How to Keep Your Heart Healthy

In the media, with your family or friends, at your physician’s office, or at your local pharmacy, you may have heard the phrase “cardiovascular disease” and you may have been left wondering and nervous about what that means. How does it affect you? Are you at risk? Is it preventable? Hopefully, In this UIC Pharmacy blog, this information will help clarify what cardiovascular disease is, what are some associated-risk factors, and how can you prevent disease development or progression by living a heart-healthy lifestyle.

            Cardiovascular disease (CVD) is a term for a group of diseases that can affect your heart or blood vessels. Typically, it describes situations in which the normal blood supply of oxygen and nutrients are in some way interrupted and do not get to where they are going – the target organ or tissues. More specifically, the most common types of preventable diseases we are talking about include:

·       Heart attack – also known as a myocardial infarction, is when there is a sudden blockage in the blood supply to your heart (a blockage to the coronary arteries) that results in little to no blood flow and resulting cardiac muscle damage.

·       Stroke – an interruption to the blood supply to your brain; this can be either caused by a blockage to the blood supply or by a hemorrhage in the brain that causes less blood and oxygen to reach your brain.

·       Peripheral artery disease – blockage of blood vessels outside of the heart and brain.

·       Ischemic heart disease – progressive blockage of the blood vessels leading to your heart that can often present as shortness of breath  or chest pain. This eventually becomes full coronary artery disease and can lead to a heart attack.

            Scary statistics – the American Heart Association (AHA) estimates 81,100,000 American adults have one or more types of CVD ; 2,300 Americans die each day. There are approximately 1.2 million new heart attacks in Americans annually, with about 220,000 of those being fatal.

            As scary as the statistics are, there are ways to know your cardiovascular risk. Often by identifying your modifiable risk factors, you may see more clearly where you are at and ways to impact your health in a positive way. These modifiable risk factors include:

·       Hypertension – high blood pressure

·       Dyslipidemia – high cholesterol

·       Diabetes – high blood sugar

·       Obesity

·       Cigarette Smoking

·       Alcohol consumption

·       Physical inactivity

·       Inappropriate diet

Living a heart-healthy lifestyle

            Identifying risk factors is one thing, but actually doing something about them is more important in preventing or managing CVD. Diet and lifestyle modifications are adjustments you can make in your daily life to reduce your CV disease risk- just ask your doctor what changes are right for you. And, like all life changes, these may not be easy! The following will be tips to get you on your way to living as heart healthy as you can. To start, the AHA lists very key diet and lifestyle goals:

Ø  Eat an overall healthy diet

Ø  Aim for a healthy body weight

Ø  Aim for your specific cholesterol goals

Ø  Aim for your specific blood pressure goal

Ø  Aim for a normal blood glucose

Ø  Be physically active

Ø  Avoid tobacco products (stop smoking)

While these goals may seem simple, there are specific things you can do to reach them.

            Let’s start with your diet. According to the AHA, you should: 1) Balance calorie intake with physical activity to maintain a healthy weight. 2) Limit intake of saturated fat to <7%, trans fat to <1%, and cholesterol to <300 mg per day of daily calories. This can be done by eating lean meats or vegetable alternatives, fat free or low fat (<2%) dairy, and minimizing intake of hydrogenated fats 3) Consume whole grain, high fiber foods. 4) Eat a diet rich in fruits and vegetables. 5) Eat fish at least twice per week. 6) Minimize your intake of food and drinks with added sugars. 7) Choose and prepare foods with little to no salt. The following is an example provided by the AHA that describes more clearly what your heart-healthy diet may look like for a 2000 calorie diet:

Food	Recommendation	Serving size (equal to 1 serving)
Grains	6-8 servings/day	1 slice of bread, 1 oz dry cereal, ½ cup cooked pasta
Vegetables	4-5 servings/day	1 cup raw leafy vegetables, ½ cup raw or cooked vegetables, ½ cup vegetable juice
Fruit	4-5 servings/day	1 medium fruit, ¼ cup dried fruit, ½ cup fresh/frozen/canned fruit, ½ cup fruit juice
Dairy	2-3 servings/day	1 cup milk, 1 cup yogurt,  1 ½ oz cheese
Meats/Fish	<6 oz per day	lean meat (turkey, chicken), fish
Nuts/Seeds/Legumes	4-5 servings/day	1/3 cup nuts, 2 tbsp peanut butter, ½ cup dry beans or peas
Fats and oils	2-3 servings/day	1 tsp margarine, 1 tbsp mayonnaise, 2 tbsp salad dressing, 1 tsp vegetable oil

           

Being physically active is the next thing you can do – think of it as getting your heart in good shape. Before starting an exercise routine, it is advisable to get a physical and discuss with your doctor prior to starting. When you are ready to start, the AHA recommends that all adults capable accumulate ≥ 30 minutes of physical activity most days of the week. At least 60 minutes is recommended if attempting to lose weight or maintain weight loss. All of this physical activity is to help you cut your risk factors, as well as maintain a healthy weight.

            If you are a smoker, smoking carries with it great risk for not only CVD, but also cancer and other illnesses. Quitting smoking can start you on your way to a healthier lifestyle, and the impact is powerful for your overall health and risk factors. Smoking cessation is not easy, so if you would like to quit or are thinking about quitting, speak to your physician or your pharmacist and they can help you come up with a plan. There are good medications available and choosing the right way for you to quit is important for your success.

            Controlling other risk factors is important as well. If you have diabetes, high cholesterol, high blood pressure, these are all things that affect your cardiovascular health. Low salt meals will help your blood pressure, sticking to low fat/lean meats or fish will help your cholesterol, and low sugar meals will help control your diabetes. Doing what you can with diet and exercise can help these, as can medications from your doctor.  In terms of alcohol consumption, some studies have found that moderate intake has some beneficial effects on cardiovascular health. However, alcohol addiction or greater than moderate intake often leads to various adverse events..

            The following are some tips to help you implement changes: 

Ø  Track time and calories – how much time you spend sitting on the couch, watching television, or remaining sedentary versus how much time  you are physically active is important. Counting calories may help you stay on track with your diet to maintain a healthy weight 

Ø  Pay attention to your environment – being aware of the habits of others around you may help you change yours, especially if you identify them as barriers to your healthy lifestyle. Also, cooking at home is likely more controlled than eating at a restaurant. Staying active – using the stairs over the elevator, walking around the house and doing housework, walking to the grocery store versus driving. All of these may help keep you physically active and healthier. 

Ø  Medication adherence – if you have diabetes, high blood pressure, or high cholesterol, taking your prescribed medications every day will help improve your cardiovascular health 

      Other dietary interventions exist that may benefit your cardiovascular health. Fish oil supplementation, plant stanols/sterols, and coenzyme Q₁₀ supplementation are all things that may benefit your cardiovascular health and have some good evidence showing promise. Selenium, beta carotene, vitamin E, soy, folate, B vitamins, flavanoids – these are all things that have variable or no success in helping with cardiovascular health. Definitely discuss these interventions with your pharmacist if you are interested in more information.

            If you want more information on your heart health or CVD, talk to your UIC pharmacist. You can also visit www.heart.org, the AHA website for more information.

Prepared by: Matthew Jarotkiewicz, UIC PharmD candidate, 2012