Your Heart's Health Is in Your Hands

Stopping heart disease before it starts is no longer the sole domain of doctors. These days you can do it largely by yourself if you watch what you eat, exercise when you can and keep close track of your cholesterol and blood pressure.

That also means there's no more excuses not to do it.

"It's all about keeping balance," says Dr. Ann Bolger, an associate professor of clinical medicine at the University of California, San Francisco and spokeswoman for the American Heart Association. "It's the stuff we do on a daily basis that is our downfall."

Many have fallen. Heart disease is the nation's top killer, claiming an estimated 700,000 lives annually. And 61.8 million people have some sort of cardiovascular trouble and 1.1 million suffer a heart attack each year, according to the AHA.

So, there's no better time to take your heart's health into your own hands, especially since February is Heart Awareness Month. Top cardiologists offer this advice on how to keep heart disease away:

• Don't Smoke: "The number one controllable risk factor for cardiovascular disease is cigarette smoking and exposure to tobacco smoking," Bolger says. "It's an extraordinarily powerful risk factor."

• Keep Moving: "Regardless of your weight and other risk factors, people who are active versus people who are not have a tremendous advantage in terms of cardiovascular disease," Bolger says. "There's no pill that's anywhere near as effective as exercise." The best exercise is the one that you will keep doing and, for most people, that is going to be walking. It's easy, simple and you don't need expensive equipment or club memberships.

  Dr. Daniel Fisher, an assistant clinical professor of medicine at New York University School of Medicine, says government guidelines recommend at least 30 minutes of moderate physical exercise on most, if not all, days of the week. In general, Fisher adds, "the more you do the better, and the higher intensity the better." But keep it in perspective and discuss it with your doctor first. "We're not going to tell a 95-year-old to run the marathon," he says.

  Any exercise you do should give you energy and make you a little thirsty. "Exercise is such an equalizer. It keeps the big swings out of your blood pressure and out of your diet," Bolger says. "It's a great stress manager and you'll sleep better. And if you sleep better, your blood pressure is in better control."

• Eat a Healthful Diet: "Obesity and being overweight in America is now an epidemic," Fisher says. "Controlling your weight is unbelievably important. As weight goes up, so does the risk of high blood pressure."

  In general, fat should make up 25 percent to 30 percent of total calories, but you also need to pay attention to the proportion of saturated fats, polyunsaturated fats and monounsaturated fats you're consuming. Protein should represent about 15 percent of calories. And carbohydrates -- from complex whole grains, fruits and vegetables -- should account for the rest of calorie consumption. You also want pay attention to portion size. "If that stuffed mushroom has lots of cheese or sausage in it, have one and eat it slowly and love it but don't have two," Fisher says.

  Counter fatty foods with raw vegetables or fruit. This, in turn, can offset the risk of sudden heart attacks, which have a greater chance of occurring when there's a swift surge of fat in the blood. Follow high-salt foods with a glass of water, which will also help fill you up. And if you fall off the wagon, don't dig a deeper hole by launching a gastronomic free-for-all. Just refocus and move on. "Just because you made a bad choice doesn't mean that the next one can't be good," Bolger says.

• Know Your Vital Statistics: That means your blood pressure and your cholesterol levels. "As your blood pressure increases, so does the risk of cardiovascular disease and stroke," Fisher says. Healthy adults need to stay under 140/90. People with diabetes and heart disease need to go lower. "The higher risk you are, the more aggressive you should be with any of these things," Fisher adds.

  And make sure your doctor tells you what your numbers are. "Your doctor should write your blood pressure down as you leave," Fisher says. "If they don't tell you, you should ask." As for cholesterol levels, if your total cholesterol is less than 200 mg/dL, your heart attack risk is relatively low, unless you have other risk factors. People whose cholesterol level is from 200 to 239 mg/dL are borderline high risk.

• Get Support: To get on the path to heart health, enlist the aid of your friends, your doctor or even your dog (if it will persuade you to go for a walk). "Look for sources of support during high-stress times," Bolger advises. "Your friends are facing the same issues. Walk with them, talk to them. Just talking about something in advance can help you." Also, consult your doctor. "You should be speaking with your doctor even if you're young, in your twenties," Fisher says. "Have your complete cholesterol panel drawn. If you're young you don't have to do it often, but you should do it."

More information

The American Heart Association's Simple Solutions Program has tips on healthy living for women. Men and women can check out lifestyle and risk reduction strategies from the association. The National Institutes of Health has a wealth of information on heart and vascular diseases.