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Preventing and Reversing Cardiovascular
Disease
Are you at risk?
Facts
about cardiovascular disease
Cardiovascular disease includes a number of conditions affecting the structures
or function of the heart, including coronary artery disease and vascular
(blood vessel) disease. Cardiovascular disease is by far the leading cause
of death in the United States.
Coronary artery disease
(narrowing of the arteries supplying blood to the heart) causes about
one million heart attacks each year. Even more worrisome, 220,000 people
with heart attacks will die before even reaching the hospital.
Research about cardiovascular
disease risk factors suggests that making even small lifestyle changes
can reduce the risk of coronary artery disease, heart attack, stroke and
other serious cardiovascular conditions.
Are
you at risk?
Risk factors are certain
conditions that increase a person’s risk for cardiovascular disease. It
is important to know:
- Some risk factors,
called "nonmodifiable risk factors," cannot
be changed.
- Some risk factors,
called "modifiable risk factors," can be
modified, controlled or treated.
- The more risk factors
you have, the greater your chance of developing cardiovascular disease.
- Higher levels of
each risk factor correlate with a higher risk for cardiovascular disease.
Nonmodifiable
risk factors - check which ones apply to you
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Increasing age. Cardiovascular disease is more likely to
occur as you get older. About 85 percent of people who die of coronary
artery disease are age 65 or older.
Male gender. Men have a greater risk of heart attack
then women.
Menopause. After menopause, a woman's risk of cardiovascular
disease increases, but does not reach the level of a man's.
Family history. Your risk of cardiovascular disease
increases if your parents, brothers, sisters, or children have the
disease.
Race. The risk of cardiovascular disease is higher
in African Americans, Mexican Americans, American Indians, native
Hawaiians and some Asian Americans. This increased risk is partly
due to higher rates of high blood pressure, obesity and diabetes
in these populations. |
Since you can't change
any of these risk factors, it is important to focus on the risk factors
you CAN change.
Risk
Factor Goals
You, along with support
from your family and friends, can work to achieve the following goals
to change or treat your modifiable risk factors and reduce your risk of
cardiovascular disease. If you already have cardiovascular disease, you
can follow these guidelines to help prevent its progression. (check which
ones apply to you)
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Stop smoking
- Smoking is
the most preventable risk factor for cardiovascular disease and
stroke.
- Smokers (including
cigarette, pipe and cigar smokers) have more than twice the risk
of a heart attack than nonsmokers.
- Smoking is
also the biggest risk factor for sudden cardiac death. Even one
to two cigarettes a day greatly increases the risk of heart attack,
stroke and other cardiovascular conditions.
- Nonsmokers
who are exposed to constant smoke also have an increased risk.
Goal:
Eliminate the use of all tobacco products. Stay away from other's
smoke.
More
information: Smoking
and Heart Disease
Lower your total cholesterol, LDL (bad) cholesterol and
triglyceride levels.
Excessive
lipids (fatty substances including cholesterol and triglycerides),
especially in the form of LDL cholesterol, cause the build-up of
fatty deposits within your arteries, reducing or blocking the flow
of blood and oxygen to your heart.
- There’s a
sharp increase in the risk for cardiovascular disease when total
cholesterol levels are 240 mg/dl and above.
Goals:
Total cholesterol less than 200 mg/dl
 LDL
cholesterol should be less than 70 mg/dl for those with
heart or blood vessel disease and other patients at very high risk
of cardiovascular disease, such as those with metabolic syndrome.
LDL cholesterol should be less than 100 mg/dl for those who have
a high risk of cardiovascular disease, such as some patients with
diabetes or those who have multiple heart disease risk factors.
For all others, LDL cholesterol should be less than 130 mg/dl.
Triglycerides
less than 150 mg/dl.
It is recommended
to have your cholesterol level checked as early as age 20 or earlier
if you have a family history of high cholesterol. The cholesterol
profile includes an evaluation of total cholesterol, HDL, LDL and
triglyceride levels. Your health care provider can tell you how
often to have your cholesterol tested.
Raise your HDL (good cholesterol).
HDL cholesterol takes the LDL (bad) cholesterol away from the arteries
and back to the liver where it can be passed out of the body. High
levels of HDL seem to protect against cardiovascular disease.
Goal:
HDL greater than 40 mg/dl; the higher the HDL level, the better.
More
information:
Cholesterol Guidelines
Lower high blood pressure
Blood
pressure is a measurement of the pressure or force inside your arteries
with each heartbeat.
- High blood
pressure increases the workload of the heart and kidneys, increasing
the risk of heart attack, heart failure, stroke and kidney disease.
- High blood
pressure is the biggest risk factor for stroke.
Goal:
120/80 mmHg or lower (high blood pressure is 140/90 or higher)
Control blood
pressure through diet, exercise, weight management, and if needed,
medications. Also limit alcohol, as it can increase your blood pressure.
More
information:
Control Diabetes
Diabetes
occurs when the body is unable to produce insulin or use the insulin
it has. This results in elevated blood sugar levels.
- People with
diabetes (especially women) have a higher risk of cardiovascular
disease because diabetes increases other risk factors, such as
high cholesterol, LDL and triglycerides; lower HDL; and high blood
pressure.
- Keeping diabetes
under control is essential in reducing your risk.
Goal:
Hemoglobin A1c test less than 7.0% if you have diabetes, and less
than 6.0% if you do not have diabetes. Follow-up
with your doctor on a regular basis.
More
information: Cleveland
Clinic Health Information Center
Maintain a healthy body weight
The
more you weigh, the harder your heart has to work to give your body
nutrients.
- Research
has shown that being overweight contributes to the onset of cardiovascular
disease.
 Excess
weight also raises blood cholesterol, triglycerides and blood
pressure, lowers HDL cholesterol and increases the risk of diabetes.
- How a person’s
weight is distributed also is important. People who carry their
weight in the middle have a greater risk of developing cardiovascular
disease, compared to people who carry their weight in their arms
and legs. Waist measurements are one way to determine fat distribution.
- Weight is
best determined by calculating Body Mass Index (BMI). BMI is a
figure calculated from your height and weight. Doctors often use
BMI as an objective indicator of whether a person is overweight,
underweight, or at a healthy weight, and it is recommended by
the National Institutes of Health for this purpose.
To calculate
your BMI, divide weight in kilograms (kg) by height in meters
squared (m2).
Metric conversions are: pounds divided by 2.2 = kg; inches
multiplied by 0.0254 = meters.
For example,
a woman who weighs 140 pounds and is 5 feet, 6 inches tall
has a BMI of 23.
140 lbs divided by 2.2 = 64 kg
5’6” = 65” x 0.0254 = 1.65
1.652 = 2.72
64 divided by 2.72 = 23
Your health
care provider can help you calculate your BMI.
Goals:
A normal BMI ranges from 18.5 to 24.9 kg/m2. Overweight
is defined as having a BMI higher than 25 kg/m2. A BMI
higher than 30 kg/m2 is considered obese.
Waist measurements
for women should be less than 35 inches. Men should aim for a waist
less than 40 inches.
Achieve and
maintain a desirable weight. A diet and exercise program will help
you reach your goal.
More
information: Overweight
and Heart Disease (includes BMI calculator)
Exercise
The heart is like any other muscle -- it needs a workout to stay
strong and healthy. Exercising helps improve how well the heart
pumps blood through your body.
- Activity
and exercise also help reduce so many other risk factors: You
can lower blood pressure, lower high cholesterol, reduce stress,
achieve and maintain a healthy body weight, help yourself quit
smoking and improve your blood sugar levels.
Goals:
Moderate exercise 30 minutes a day, on most days. More vigorous
activities are associated with more benefits.
Exercise should
be aerobic, involving the large muscle groups. Aerobic activities
include brisk walking, cycling, swimming, jumping rope and jogging.
If walking is your exercise of choice, use the pedometer goal of
10,000 steps a day.
Consult your
doctor before starting any exercise program.
More
information:
Exercise for your health
Follow a heart-healthy diet
The old saying, “You are what you eat,” may be truer than
ever - especially when it comes to cardiovascular disease. Four
risk factors are related to diet: high blood pressure, high blood
cholesterol, diabetes and obesity.
Goals:
Eat foods low in sodium, saturated fat, cholesterol, trans fat (partially
hydrogenated fats) and refined sugar.
Omega-3 fatty
acids are good fats and come from tuna, salmon, flaxseed, almonds,
and walnuts. Mono- unsaturated fats also are preferred and are found
in olive and peanut oils.
Also eat plant-based
foods such as fruit and vegetables, nuts and whole grains.
More
information:
Nutrition Strategies
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Contributing
Risk Factors
(check which
ones apply to you)
Some risk factors
are not considered traditional risk factors, but are still thought to
contribute to overall risk for heart disease. These include:
Individual response to stress: Although
stress is not considered a traditional risk factor, some researchers have
noted a relationship between cardiovascular disease risk and stress in
a person’s life, their health behaviors and socioeconomic status. Stress
may affect established risk factors.
Learn to manage stress
by practicing relaxation techniques, learning how to manage your time,
setting realistic goals, and trying some new techniques such as guided
imagery, massage, Tai Chi or yoga.
Drinking too much alcohol Intake of too much alcohol
can lead to increased blood pressure, heart failure and stroke. It is
also linked to high triglycerides, irregular heart beats, obesity, and
cancer. Research has shown that those who drink one drink per day (4 oz.
of wine, 12 oz. of beer, or 1-1/2 oz. of 80-proof spirits) may have less
risk. However, the American Heart Association does not recommend that
non-drinkers start using alcohol or that drinkers increase the amount
they drink.
Know
your risk factors
If you have a family history of cardiovascular disease or high cholesterol,
it is even more important to decrease your other risk factors. Get your
cholesterol levels tested every year. Make sure you follow-up with your
health care provider every year for a checkup.
Ask your
doctor about the ultra-sensitive C-reactive protein (us-CRP) blood test.
High us-CRP levels are related to an increased risk of heart
attack, stroke, peripheral vascular disease and restenosis (reclosing)
of the arteries after angioplasty procedures.
Homocysteine
is a protein in the blood. High levels of homocysteine -- above
10 -- are associated with an increased risk of cardiovascular disease.
There have been conflicting studies about the benefits and risks related
to treatment of elevated homocysteine levels with folic acid and B vitamins.
Therefore, ask your doctor before taking these supplements.
Click
here to learn more about these laboratory tests
Resources:
To
learn more about risk factors for heart and blood vessel disease
Calculate
your risk
The following risk
factor assessment tools can be used to calculate your risk or make important
treatment decisions:
These tools are designed
to help you become more aware of your personal risk factors and to assist
you in understanding treatment options. They are not meant to replace
of the medical advice of your doctor or health care provider.
Here’s
to your heart-health! The
Preventive Cardiology and Rehabilitation Program at The Cleveland Clinic
comprises a multi-disciplinary team of physicians, nurses, dietitians,
exercise physiologists, and behaviorists. This team cares for people who
either have heart disease or who are at risk. The program includes assessment,
education, treatment and follow-up. A referral is required for an evaluation.
Preventive Cardiology provides reports to your referring doctor on your
treatment and progress.If you would like to be evaluated at the Cleveland
Clinic for risk factors and current prevention strategies for cardiovascular
disease, please use the Contact Us
Form or contact the Preventive Cardiology and Rehabilitation Program
at 216.444-9353 (or toll-free at 800/223-2273, extension 49353).
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