Johns Hopkins Health Alerts | Heart Health | Heart Attack Prevention

Dr. Roger Blumenthal and his cardiovascular team at Johns Hopkins offer guidelines to help you maintain a healthy heart.

You can modify or treat most of the risk factors associated with a heart attack or stroke. Here is an easy-to-remember checklist of primary prevention measures for people without symptoms of (a history of) coronary heart disease (CHD).

• Heart Attack Prevention Tip #1: Take low-dose aspirin.
  Goal: Low-dose aspirin (75 to 162 mg per day) for people at elevated risk for a heart attack. Not recommended for some people, so be sure to consult with a physician before starting aspirin therapy.
• Heart Attack Prevention Tip #2: Keep your blood pressure under control.
  Goal: <140/90 mm Hg (optimal is <120/80 mm Hg); <130/80 mm Hg for people with diabetes or kidney disease. If you cannot reach this goal after three to six months of lifestyle changes, you may benefit from medication to prevent a heart attack.
• Heart Attack Prevention Tip #3: Lower your cholesterol. Goal: Total cholesterol <200 mg/dL; LDL cholesterol <160 for people with no more than one risk factor for a heart attack; LDL <130 for those with two or more risk factors; LDL <100 (with an optional goal of <70) for some people with two or more risk factors as well as for those with diabetes, history of stroke or aortic aneurysm, peripheral arterial disease, or coronary heart disease; HDL >40 for men and HDL> 50 for women (and preferably >60 for both men and women); triglycerides <150. If you cannot reach LDL goal after three to nine months of lifestyle changes, consider drug therapy to lower LDL. Exercise, improvements in diet, and quitting smoking can help meet HDL goals.
• Heart Attack Prevention Tip #4: Watch your diet.
  Goal: Consume a variety of fruits, vegetables, whole grains, low-fat or nonfat dairy products, fish, legumes, poultry, and lean meats. Saturated fats should make up <7% of total calories. If overweight, make changes in caloric intake to achieve and maintain a desirable body weight (body mass index of 18.5 to 24.9). For those who drink, limit alcohol intake (no more than two drinks a day for men, one drink a day for women).
• Heart Attack Prevention Tip #5: Walk or do some form of exercise every day.
  Goal: Perform at least 30 minutes of moderate-intensity physical activity (such as brisk walking) at least five days of the week. More vigorous activity can provide additional benefits, including weight loss if caloric expenditure exceeds caloric intake.
• Additional Special Heart Attack Prevention Goals:
  Individuals who smoke should stop completely.
  Individuals with metabolic syndrome should reach normal fasting blood glucose levels (<100 mg/dL). People with diabetes should strive for the best possible control of blood glucose levels. If diet and exercise do not adequately lower blood glucose levels, medication is usually recommended; other risk factors for coronary heart disease must be treated aggressively.

Johns Hopkins Health Alerts | Heart Health | Heart Attack Prevention