Some risk factors for heart attack cannot be changed. These include age (coronary heart disease increases with age, especially in men age 45 and older and women age 55 and older); gender (before age 50, heart disease is far more common in men than women—though after menopause, women’s risk increases); and heredity (you are at increased risk of a heart attack if you have a father or brothers who experienced a heart attack before age 55 or a mother or sisters who had a heart attack before age 65.
But most of the established risk factors associated with a heart attack (or stroke) can be modified. These include cigarette smoking; high blood pressure; elevated levels of cholesterol and other lipids (fats); obesity; and a lack of physical activity.
Here is an easy-to-remember checklist of primary heart attack prevention measures for people without symptoms or a history of heart disease. For some measures, more stringent recommendations apply to people with known heart disease or who are at very high risk.
Checklist of Primary Prevention Measures to Protect Against Heart Attack and Heart Disease:
Blood Pressure -- Goal: Your blood pressure should be below 140/90 mm Hg; 120/80 mm Hg is optimal; if you have diabetes, coronary heart disease, or kidney disease, your blood pressure should be below 130/80 mm Hg.
If you cannot reach this goal after three months of lifestyle changes, you may benefit from medication to lower blood pressure.
Cholesterol -- Goal: Your total cholesterol should be below 200 mg/dL. Levels of LDL ("bad") cholesterol should be below 160 for people with no more than one risk factor; below 130 for those with two or more risk factors; below 100 (with an optional goal of below 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.
Levels of HDL (“good”) cholesterol should be above 40 in men an above 50 in women; levels of triglycerides should be below 150.
If you cannot reach your LDL goal after three months of dietary changes, consider drug therapy to lower LDL. Exercise, improvements in diet, and quitting smoking can help you meet HDL and triglyceride goals.
Diet and Weight Control -- Goal: Consume a variety of fruits, vegetables, grains, low-fat or nonfat dairy products, fish, legumes, poultry, and lean meats. Saturated fats should make up less than 10% of total calories. If overweight, make changes in caloric intake and 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).
Exercise -- Goal: Perform at least 30 minutes of moderate-intensity aerobic physical activity (such as brisk walking) on most days of the week as well as muscle-strengthening exercises twice a week. More vigorous and frequent activity can provide additional benefits, including weight loss if caloric expenditure exceeds caloric intake.
Additional Special Goals:
- If you smoke, stop completely.
- Low-dose aspirin (81 mg per day) reduces the tendency of blood to clot, thereby decreasing the risk of a heart attack. If you are at elevated risk for a heart attack, you may benefit from aspirin therapy. However, aspirin is not recommended for everyone, so be sure to consult with a physician before starting aspirin therapy.
- 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.
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Posted in Heart Health on November 26, 2005
Reviewed March 2010
