Are you doing everything you should to maintain your heart health?
Probably not, the nation’s best cardiologists say.
In fact, most Americans may have health factors that raise their risk of heart disease, according to Malissa J. Wood, M.D., assistant professor at Harvard Medical School and co-director of the Corrigan Women’s Heart Health Program at Massachusetts General Hospital in Boston.
Boosting your cardiovascular health takes some basic lifestyle changes, from exercising more and improving your diet to getting enough sleep at night.
And the time to start is now, says Noel Bairey Merz, M.D., Director, Barbra Streisand Women’s Heart Center at the Cedars-Sinai Heart Institute; Director, Preventive and Rehabilitative Cardiac Center; and Women’s Guild Chair in Women’s Health.
“It’s time to do everything you know you should be doing – exercising, eating a low-fat and high-fiber diet, losing weight and quitting smoking,” Dr. Bairey Merz advises. “Thousands of studies have told you this is necessary. Now, just do it.”
We asked eight of the country’s best physicians – including Mehmet Oz, M.D., of the “Dr. Oz Show” and Travis Stork, M.D., from the “The Doctors” – for advice on keeping your ticker running smoothly.
Read on for their important advice, straight from the heart doctor to you.
Roger Blumenthal, M.D., professor of medicine and director of the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease in Baltimore: We often give patients a pedometer, which reminds them to increase the amount of walking they do in a day.
The minimum goal is 5,000 steps a day, which is about 2 miles. But to get fit, you need to take more than 10,000 steps most days of the week. The brisker the walking (or any physical activity), the better.
Marc Gillinov, M.D., staff cardiac surgeon at the Cleveland Clinic in Ohio and co-author of Heart 411 (Three Rivers Press): Exercise is more powerful than any medicine we’ve ever developed. It increases your HDL (“good”) cholesterol, [and] decreases your LDL (“bad”) cholesterol, triglycerides, blood pressure and inflammation. It helps with weight loss, increases lean body mass [and] the efficiency of your heart.
It relaxes the arteries of the heart and elsewhere in the body, and improves the health of the inner lining, or endothelium.
Also, people who exercise are somewhat less likely to form blood clots, which are generally part of a heart attack.
Try a walk fast, use an elliptical [machine] if you want to go a little more aggressive, or [play] a sport.
You want to get your heart revved up. That releases nitric oxide, a short-lived gas that relaxes and dilates the arteries, helping to prevent high blood pressure.
Travis Stork, M.D., emergency physician at Vanderbilt University Medical Center in Nashville, Tenn., and panelist on TV’s “The Doctors”: When you’re an ER physician, you tend to take care of heart disease after it’s too late. So I’ve become passionate about educating about simple things they can do to prevent a visit to the ER one day.
Some studies suggest that if you just walk 30 minutes a day, you can add three years to your life. Exercise lowers your C-reactive protein levels, [an inflammatory response that] that can be a marker for heart disease.
It’s not about becoming a hard-core athlete. It’s about being on your feet more, being more active.
[For example], stand up when you’re taking a phone call. If you live in an apartment building on the fourth floor, take the stairs. Those little steps add up greatly over time.
Women [should do both] aerobic exercise, focusing mainly on the cardiovascular system, and resistance exercise, which also has incredible benefits.
People who stand more are also more likely to maintain a healthy weight [because] you’re using the large muscles of your lower back and your legs, which burns more calories.
But there are also [benefits] involving inflammation in the blood vessels and how you process sugar and fats.
When you’re sitting down, those systems aren’t working properly. When you stand, you’re more likely to have a better metabolic profile.
Heart Doctor Health Advice #3: Know your numbers
Dr. Bairey Merz: Numbers can tell a lot. Optimal numbers are:
- A total cholesterol lower than 180 mg/dl (milligrams per deciliter)
- HDL [“good”] cholesterol greater than 50 for women and greater than 40 for men
- Blood pressure lower than 130/80
- A fasting blood sugar not higher than 100 mg/dl.
If your numbers are high, work with your physician and come up with a plan to reduce the risk.
Heart Doctor Health Advice #4: Watch your waistline
People whose waist is more than half their height are much more likely to have a heart problem.
Waist fat causes high blood pressure, because it puts pressure on your kidneys, which is the organ that regulates your pressure. It causes your liver to make LDL cholesterol, the kind that causes heart disease. And it blocks the ability of insulin to work, which leads to diabetes.
The height-waist ratio works for men, women and kids.
It’s not your belt size, though – measure the waist itself.
Heart Doctor Health Advice #5: Eat a balanced diet
Dr. Blumenthal: Some of my patients use websites that make it easier to track calories. Getting some ballpark idea of whether you’re taking in 1,200 or 3,000 calories a day can be very helpful.
Most women over 50 require a lot fewer calories than they did when they were 30.
Seeing a dietitian or nutritionist at least once can be very helpful, because they can more accurately estimate the calories and the fat that you’re taking in.
We often tell people the things they shouldn’t do – like no desserts or fried foods – but it’s important to emphasize eating more fruits and vegetables, fiber and whole grains. Change white rice and white bread for brown rice and whole-wheat bread.
As a corollary, though, you have to watch your calories, because no matter what diet you’re on, if you eat more calories than you need you’ll gain weight. And if you gain weight, you increase your heart risk.
Dr. Stork: There are a couple of main culprits in rising obesity rates, which put us at risk for heart disease. People are eating more processed foods high in sugar and saturated fats, and they’re also making less food at home.
When it comes to food, keep it simple. If you do nothing else, get rid of all the refined grains in your house.
- Switch to whole-grain pasta and whole-wheat bread.
- Oatmeal or whole-grain oat cereal in the morning can lower your cholesterol levels.
- When you’re dressing a salad, use olive or other oils that are good for heart health instead of overly processed dressings made with saturated fat.
- Also, limit processed foods, which are where we get 90% of our sodium, [a risk factor for high blood pressure].
Dr. Blumenthal: There’s really no substitute for optimizing your diet. Eat fish at least once and preferably twice a week.
Heart Doctor Health Advice #7: Know the symptoms of a heart attack
The problem is that [symptoms can be] different for women. They more typically have extreme fatigue, nausea and a feeling of tightness around their chest.
If you have symptoms that could indicate heart disease – such as high blood pressure that doesn’t respond to medication or water retention in your legs – see your doctor immediately.
(Read more about Symptoms of Heart Disease in Women.)
Heart Doctor Health Advice #8: Keep aspirin on hand
Dr. Bairey Merz: First, check with your health-care provider to ensure that aspirin is safe for you. If so, keep it handy.
If you notice symptoms of a heart attack, consider [chewing and swallowing] an aspirin immediately [to help inhibit blood clots]. Then get yourself to the hospital.
When you arrive at the hospital, make sure the admitting nurse or doctor knows that you think you’re having a heart attack.
Nieca Goldberg, M.D., medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center in New York and author of The Women’s Healthy Heart Program (Ballantine Books): The benefit of taking aspirin regularly to prevent a heart attack really starts in women when they’re 65. [So before starting an aspirin regimen], talk to your doctor.
Aspirin has been proven to reduce the risk for a second heart attack in women no matter what age.
Dr. Bairey Merz: See your dentist regularly. Infection in the teeth, gums and mouth can contribute to and trigger heart disease.
Heart Doctor Health Advice #10: Get enough sleep
Sleep deprivation has become part of our culture. But sleep isn’t a luxury, but a necessity like food and water.
Sleep deprivation increases the risk of diabetes, high blood pressure and heart disease. One study showed that women who consistently got less than 5 hours of sleep per night had three times the risk of heart attack.
Most people should avoid caffeine after about 3 p.m., because it has subtle effects that disturb sleep. Alcohol should be stopped about 2-3 hours before you go to sleep. Even though it can make you fall asleep more easily, it can also wake you up in the middle of the night.
Heart Doctor Health Advice #11: Stop smoking
Dr. Grogan: Smoking is the single most preventable cause of heart disease. Quitting may be hard, but it’s necessary.
