Strategies to prevent heart disease

Smoking or using tobacco of any kind is one of the most significant risk factors for developing heart disease. Chemicals in tobacco can damage your heart and blood vessels, leading to narrowing of the arteries due to plaque buildup (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure and heart rate by forcing your heart to work harder to supply enough oxygen.

Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't smoke or take birth control pills, because both can increase the risk of blood clots.

When it comes to heart disease prevention, no amount of smoking is safe. But, the more you smoke, the greater your risk. Smokeless tobacco, low-tar and low-nicotine cigarettes, and secondhand smoke also can be risky. Even so-called social smoking — smoking only while at a bar or restaurant with friends — can be dangerous and increase the risk of heart disease.

The good news, though, is that your risk of heart disease begins to lower soon after quitting. Your risk of coronary heart disease significantly reduces one year after quitting smoking. Your risk of coronary heart disease drops almost to that of a nonsmoker in about 15 years. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

Getting some regular, daily exercise can reduce your risk of heart disease. And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.

Physical activity can help you control your weight and reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes.

In general, you should do moderate exercise, such as walking at a brisk pace, for about 30 minutes on most days of the week. That can help you reach the Department of Health and Human Services recommendations of 150 minutes a week of moderate aerobic activity, 75 minutes a week of vigorous aerobic activity, or a combination of moderate and vigorous activity. For even more health benefits, aim for 300 minutes of moderate aerobic activity or 150 minutes of vigorous aerobic activity every week. In addition, aim to do strength training exercises two or more days a week.

However, even shorter amounts of exercise than these recommendations can offer heart benefits, so if you can't meet those guidelines, don't give up. You can even get the same health benefits if you break up your workout time into three 10-minute sessions most days of the week.

And remember that activities such as gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

Eating a healthy diet can reduce your risk of heart disease. Two examples of heart-healthy food plans include the Dietary Approaches to Stop Hypertension (DASH) eating plan and the Mediterranean diet.

A diet rich in fruits, vegetables and whole grains can help protect your heart. Aim to eat beans, low-fat or fat-free dairy products, lean meats, and fish as part of a healthy diet.

Avoid too much salt and sugars in your diet.

Limiting certain fats you eat also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — try to limit or avoid saturated fat and trans fat. Aim to keep saturated fat to 5 or 6 percent of your daily calories. And try to keep trans fat out of your diet altogether.

Major sources of saturated fat include:

• Red meat
• Full-fat dairy products
• Coconut and palm oils

Sources of trans fat include:

• Deep-fried fast foods
• Bakery products
• Packaged snack foods
• Margarines
• Crackers, chips and cookies

If the nutrition label has the term "partially hydrogenated" or "hydrogenated," it means that product contains trans fat.

But you don't have to cut all fats out of your diet. Healthy fats from plant-based sources — such as avocado, nuts, olives and olive oil — help your heart by lowering the bad type of cholesterol.

Most people need to add more fruits and vegetables to their diets — with a goal of five to 10 servings a day. Eating many fruits and vegetables not only can help prevent heart disease, but also may help improve your blood pressure and cholesterol levels, and improve diabetes.

Eating two or more servings a week of certain fish, such as salmon and tuna, may decrease your risk of heart disease.

Following a heart-healthy diet also means keeping an eye on how much alcohol you drink. If you choose to drink alcohol, it's better for your heart to do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger. One drink is defined as 12 ounces (355 milliliters, or mL) of beer, 5 ounces of wine (148 mL), or 1.5 fluid ounces (44mL) of 80-proof distilled spirits.

At that moderate level, alcohol may have a protective effect on your heart. Too much alcohol can become a health hazard.

Being overweight — especially if you carry excess weight around your middle — increases your risk of heart disease. Excess weight can lead to conditions that increase your chances of heart disease — including high blood pressure, high cholesterol and diabetes.

Metabolic syndrome — a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides — also increases the risk of heart disease.

One way to see if your weight is healthy is to calculate your body mass index (BMI), which considers your height and weight in determining whether you have a healthy or unhealthy percentage of body fat. BMI numbers 25 and higher are generally associated with higher cholesterol, higher blood pressure, and an increased risk of heart disease and stroke.

The BMI is a good, but imperfect guide. Muscle weighs more than fat, for instance, and women and men who are very muscular and physically fit can have high BMIs without added health risks. Because of that, waist circumference also can be a useful tool to measure how much abdominal fat you have:

• Men are generally considered overweight if their waist measurement is greater than 40 inches (101.6 centimeters, or cm).
• Women are generally overweight if their waist measurement is greater than 35 inches (88.9 cm).

Even a small weight loss can be beneficial. Reducing your weight by just 3 to 5 percent can help decrease your triglycerides and blood sugar (glucose), and reduce your risk of diabetes. Losing even more weight can help lower your blood pressure and blood cholesterol level.

Sleep deprivation can do more than leave you yawning throughout the day; it can harm your health. People who don't get enough sleep have a higher risk of obesity, high blood pressure, heart attack, diabetes and depression.

Most adults need seven to nine hours of sleep each night. If you wake up without your alarm clock and you feel refreshed, you're getting enough sleep. But, if you're constantly reaching for the snooze button and it's a struggle to get out of bed, you need more sleep each night.

Make sleep a priority in your life. Set a sleep schedule and stick to it by going to bed and waking up at the same times each day. Keep your bedroom dark and quiet, so it's easier to sleep.

If you feel like you've been getting enough sleep, but you're still tired throughout the day, ask your doctor if you need to be evaluated for obstructive sleep apnea.

In obstructive sleep apnea, your throat muscles relax and block your airway intermittently during sleep. This may cause you to stop breathing temporarily. Signs and symptoms of sleep apnea include snoring loudly; gasping for air during sleep; waking up several times during the night; waking up with a headache, sore throat or dry mouth; and memory or learning problems.

Treatments for obstructive sleep apnea may include losing weight if you're overweight or using a continuous positive airway pressure (CPAP) device that keeps your airway open while you sleep. CPAP treatment appears to lower the risk of heart disease from sleep apnea.

Some people cope with stress in unhealthy ways — such as overeating, drinking or smoking. Finding alternative ways to manage stress — such as physical activity, relaxation exercises or meditation — can help improve your health.

High blood pressure and high cholesterol can damage your heart and blood vessels. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

• Blood pressure. Regular blood pressure screenings usually start in childhood. You should have a blood pressure test performed at least once every two years to screen for high blood pressure as a risk factor for heart disease and stroke, starting at age 18.

  If you're age 40 or older, or you're between the ages of 18 and 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year. Optimal blood pressure is less than 120/80 millimeters of mercury (mm Hg).

• Cholesterol levels. Adults should generally have their cholesterol measured at least once every five years starting at age 18. Earlier testing may be recommended if you have other risk factors, such as a family history of early-onset heart disease.

• Diabetes screening. Since diabetes is a risk factor for developing heart disease, you may want to consider being screened for diabetes. Talk to your doctor about when you should have a fasting blood sugar test or hemoglobin A1C test to check for diabetes.

  Depending on your risk factors, such as being overweight or having a family history of diabetes, your doctor may recommend early screening for diabetes. If your weight is normal and you don't have other risk factors for type 2 diabetes, the American Diabetes Association recommends starting screening at age 45, and then retesting every three years.

If you have a condition such as high cholesterol, high blood pressure or diabetes, your doctor may prescribe medications and recommend lifestyle changes. Make sure to take your medications as your doctor prescribes and follow a healthy lifestyle plan.