Every February is American Heart Month, a time to focus on the health of our heart, the organ that dutifully pumps blood throughout our body. While American Heart Month has been observed every February for decades and much progress has been made in improving heart health over that time, there is still much to be done and a great need for continued heart health awareness.
Heart disease, also called cardiovascular disease, remains the leading cause of death for both men and women in the United States, responsible for roughly one 1 in 4 deaths – some 659,000 people each year. Put another way, a person dies every 36 seconds from heart disease in this country. In addition, heart disease takes a terrible economic toll – when factoring in health care expenses and lost productivity, cardiovascular disease costs the United States more than $360 billion a year.
Despite these unfortunate statistics, a lot of progress has been made in the fight against heart disease. Increased knowledge about how to keep our hearts healthier longer has made a big difference. Advances in medical treatment have helped manage conditions that contribute to heart disease. And evolving technology gives people more tools than ever to help protect their cardiovascular health.
Types of Heart Disease
The term heart disease, or cardiovascular disease, encompasses a number of conditions, including:
- Heart Attack: Someone has a heart attack every 40 seconds in the United States. Also known as a myocardial infarction, a heart attack occurs when the heart suddenly receives inadequate blood flow. The longer the heart goes with insufficient blood flow, the greater the damage that will be done to the heart muscle.
Each year, more than 800,000 Americans suffer a heart attack. Nearly 25% of these are “repeat” heart attacks – in other words, the person has had at least one heart attack in the past. About 20% of all heart attacks are “silent” – the person has no idea he or she has suffered a heart attack, yet the heart has still sustained damage.
Everyone needs to be able to recognize the signs of a heart attack:
- Chest pain or discomfort
- Pain or discomfort in the jaw, neck or back
- Feeling weak, light-headed or faint (this is more common in women)
- Pain or discomfort in arms or shoulder
- Shortness of breath
IMPORTANT: If you or someone around you suddenly begins to experience one or more of these symptoms, call 911 immediately. The sooner you seek and receive medical attention, the greater your odds of recovering from a heart attack.
- Coronary Artery Disease: Coronary Artery Disease (CAD) is the most common form of heart disease and is often the root cause of heart attacks and other heart problems. CAD occurs when plaque – deposits of cholesterol and other substances – build up in the coronary arteries that supply blood to the heart. When blood flow to the heart is impeded over a long period of time, the heart weakens. If blood flow to the heart is completely cut off, a heart attack will result. CAD can also cause blood clots, which may lead to stroke.
- Angina: Angina is chest pain caused by reduced blood flow to the heart.
- Arrhythmia: Arrhythmia occurs when the heart beats irregularly. A heart that beats out of rhythm increases the risk of blood clots and stroke.
- Atherosclerosis: This condition is characterized by the narrowing of the arteries as a result of plaque buildup.
- Peripheral Arterial Disease (PAD): When the arteries that supply blood to the arms and legs narrow or stiffen as a result of atherosclerosis, the blood and oxygen flow to the limbs can be diminished or even blocked. This can lead to numbness, tingling and pain in the legs and arms.
- Cardiomyopathy: This condition results from the stiffening or enlargement of the heart muscle, which can cause inadequate blood pumping. Cardiomyopathy can result from many factors, including genetic ones. Uncontrolled high blood pressure is a key risk factor for this condition.
- Congestive heart failure: Congestive heart failure, sometimes referred to simply as heart failure, results from the gradual weakening of the heart muscle. The heart is still beating but no longer pumps blood correctly. One of the results of congestive heart failure is the buildup of fluids in the lungs, limbs and liver.
Top Causes of Heart Disease
There are a number of underlying health conditions that contribute to heart disease. High blood pressure, elevated cholesterol and diabetes are some of the most common, affecting millions of Americans.
Hypertension (high blood pressure):
Chronic high blood pressure, or hypertension, usually produces no noticeable symptoms, but can result in severe damage to the heart if untreated. Here are some key statistics:
- About half of all adults in the United States have hypertension
- Of those who have high blood pressure:
- Only one 1 out of 4 has their blood pressure under control
- 1 in 3 have no idea their blood pressure is elevated and therefore are not being treated for it.
- Many are young: 1 in 4 people aged 20-44 have hypertension
Blood pressure refers to the force of blood against the arteries and its measurement includes two numbers:
- Systolic (upper number): when the heart beats
- Diastolic (lower number): when the heart is resting, in between beats
Blood pressure is categorized in the following ways:
- Normal: Less than 120/80 mm Hg;
- Elevated: Systolic between 120-129 and diastolic less than 80;
- Stage 1 Hypertension: Systolic between 130-139 or diastolic between 80-89;
- Stage 2 Hypertension: Systolic at least 140 or diastolic at least 90;
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120
Consistently elevated blood pressure can damage the arteries over time. It also makes the heart work harder to pump blood, causing extra strain and possible damage to the heart. Hypertension often develops gradually with age. There are several known risk factors that contribute to high blood pressure, including:
- Too much salt consumption
- Too little potassium intake
- Excessive alcohol use
- Tobacco use
If diet and exercise are insufficient to bring blood pressure into a normal range, your physician may prescribe medication.
All adults should have their blood pressure checked by a medical professional periodically:
- Men and women, age 18-39: every three to five years
- Men and women, age 40 and older: at least once a year
Elevated Cholesterol
Cholesterol is a waxy, naturally occurring substance in our bloodstream. Our bodies need some cholesterol to help build healthy cells and aid in the digestive process. While we naturally produce all the cholesterol we need, we also consume additional cholesterol through food, such as meat, dairy and eggs.
Cholesterol is transported through the bloodstream by lipoproteins. There are two types of lipoproteins, low-density (LDL) and high-density (HDL). LDL is often referred to as “bad cholesterol” and HDL as “good cholesterol.”
LDL cholesterol is bad for us because it contributes to the buildup of plaque in the arteries, which can lead to coronary artery disease, angina and heart attack.
Conversely, the higher your HDL, the better – that’s because HDL transports cholesterol and fat through the blood and to the liver, so they can be eliminated from the body.
Triglycerides, a type of fat found in the blood, can also be harmful to cardiovascular health if levels are too high.
A cholesterol screening, which is a simple blood test that measures cholesterol and triglyceride levels, will determine if your levels are in the normal range. Everyone should receive cholesterol screenings periodically:
- Children between the ages of 9-11
- Young adults between the ages of 17-21
- Adults every 4-6 years, if no history of heart disease
- Adults with a history of heart disease should visit with their physician about how often to be screened.
If your LDL cholesterol is elevated, you can sometimes bring it down by making dietary adjustments. Eating less saturated fat, the type of fat found in meat and dairy, can help improve cholesterol levels.
In addition to dietary adjustments, HDL levels can be elevated through regular exercise, which has numerous heart health benefits. If diet and exercise alone are insufficient to bring cholesterol levels into a healthy range, your physician may prescribe a statin. Statins are commonly prescribed to reduce cholesterol levels and improve heart health.
Diabetes
A disorder of the metabolism, diabetes is a major risk factor for heart disease. Under normal circumstances, our liver breaks down carbohydrates into glucose, also known as blood sugar. The liver releases the glucose into the blood stream. Meanwhile, the pancreas produces insulin, a hormone that helps the body’s cells absorb the glucose and use it for energy. If a person’s cells are unable to absorb enough glucose, blood sugar levels rise. This can lead to diabetes.
Your doctor can check your blood sugar with a simple blood test. If glucose levels are elevated, there are several things that can be done to bring them down. Some foods should be avoided or eaten only in moderation, such as white flour products like bread and pasta, as well as white rice. Sugary drinks, including soda and fruit drinks, can also cause blood sugar levels to spike. Getting regular exercise and remaining hydrated are important keys to keeping blood sugar levels in check.
All adults should have their blood sugar levels checked periodically:
- Men and women ages 45 and older, every three years
- Men and women ages 19-44, if overweight or obese
- Women who have had gestational diabetes
Lifestyle Choices
Good decision-making is an important factor in our heart health; poor lifestyle choices can put our heart at risk – both by damaging the heart directly and increasing the likelihood of conditions discussed above.
Don’t Smoke!
Smoking is a leading cause of heart disease, not to mention numerous types of cancer. Here are a few of the ways smoking damages the heart:
- Causes arteries to narrow
- Elevates blood pressure and heart rate
- Increases the risk of blood clots and arrhythmia
- Contributes to unhealthy cholesterol and triglyceride levels
- Can contribute to diabetes
If you smoke, now is the time to quit. No matter how old you are or how long you have smoked, you will see immediate benefits from quitting: within one year of stopping smoking, the risk of heart attack drops significantly.
Eat Well
Among the advances in heart health the last few decades is a greater understanding of the role diet plays. People who are overweight or obese have an elevated risk of heart disease, partly because the heart must work harder to pump blood. So, what we eat and how much we eat are major factors in our heart health.
Generally speaking, these foods are good for us and our diets should be centered around them:
- Fresh fruits and vegetables
- Whole grains
- Unsalted nuts
- Lean meat
- Fish
- Water: we should all get at least 64 oz per day
Other foods should be eaten only in moderation, including:
- Fried foods
- Processed meats
- Food with high sugar or salt levels
- Alcoholic beverages
Everyone should completely avoid foods that contain trans-fat, which increases bad cholesterol and reduces good cholesterol. Soft drinks and other sugary drinks are a major contributor to obesity – they are loaded with calories and have no nutritional value.
Many of us need to rethink our serving sizes, as well. If you were to base a portion size on what you saw in a restaurant, you’d be eating way too much. An appropriate meat serving size – even for healthier meats like lean chicken or fish – is 4 ounces. A serving of whole wheat pasta – a good choice if the portion is not too large – is 1 cup, uncooked.
Familiarize yourself with nutrition labels on food. Use measuring cups and kitchen scales to ensure that you are not overserving yourself and your family.
Exercise for Your Heart
Do you ever wonder why they call it cardio exercise? It’s because activities like walking, running, swimming and bicycling provide your heart with a workout. By causing your heart to beat faster to pump blood, exercise helps your heart become stronger and healthier.
Exercise also burns calories, helping us keep excess weight off. It can also help lower blood pressure and increase the good, HDL cholesterol. As you can see, there are a lot of good heart health reasons to get moving!
Your exercise plan doesn’t have to be elaborate or expensive; you don’t have to join a gym or buy a bunch of equipment. Simply going for a brisk walk helps get your heart a needed workout. Get at least 30 minutes of physical activity, 5 days a week.
Sleep Well and Reduce Stress
Most adults need 7-9 hours of sleep a night, but many of us get less than that. Over time, inadequate sleep puts additional strain on your heart. Sufficient sleep is a way to mitigate stress, another contributor to heart problems. We all experience stress – learning to manage and reduce it are keys to not letting it adversely affect your health. In addition to adequate sleep, exercise and spending time on things you enjoy help to mitigate stress.
Put Technology to Work
While a device or app are not substitutes for the basics – eating right, getting exercise, avoiding tobacco – we have some technological tools at our disposal that can help us along the way.
If you have a smartphone, as most people do, you have a key asset that can help with healthy habits. Our phones double as a fitness tracker, logging the number of steps we take in a day and how many flights of stairs we’ve climbed. If you carry your phone in your pocket all day, that’s a useful way to track your steps.
There are hundreds of health and fitness apps you can use on your phone, as well. Many of them are free. In fact, phones come with pre-installed health apps: Apple Health if you’re an iPhone user; Google Fit if you use an Android. Not only can these apps track your steps, but you can also use them to log a lot of important health data and chart trends over time. For example, you can log your weight and then see if you are gaining or losing weight week to week.
If you’re watching what you eat, you can use any number of food-tracking apps to help you. Some will provide a calorie goal for each day, factoring in whether you are trying to lose weight and how many calories you have burned through exercise. Some food apps will track not only your calorie consumption but your nutrient intake – this can be useful for someone trying to watch how much salt or sugar they are consuming, for example.
If you have health conditions you are trying to manage, there may be specialized apps that can help. For example:
- If you have high blood pressure, you can use a smart blood pressure monitor that syncs to your phone, allowing you to easily log and track your blood pressure over time.
- If you have diabetes, you can use a Bluetooth-enabled blood glucose monitor that sends your results to your phone.
- Those with arrhythmia may benefit from a personal EKG device that syncs to their phone.
In many cases, these apps can also send the data to your health care provider (with your permission), so your doctor can monitor your results, as well.
Show Your Heart Some Love
This American Heat Month, make a promise that you will show your heart some love by taking good care of it. Eating right, getting exercise, avoiding tobacco – these are things we can all do to strengthen our heart. If you have an underlying condition, like high cholesterol or hypertension, work with your primary care provider on a plan to reduce your risk. And if it’s been a while since you’ve been in for a checkup and the routine screenings that can pick up early warning signs for heart disease, make an appointment to see your provider soon.
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