Preventing a Heart Attack

An Ounce of Prevention is Worth a Pound of Cure
by John M. Cox, DO, FACC
Published in The Joplin Globe
Thursday, February 19, 2009

Cardiovascular disease is the number one killer in the United States. This is primarily due to the lifestyle of most Americans. While we cannot run away from our genetics, if an individual has a strong family history of cardiovascular disease, there is certainly an increased risk. However, modifiable risk factors are in your hands and can be changed, resulting in a marked decrease in the incidence of death and cardiovascular problems.

The four states region has one of the highest incidences of cigarette smoking in the United States; nearly one third of our population smokes. Cigarette smoking accelerates the aging process in the blood vessels, including increased cholesterol deposits and subsequent problems, such as stroke, heart attack, and blockage of blood vessels of the limbs. When I discuss this issue with my patients, I often ask them how many body parts they are willing to sacrifice in return for continuing to smoke. This is precisely what an individual does when they smoke. Eventually, they substantially increase their risk of heart attack, stroke, loss of limb due to amputation, renovascular disease and, of course, increase the risk of a multitude of cancers. Discontinuing tobacco products is vitally important in reducing cardiovascular risk.

The food we eat also profoundly affects our health. A high fat diet increases the risk of not only cardiovascular disease, but a variety of cancers, and obesity. A healthy diet is low in saturated fats such as fruits and vegetables and high in monounsaturated fats such as ocean-swimming fish, certain types of nuts, and olive oil, among others. This is not to say that one cannot eat some animal fats, but this should be limited. A three to six ounce serving of grilled or broiled lean meat, low fat dairy products, whole grain fruits and vegetables and no more than two eggs per week will reduce your caloric intake and help keep weight in the normal range.

Regular physical exercise is an essential part of a healthy lifestyle. There have been many studies demonstrating that continued viability as one ages is greatly dependent upon regular physical and mental activity. Exercise should be at least thirty minutes three to four times a week. The intensity of the exercise should be such that one gets breathless or feels like a workout has taken place. Increasing the exercise duration and frequency beyond this certainly adds additional conditioning and reserve. The exercise should be designed so that, as we age, the joints are protected. Exercise bicycles and elliptical machines are generally less stressful on the joints. However, a simple brisk walk outside is an excellent way to get exercise as well.

Other modifiable risk factors include tight control of blood pressure and high cholesterol and, if you are diabetic, blood sugar. “Normal” blood pressure is generally less than 135/85. Individuals over the age of 80 might tolerate a slightly higher pressure than that, but certainly not greater than 150. High blood pressure increases the risk of stroke and heart attack, and prematurely ages blood vessels. With enough work, your physician should be able to control blood pressure in those ranges. Blood sugar should also be tightly controlled. Again, this requires a cooperative effort with your physician.

Some individuals are born with a tendency to have higher cholesterol than others. The level of cholesterol in the blood that is “safe” depends on your other medical problems. If you have a known blood vessel blockage, it is generally accepted that the bad cholesterol, LDL, should be less than 70. Diabetics should also have an LDL goal of less than 100 and, more appropriately, closer to 70. Medications to lower cholesterol are available and generally have a low risk of side effects.

We are fortunate to have excellent facilities for the care of heart disease in this region. However, the best plan is not to need those facilities in the first place by taking good care of yourself through diet, exercise, abstinence from cigarettes, and control of such things as high blood pressure, diabetes, and high cholesterol.

About John M. Cox, DO, FACC
John M. Cox, DO, FACC, is a Cardiologist at Freeman Heart and Vascular Institute.