Change your life style to prevente heart desease
As these descriptions of the various forms of heart disease indicate, much is known about the causes, often referred to as “risk factors.” Some—such as heredity, age, race, and gender—cannot be controlled. But many others are controllable and there are many ways you can prevent heart disease.
Basically, heart disease prevention falls into two categories: lifestyle or behavior modification
Lifestyle
Cigarette Smoking. The single most important thing you can do to prevent heart disease is not smoke. If you do smoke, you should stop; your risk of heart disease will begin to decline, reaching the level of a non-smoker after 5 to 10 years.
The higher risk of cardiovascular disease in women due to smoking is similar to that of men. Low tar and low nicotine cigarettes seem to be no less harmful than regular cigarettes. A range of studies has shown that women who smoke are from 2 to 6 times more likely than non-smokers to develop heart disease. Statistics from the Nurses’ Health Study, a large, ongoing survey of women’s health, show that half of the cases of heart disease in women aged 30 to 55 can be linked to cigarette smoking.
The most dramatic increase in risk is in women who smoke and use oral contraceptives. Tests have shown that these women are 20 to 30 times more likely to suffer heart disease and stroke than women who do neither. However, most of the data on this subject came from studies done when participants were taking a much higher dose of estrogen than is currently prescribed. As a result, further research is needed on the effects of today’s lower-dose oral contraceptives.
Cigarettes act in a number of ways to increase your risk of heart disease. Smoking causes thickening of the blood, which can lead to clots. It raises the level of carbon monoxide in the blood, robbing the heart and other tissues of needed oxygen. The nicotine in tobacco also constricts the coronary arteries, raising blood pressure, and causing the heart to work harder. Thus smoking increases the amount of oxygen that the heart needs, while at the same time decreasing the amount it gets.
High blood pressure contributes to heart disease because it makes the heart work harder. Controllable factors that contribute to high blood pressure include overweight, lack of exercise, excessive salt intake, and cigarette smoking. It follows logically that losing weight, exercising, limiting salt in your diet, and stopping smoking can reduce blood pressure to healthier levels. Living with continually high levels of stress is also linked to high blood pressure.
The first thing you can do to control your blood pressure is to know what it is. Although you can measure blood pressure with a sphygmomanometer at the supermarket or shopping mall, it is a good idea to discuss the implications of your blood pressure level with your doctor.
Cholesterol, a very popular topic these days, is a substance that circulates in the blood, and is essential for functions such as producing some hormones (including estrogens) and building a protective membrane for our cells. We get some from what we eat, but mostly it is manufactured in the liver.
Cholesterol travels through the bloodstream attached to lipoproteins, compounds composed of fats (lipids), proteins, and triglycerides. There are four kinds of lipoproteins, classified according to their weights: very low density (VLDL), low density (LDL), high density (HDL) and very high density (VHDL). You’ve probably heard about “good” and “bad” cholesterol. The good is HDL, which is associated with a cleansing effect in the blood; and the bad is LDL, which leaves deposits on the interior walls of the arteries, hampering the flow of blood and leading to atherosclerosis.
In general, a total cholesterol count of less than 200 milligrams per deciliter of blood is viewed as healthy; if that count reaches 240, the risk of heart disease doubles. However, most of the studies that have drawn this conclusion have been done on men. One study focusing on women has found that the most important factor predicting coronary artery disease in women is not total cholesterol, but the ratio of HDL to total cholesterol: The higher your HDL, the less likely you are to get heart disease.
Triglycerides are another kind of fat in your bloodstream, but elevated triglycerides are not necessarily associated with an increased risk of heart disease. Triglyceride levels fluctuate widely throughout the day, depending on what you eat. They may, however, be associated with high cholesterol levels.
You can do a great deal to achieve a healthier cholesterol level by controlling your diet. Reducing cholesterol and fat intake, particularly saturated fats, will lower total cholesterol levels. Monounsaturated fatty acids (such as those found in olive and canola oil) tend to raise HDL, so those are the healthiest oils to choose for cooking. Polysaturated oils (safflower, corn) lower LDL, which is good, but also lower HDL. The worst offenders are the saturated fats (meat fat, butter), which raise LDL, lower HDL, and also include cholesterol itself. (For more information, turn to chapter 15, “A CommonSense Look at Diet and Health.”)
Diet is not the only thing that affects your cholesterol level; other factors include heredity, smoking, and hormones. Estrogen plays an important role in keeping cholesterol levels down, and the hormonal changes of menopause will adversely affect your LDL and HDL counts.
Exercise and weight. Lack of exercise has been shown to be a risk factor for heart disease. Regular aerobic exercise seems to tone the heart muscle and help prevent heart disease. Again, most of the studies about exercise and heart disease have been done on men, but the effects are thought to be similar in women. Strenuous athletics are not necessary; moderate exercise such as brisk walking or stair climbing are sufficient to benefit the heart.
Exercise also lowers cholesterol and blood pressure and is usually associated with weight loss. Being overweight also contributes to high cholesterol and high blood pressure, both factors in developing heart disease.
Body shape is another risk factor for heart disease. Women with “apple-shaped” bodies—more weight around the waistline—have a greater risk than “pear-shaped” women who carry most of their weight around their hips.
Women, especially those who have already suffered heart disease and those with high risk factors, should know that although the benefits of exercise usually outweigh the risks, there is a slight chance that strenuous exercise can contribute to heart attacks, strokes, and arrhythmias. You should plan and discuss any exercise program with your doctor, particularly if you have not been physically active for a while.
Alcohol consumption. The effect of alcohol on heart disease is a very controver-sial subject. On one hand, there is plenty of documentation of the negative effects of excessive drinking on not just the heart, but a number of body systems. On the other, a number of tests in recent years have indicated that moderate drinking (1 or 2 drinks a day) may protect against heart disease.
Social and psychological factors. It was once speculated that as women entered the workforce in increasing numbers and began experiencing the same workplace stresses as men, heart attack rates in middle-aged women would begin to approach those of their male counterparts. That has not happened. Women working outside the home have about the same rates of heart disease as women who don’t. Twenty years of research in the Framingham study found that employment itself is not predictive of heart disease, but factors such as high demands and low control of the situation, as well as financial anxiety, are related to higher rates of heart disease.
In men, heart disease has been linked to the so-called “Type A” personality, the impatient, driven, competitive personality type. No similar link has been found in women. In fact, Framingham data have shown that women who suppress anger and hostility are more likely to suffer heart disease than those who express it in the Type A manner. Having depression or anxiety is also linked to increased rates of heart disease in women.
Research over the last 10 years has consistently found that heart disease occurs more frequently in less educated women in lower socioeconomic groups than in better educated women in higher socioeconomic groups. The reasons for this are probably related to a number of factors including poorer health care, lack of health insurance, gender discrimination, and increased stress.