February is the month of hearts. You only have to walk into a store to be bombarded with a veritable avalanche of chocolate candy hearts, heart-shaped cards, tiny little pastel candies imprinted with “be mine” messages, heart-shaped cookies, and more. But despite all the attention to hearts, few people take the time to send an “I love you” message to the hearts beating inside their chests.
Cardiovascular diseases are diseases of the heart and blood vessels. They include hypertension (high blood pressure), coronary heart disease (heart attack), cerebrovascular disease (stroke), peripheral vascular disease, heart failure, rheumatic heart disease, congenital heart disease, and cardiomyopathies.
Since 1980, scientists have made tremendous strides in understanding and treating cardiovascular diseases. In the United States, the death rate due to cardiovascular disease decreased by almost 30 percent between 1996 and 2006 (AHA, 2010). Yet cardiovascular disease remains the number one cause of death in the United States, directly causing one out of every three deaths.
Cardiovascular disease is mentioned on a full 56 percent of death certificates. That means that although cardiovascular disease may not have been the primary reason that person died, it probably contributed to it.
Cardiovascular disease not only causes death – it also causes a tremendous amount of disability. More than 81 million Americans – more than one third of the U.S. population are living with cardiovascular disease. More than half of those living with cardiovascular disease are younger than 60 years of age. Many of those people can’t even walk up a set of stairs.
New research from the American Heart Association (AHA) and the Centers for Disease Control (CDC) affirms just how important it is to take care of your heart – before heart disease develops. Just a few weeks ago, the American Heart Association updated its goals for cardiovascular health. The new framework emphasizes the need to start prevention efforts early – during childhood, adolescence, and young adulthood – long before most people even start to think about the potential for heart disease.
It’s a whole new way of looking at heart disease. While the focus remains on risk factors – conditions or behaviors that increase the chance that you’ll develop heart disease – it’s shifted in two important ways. First, researchers are changing their focus from simply saying “well, your heart doesn’t look too bad” to a goal of “your heart looks really strong and healthy, and you’re doing the things you need to keep it that way.” In other words, the new definition of a healthy heart includes not only as the absence of disease, but whether you’re taking the steps to keep it healthy.
Risk factors for heart disease fall into two categories: those you can’t do anything about, and those you can. Things you can’t do anything about are your age, gender, family history, and race/ethnicity. The older you are, the more likely you are to have heart problems. While men are still more likely to have heart disease than women, women are rapidly catching up – heart disease is still the most common killer of women. Post-menopausal women are at equal or greater risk. If there’s a history of heart disease in your family, you know you’re at risk. Cardiovascular disease is also more prevalent among black Americans and Hispanics, although there’s no clear evidence that the higher prevalence is due to genetics – social and economic factors may play a role in increased prevalence for these groups.
If you fall into one or more of these groups, it’s all the more important for you to address the other category of risk factors: those you can do something about.
- Dump the tobacco. You’ve heard it before, and you’re going to hear it again here: Quit smoking. Smoking is the biggest risk factor for sudden cardiac death. Smoking any type of tobacco product (including cigarettes, pipes and cigars) more than doubles the risk of heart attack. Why? Smoking increases the buildup of fatty acids and plaques in blood vessels, called atherosclerosis.
- Stay away from other people’s smoke. Exposure to second-hand smoke increases the risk of cardiovascular disease. The AHA estimates that 37,000 to 40,000 people in the United States die because of cardiovascular disease caused by exposure to environmental tobacco smoke (“second-hand smoke”). The “stay away from smoke” rule includes not exposing your kids to second-hand smoke. Children are especially vulnerable, because their lungs and hearts are still developing. If you have kids or grandkids, don’t allow anyone to smoke in your home or car. Moving to another room is not enough – they need to go outside if they insist on smoking.
- Manage your weight. Overweight and obesity are key risk factors not only for cardiovascular disease in general, but for physiological risk factors – hypertension, high blood cholesterol, and diabetes. In a vicious circle, poor diet and physical inactivity may lead to overweight and obesity, which in turn may reduce the likelihood that a person will eat well and get adequate exercise. So shed those extra pounds. Yes you can. You don’t need a fad diet or a subscription to one of those overpriced “diet” packages or yet another diet book. All you need to do is burn more calories than you eat
- Eat real, heart-healthy food.
- Know what you’re eating and drinking. Learn about the nutrient content of the foods you eat and the drinks your consume. Read labels and learn to estimate the calories you consume in a given meal, including the breakdown of fats, proteins, and carbohydrates.
- Focus on whole foods. Fruits, vegetables, and whole grains should form the basis of your diet. Eat five or more servings of fruits (two cups) and vegetables (two and a half cups) and at least three servings of whole grains each day. Pay attention to serving sizes: one grain serving is one slice of whole wheat bread, one-half cup of cooked pasta or rice (about the amount that would fit in a cupcake wrapper). A good rule of thumb: Shop mostly in the outer perimeter aisle of your grocery store, where most stores sell fresh fruits, vegetables, and other unprocessed foods.
- Pick your fights – and your fats. Use fats sparingly, and when you do, use heart-healthy fats. Generally, that means using liquid vegetable oils such as olive or canola oil. Avoid transfats (found in margarine, vegetable shortening, most purchased baked goods, and almost all processed foods).
- Go fish. Eat at least 2 servings of fish or another source of essential fatty oils (omega-3s) per week. Good vegetarian sources are flaxseed and evening primrose oil.
- Go a little nuts. A growing body of research suggests that adding a handful of nuts to your diet every day can help your heart. Nuts contain a host of heart-friendly nutrients, including fiber, unsaturated fats, omega-3 fatty acids, plant sterols, Vitamin E, and L-arginine. Both separately and in combination, these nutrients have been shown to lower cholesterol, help control blood sugar, and even increase the flexibility of arteries. But be aware: Nuts are an “energy-dense” food. , containing a lot of calories (especially from fats)
- “B” on top of things. Take a daily multivitamin that contains B-complex vitamins, especially folic acid. Several of the B vitamins, especially folic acid (Vitamin B6) and B12 help to lower the level of homocysteine, a sulfur-containing amino acid, in the body. High levels of homocysteine have been linked with cardiovascular disease, including sudden cardiac death and stroke.
- Spill the salt. Consume no more than 1500 milligrams of salt per day, especially if you have high blood pressure or if it runs in your family.
- Sip a little. The evidence is mixed, but moderate consumption of red wine – defined as no more than one glass per day for women and two glasses per day for men – may help your heart and blood vessels. Researchers aren’t exactly sure why red wine seems to be beneficial, but most evidence points toward substances called antioxidants. Antioxidants are thought to help the body’s cells resist damage caused by free radicals, which are charged particles created by normal bodily processes such as breathing or environmental contaminants like exhaust. Free radicals can damage blood vessels, leading to increases in LDL-cholesterol oxidation and plaque formation on arterial walls. Antioxidants found in red wine include flavonoids and reseveratol.
- Have a cuppa. A growing body of research on tea (black, oolong, and green tea from the Camillia sinensis plant, not herbal infusions), suggests that tea may help your heart and blood vessels. Tea is especially high in antioxidants called polyphenols. A 2001 study from Boston University showed that consumption of black tea helped increase the flexibility of blood vessels in people with existing coronary artery disease.
- Slip in some (dark) chocolate. Like red wine and tea, chocolate – especially dark chocolate – is rich in antioxidants called flavonoids. Stick with a pure, dark chocolate – skip the chocolate-covered-caramel-marshmallow-nougat versions – and enjoy a bit of chocolate.
- Get off your butt. Get at least 30 minutes of aerobic exercise daily. That means activity that keeps your heart rate up for a sustained period of time – walking, running, swimming, bicycling, etc. Getting more exercise doesn’t necessarily mean you need the latest fashion and a $100-a-month subscription to a gym. Add just a little extra motion to your everyday activities. Park at the far end of the parking lot, or better yet, walk or bicycle to the grocery store if you can. Take the stairs instead of the elevator. Walk to school and back with the kids: Not only will you benefit, it will set a good example for them.
- Know your numbers. The AHA recommends that everyone aged 20 years and older get the following screening tests:
- At least every two years:
- Overweight/obesity. You may not even realize that you’re overweight or obese – or that your kids are. Get on the scale, get out the tape measure, and have your doctor calculate your body mass index (BMI).
- Blood pressure. If it’s borderline high, your doctor may want you to monitor it regularly.
- At least every five years (or every two years if you are at risk):
- Blood cholesterol levels. The numbers you need are: total cholesterol, “good” (HDL) cholesterol, bad (LDL) (“bad”) cholesterol, and triglycerides.
- Blood glucose (sugar) level. A reading higher than 100 suggests you may be at risk of developing diabetes, and you need to take steps now to stop the progression.
- At least every two years:
So give yourself and your loved ones a real Valentine’s Day present this year, one that doesn’t involve frilly ribbons and pink candy hearts Wake up to a cup of tea and a bowl of oatmeal, pull out your walking shoes, and tell your heart “I love you!”