How can we reduce our risk of having a heart attack?
Cardiovascular disease continues to be the leading cause of death for both men and women in the United States, despite the incredible advancements we have seen in medical and procedural therapy. According to the CDC, one person dies every 36 seconds in the United States from cardiovascular disease, and about 655,000 Americans die from heart disease each year — that’s 1 in every 4 deaths. Heart disease costs the United States about $219 billion each year from 2014 to 2015. This includes the cost of health care services, medicines, and lost productivity due to death.
The good news is, over 80% of heart disease is preventable with lifestyle changes and appropriate medical therapy. But unfortunately with so much misinformation on social media, it can sometimes be confusing to figure out what to eat, how much to exercise, and what lifestyle is best to prevent heart disease. Should you be eating low carb? Or low fat? Does exercise matter? Or does it not matter? Well, the answer is somewhere in between.
The 2019 American College of Cardiology and American Heart Association Guidelines for Primary Prevention of Cardiovascular Disease have outlined all of the ways we can reduce our risk for heart disease.
Quitting smoking can be one of the most important changes you can make for your health. Tobacco use is the leading preventable cause of disease, disability, and death in the United States. Smoking and chewing tobacco use increases the risk of not only death from heart disease, but death from all causes. Even secondhand smoke is a major cause of heart disease and stroke. And even low levels of smoking increase risks of having a heart attack; so the only way to decrease your risk, is by quitting tobacco all together.
2. Know your numbers!
Make sure to see your healthcare provider to help evaluate your risk for heart disease. Find out your blood pressure, cholesterol, hemoglobin A1c (a test for diabetes!) and know where you stand. From there, your healthcare provider can help guide you in the right direction. If you are diagnosed with diabetes, hypertension, or high cholesterol, you may need medications to help control those diseases. Guideline directed medical therapy can be lifesaving. But it is important to know that lifestyle change is always recommended. Changing your diet and incorporating exercise, can often not only improve, but even put many chronic diseases into remission.
Both Plant-based and Mediterranean diets, have consistently been associated with lower risk of death from not only heart disease, but all cause mortality as well. Focusing on increased fruit, nut, vegetable, legume, and lean vegetable protein, (or if you eat animal protein, preferably fish) consumption, with the inherent soluble and insoluble vegetable fiber, has consistently demonstrated to be beneficial for cardiovascular and total overall health.
4. Physical Activity
Often people ask “what is the best exercise for health”, and the answer is: the one you enjoy the most and will stick with! Whether it’s walking, running, biking, dancing, gardening, weights, or yoga, exercise can be a beneficial component of cardiovascular disease prevention. Ideally we recommend trying to reach at least 150 minutes of accumulated moderate-intensity physical activity per week or 75 minutes of vigorous-intensity physical activity per week, but remember that something is better than nothing. But you need to find an activity that you enjoy, so you have less of a barrier to stick with it.
5. Find your Physician or Healthcare Provider Advocate
The most important way to prevent atherosclerotic vascular disease, heart failure, and atrial fibrillation is to promote a healthy lifestyle throughout life. A team-based care approach is an effective strategy for the prevention of cardiovascular disease.
Changes in diet and lifestyle can be hard. And for patients struggling with their weight, hearing they should just change their diet and lifestyle as if it is simple to flip a switch, undermines the complexity of diseases like obesity. This is why at our practice in Newport Beach, California, we focus on a multidisciplinary approach to lifestyle change. We have extended patient visits, and believe strongly that spending time with our patients is our most valuable asset. Patients often do not feel heard by their provider, and feel that they are prescribed a medication as a bandaid, and they are left to figure out the rest. We focus on a comprehensive approach, which for some patients may include life saving and guideline directed medical therapy, but for ALL patients it includes a focus on lifestyle change and modification. As a preventive cardiologist, I know I can help my patients best with a team approach, so my patients may also see one of our registered dietitians, or obesity medicine specialists, or our athletic trainers.
I believe in compassionate, evidence based patient care. We must be science based in our medical decision making, but we must always bring compassion and empathy to our shared decision making with our patients. We must listen, and hear our patients thoughts and concerns. And we must meet our patients where they are at, and help support them in every way possible on their journey toward optimizing their health.
Dr. Belardo is a cardiologist in a multidisciplinary practice in Newport Beach, California. Dr. Belardo sees patients for cardiovascular disease, preventive cardiology, advanced lipidology, cardiometabolic health, and weight loss. She is the co-chair of the American Society of Preventive Cardiology Nutrition Committee, a member of the American College of Cardiology Nutrition and Lifestyle Committee, and the Communications Catalyst for the California Chapter of American College of Cardiology.
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