can reduce heart attack risk by 27 percent. Stop smoking Smokers are two to three times more likely to die from coronary heart disease than nonsmokers, notes the American Heart Association. In addition to raising blood pressure and lowering the level of HDL (good) cholesterol, smoking injures blood vessels, boosting your risk of having a heart attack. Even if you've been smoking for years, kicking the habit will help your heart. Studies have found that within one year after you quit, your heart attack risk is cut almost in half; within 15 years, it's similar to that of a nonsmoker. Control your blood sugar High blood sugar can promote the growth of plaque. To be safe, your blood sugar level, tested after fasting, should be from 70 to 130 milligrams per deciliter of blood. Your doctor can order this test. Control your weight Obesity increases the likelihood that your cholesterol, blood pressure, and blood sugar will be too high; losing weight can often bring these numbers down. Being even slightly overweight also boosts your risk of heart attack, particularly if you tend to gain weight around your middle. Exercise regularly For optimal heart health, heart researchers recommend 30 minutes of moderate exercise—such as brisk walking—most days of the week. Exercise can help you control your weight, and it can also help you avoid diabetes if your blood sugar is inching up. If you've already had a heart attack, the challenge is to control the risk factors even more stringently, heart researchers say. Yet few heart attack survivors do this. "I witness the cholesterol story time and time again," says Elliott Antman, M.D., director of the cardiac-care unit at Brigham and Women's Hospital. "People come to me for a second opinion after having a heart attack and I ask them, 'Have you ever been told what your cholesterol levels were?' The person will say, ' Yes, I was told they were normal.' That's not good enough anymore," if you've already had a heart attack. If you can get your LDL cholesterol level below 70, Antman says, it is unlikely you will have another heart attack. An LDL of less than 70 is also a good goal for people who have never had a heart attack, says Daniel Rader, M.D., head of preventive cardiovascular medicine at the University of Pennsylvania. Rader offers extra tests for his high-risk patients, including one for the blood protein CRP; if this protein is elevated, it indicates an increased heart-disease risk. Rader also offers heart scans to assess the extent of plaque in a person's arteries. If the tests reveal additional risk, he will suggest drugs to drive an LDL level down to 70. With an LDL level that low, Rader says, "your lifetime risk of heart disease will be reduced dramatically." It may not reach zero, he says, but it will be a lot lower.
Naomi is counting on it. Her LDL cholesterol level, with medication, is currently 69; she's taking another drug to control her blood pressure, and she exercises religiously. "I feel good," she says, though she knows what's at stake: that only an aggressive approach on all fronts will help her avoid a third—and potentially fatal—heart attack.
2009 H1N1 Flu (Swine Flu) What You Can Do To Stay Healthy
·Stay Informed. Center for Disease Control www.cdc.gov/H1N1Flu/ ·Influenza is thought to spread mainly person-to person through coughing or sneezing of infected people. ·Take everyday action to stay healthy. oCover your nose and month with a tissue when you cough or sneeze.Throw the tissue in the trash after you use it. If without tissue, cough into your elbow area not your hand. oWash your hands often with soap and water, especially after you cough or sneeze.Alcohol-based hands cleaners are also effective, do not use on children under age of four. oAvoid touching your eyes, nose or month.Germs spread that way. oStay home if you get sick, CDC recommends that you stay home from work, school and church and limit contact with others to keep from infecting anyone else. ·Follow public health advice regarding school closures, avoiding crowds and other social distancing measures. oDuring an H1N1 flu outbreak in our area there may be a need to limit public gatherings. The Session is currently developing contingency plans for possible closure and means of communication of closures and ongoing needs. ·Find healthy ways to deal with stress and anxiety.
·Call 1800-CDC-INFO for more information.
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