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Johns Hopkins Health Alert

Heart Attack Prevention Checklist

Are you doing all you can to stay heart healthy? Here are the ABC's of heart attack prevention -- an easy-to-remember checklist of the steps you can take to prevent a heart attack, from the cardiologists at Johns Hopkins.

Aspirin -- A daily low-dose aspirin (75–162 mg a day) is advised for people with an elevated risk of a heart attack. In some individuals, a dose of 325 mg is recommended. Aspirin is not appropriate for everyone, so be sure to consult with your doctor before starting aspirin therapy for your heart.

Blood Pressure -- Keep your blood pressure below 140/90 mm Hg (and ideally less than 120/80 mm Hg). If you have diabetes or kidney disease, make sure your blood pressure is less than 130/80 mm Hg. If you're unable to reach these goals after three to six months of lifestyle changes, your doctor may prescribe a blood pressure-lowering medication.

Cholesterol -- Your total cholesterol should be below 200 mg/dL. Keep your LDL ("bad") cholesterol well under 160 mg/dL if you are at low risk for a heart attack, below 130 mg/dL if you are at moderate risk for a heart attack, and less than 100 mg/dL if you are at high risk for a heart attack (and ideally lower than 70 mg/dL if you're at very high risk, for example, because of a recent heart attack or stroke). Your HDL ("good") cholesterol should be 40 mg/dL or greater if you are a man and 50 mg/dL or more if you are a woman (and preferably 60 mg/dL or higher). Your triglyceride level should be under 150 mg/dL.

If you are unable to reach your LDL goal after three to nine months of lifestyle changes, your doctor may prescribe medication. Exercise, dietary modifications, and possibly medication can help you meet your HDL goal. Losing excess weight, exercising regularly, and medication can help reduce your triglyceride level.

Diet and Weight Control -- Consume a variety of fruits, vegetables, whole grains, low-fat dairy products, fish, beans, poultry, and lean meats. Saturated fats should make up less than 7% of total calories; trans fats, less than 1%. If you're overweight, reduce your calorie intake and increase your physical activity to achieve and maintain a desirable body weight (a BMI below 25).

Exercise -- Perform at least 30 minutes of moderate-intensity physical activity, such as brisk walking, on five days each week. Exercising for longer periods (60-90 minutes a day) or more vigorously can provide additional benefits, including weight loss if that's one of your goals.

Additional Heart Attack Prevention Goals:

  • If you smoke, you should stop completely.

  • If you have diabetes, strive for the best possible control of your blood glucose level (HbA1c less than 7%). If diet and exercise do not adequately lower blood glucose, your doctor will recommend medication.

  • If you have prediabetes, keep your fasting blood glucose level below 100 mg/dL. You can do this by reaching a healthy weight and engaging in regular physical activity.

Posted in Heart Health on March 13, 2009
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.




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