Johns Hopkins Health Alert
The ABCs of 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 (or a history of) coronary heart disease (CHD).
- Heart Attack Prevention Tip #1: Take low-dose aspirin.
Goal: Low-dose aspirin (81 mg per day) for men ages 45 to 79 whose risk of a heart attack exceeds their risk of gastrointestinal bleeding from aspirin. Not recommended soley to prevent heart attacks in women. However, aspirin can be considered for stroke prevention in women ages 55 to 79 if their risk of a stroke exceeds their risk of gastrointestinal bleeding. 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 (ideal is <120/80 mm Hg); <130/80 mm Hg for people with diabetes or kidney disease. If you cannot reach this goal after three 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 mg/dL for people with no more than one risk factor for a heart attack; LDL <130 mg/dL for those with two or more risk factors; LDL <100 mg/dL (with an optional goal of <70 mg/dL) for people with diabetes, history of stroke or aortic aneurysm, peripheral arterial disease, or coronary heart disease; HDL >40 mg/dL for men and HDL >50 mg/dL for women (and preferably >60 mg/dL for both men and women); triglycerides <150 mg/dL. If you cannot reach your LDL goal after three months of lifestyle changes, consider drug therapy to lower your LDL. Exercise, improvements in diet, and quitting smoking can help you meet your 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, reduce caloric intake and increase physical activity 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 prediabetes should reach normal fasting blood glucose levels (<100 mg/dL) by achieving a healthy weight and engaging in regular physical activity. People with diabetes should strive for the best possible control of blood glucose levels (typically, an A1c level of <7%). 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 in people with diabetes.
Posted in Heart Health on November 2, 2006
Medical Disclaimer: This information is not intended to substitute for the advice of a physician. Click here for additional information: Johns Hopkins Health Alerts Disclaimer
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They have already posted an article on the dangers of sleep apnea at: http://www.johnshopkinshealthalerts.com/alerts/lung_disorders/JohnsHopkinsHealthAlertsLungDisorders_470-1.html so I would say that Johns Hopkins more than gets it. It is simply a matter of not always cross-referencing all the articles, hence the search feature found at most good websites!
Posted by: Jo | November 12, 2006 10:54 AM
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Re: Dr. Blumenthal's entry on heart health in the 02Nov06 Health Alert
It is so ironic that the entry immediately following the one by Dr. Blumenthal described how heart attacks are three times more frequent in people with sleep apnea than they are in other people. Yet, preventing or overcoming sleep apnea was not included in Dr. Blumenthal's list of recommendations for heart health. Like most cardiologists, in spite of all the published studies on the impact of sleep apnea on serious cardiovascular problems, he still doesn't get it.
Posted by: Burt Abrams | November 4, 2006 3:43 PM