1. Take responsibility for your health.
Cardiovascular disease is the major cause of death in America,
accounting for 34 percent of deaths, many suddenly and almost all of them
premature. This is down from 40 percent just four decades ago, mainly due to
treatment of common risk factors. If you have diabetes, your risk increases
dramatically. The best prevention against heart disease and stroke is to
understand the risks and treatment options. The greatest risk is ignorance or
misinformation. The first step is to take responsibility for your health.
2. Know your risks.
The most influential risk factor for cardiovascular disease is age
– the older you are, the greater your risk. The second is your genetic make-up.
Although everyone is excited by the scientific progress in genomics research,
conclusive gene tests are still in their infancy. But, as I tell our medical
students, “A good family history is a poor man’s gene test.” We have long known
that if your parents, grandparents, or other relatives were afflicted with or
died of heart disease, diabetes or stroke, your risk is much greater.
3. Don’t smoke or expose yourself to second-hand smoke.
The evidence is overwhelming that cigarette smoking and second-hand
exposure to smoke increases the risks of heart disease, lung disease,
peripheral vascular disease and stroke.
4. Maintain a healthy blood pressure.
High blood pressure, called hypertension, is known as “the silent
killer” as it goes without symptoms in most individuals. High blood pressure
causes wear and tear of the delicate inner lining of your blood vessels. The
higher your blood pressure (BP) the greater your risk. The risk begins to
increase from a pressure of 115/70 mmHg and doubles for each 10 mmHg increase
in systolic (the larger number) and 5 mmHg increase in the diastolic (the
smaller number). Heredity and increasing age raise the risks. Measuring blood
pressures at home reflects more accurately your risk than having the blood
pressure taken at a physician’s office. It is worth the investment to get a
cuffmeter.
It is best not to rely only on the readings at your doctor’s office
as some individuals suffer from “white coat” hypertension – their BP is up only
when they are at the doctor’s office. Others have “masked” hypertension –
higher when not in the doctor’s office. Prognosis is best related to home BP.
But for home blood pressure readings, you should not use finger or wrist units
– only regular upper arm units.
5. Monitor your cholesterol (blood lipids).
Abnormal or high blood lipids (fats) are a major contributor to
cardiovascular disease. Your blood lipids include the LDL (bad cholesterol;
remember as “Lousy cholesterol”), HDL (good cholesterol; remember as “Healthy
cholesterol”) and triglycerides. The lower your LDL and the higher your HDL,
the better your prognosis. The amount of cholesterol in your blood is
determined mainly by three factors: the amount produced by the liver (this is
largely genetic), the amount absorbed from the intestinal tract (some from what
you eat, but a lot more from cholesterol produced by the liver and excreted
into the digestive tract) and, finally, age – your cholesterol increases with
age. If you are at risk, medication is almost always necessary to lower the LDL
or to raise your HDL. The ideal ratio of total cholesterol divided by HDL
cholesterol is 3.0. If higher, you might need diet as therapy. The problem with
diet is that, in general, it can only decrease total blood cholesterol by about
10 percent. If you have a strong family history or elevated Lp(a) (a rare
abnormal cholesterol that increases the risk), drug therapy is usually needed.
6. Limit your calories.
Fad diets do not work. If any of them did, we all would be on THAT
one, wouldn’t we? The obesity rate in Americans is alarming, contributing to a
near epidemic of diabetes, which is a cardiovascular disease. If you have
diabetes, your risk is the same as someone who already had a heart attack.
Obesity is caused by consuming more calories than your body burns. Abdominal
obesity is the major risk. Portion sizes and the amount of sugars in the American
diet have dramatically increased over the past few decades. At the same time,
the daily amount of exercise has been decreasing. It is good advice to “drink
slim” (water, tea, coffee). Use portion control before you start eating and
push away from the table before you are “full.”
7. Make exercise a daily habit.
The lack of exercise is contributing to the obesity epidemic in
Americans. Studies indicate that walking two miles a day is optimal for overall
health, and those two miles of walking do not have to be done all at once.
Exercise does more than burn calories; it also activates genes that are
beneficial to health in other ways. Plus, exercise is one of the best
treatments for depression and anxiety. However, exercise alone cannot control
or reduce your weight – you must also modify your diet.
8. Pick your pills wisely.
There is a great interest in alternative medicine and
understandably so, because patients want to be empowered to take responsibility
for their own health. However, many take alternative medicines because of the
way they are marketed. The mere fact that a substance is “natural” does not
prove its health benefit. After all, nobody in their right mind would take
arsenic simply because it is “natural.” It is important to know that research data
are often lacking for alternative medications, supplements and vitamins, none
of which are regulated by the U.S. Food and Drug Administration (FDA).
Do we ever prescribe alternative medicines? On occasion we do! The
major risk with many alternative medications is that the patient thinks they
are doing something to improve health, when in fact they are not. Although some
vitamins have been shown to possibly help some conditions, to date none have
been shown to decrease the risk of cardiovascular disease. There are some rare
exceptions, such as fish oils and niacin (vitamin B). It is also important to
note that high doses of some vitamins may interfere or counteract the
beneficial effects of some prescription drugs.
9. Reduce stress.
Stress contributes to cardiovascular disease and, if severe, can
cause a heart attack or sudden death. There are plenty of options that help
reduce stress, such as regular exercise, adequate sleep, striving for a good
marriage, laughing, volunteering or attending religious services. Watching TV
generally does not relieve, but can aggravate stress. Also, try to avoid
situations and people who make you anxious or angry.
10. Stay informed: Science changes constantly.
The only constant is change. This is especially true in medicine as
new techniques and new insights develop constantly. Do not believe every piece
of “scientific information” you find in the media or advertisements. An
overwhelming number of research studies that make it into scientific
publications are poorly designed or yield data that are not representative,
e.g., due to a lack of a sufficient number of participants. Keep in mind that
many studies are financed or sponsored by individuals or companies with a
vested interest in gaining favorable results. The situation can be especially
confusing when scientific studies yield different or even contradicting
results, and this happens quite often.
Source: heart.arizona.edu.com

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