10 must-dos to keep your heart healthy
*Heart disease is the number one killer of Canadian women. The country's top cardiologists offer wise advice on how to be heart smart. *
by Alison Grafton (homemakers.com)
On a chilly morning three years ago, Mary Stasyk* awoke not to her 6 a.m. alarm but to a severe chest pain that radiated to her jaw and the back of her neck. "I thought I was having a bad bout of heartburn or had hurt my chest muscles working out with weights," recalls Mary, who was 46 years old at the time. Later that day in a Toronto hospital, a cardiologist told Mary that she had suffered a heart attack. She was shocked: "I thought I was way too young and definitely the wrong sex."
Too many Canadian women share that attitude, notes Dr. Beth Abramson, a cardiologist at St. Michael's Hospital in Toronto and a spokesperson for the Heart and Stroke Foundation of Canada. "Though surveys show that women's greatest fear is breast cancer, heart attacks and strokes account for more deaths in women than all cancers combined," says Abramson.
It's best to address your vulnerability to heart disease as early as possible, especially if you have a family history of early heart disease -- a father who had a heart attack before age 55, a mother before age 65 or a sibling who has suffered a heart attack. Here are the top 10 ways to reduce your risk of coronary heart disease and heart attacks.
1. Stop smoking.
"This step will give you the single biggest bang for your risk-reduction buck," says Arthur. A woman who smokes is two to three times more likely to develop heart disease than a nonsmoker. That's because tobacco smoke cuts oxygen to the heart, promotes inflammation and fatty deposits in the arteries and makes the blood more apt to clot. "Smoking a pack a day is as bad for your heart health as gaining 65 pounds all at once," says Abramson. "But stopping smoking starts to have a positive impact on the blood vessels within days, and after two or three years, an ex-smoker's risk of heart disease is similar to a nonsmoker's."
As well, be sure to avoid secondhand smoke, says Dr. Andrew Pipe, director of prevention and rehabilitation at the University of Ottawa Heart Institute. "An idling cigarette delivers even more toxic chemicals to a bystander than to the smoker who inhales it."
*2. Exercise regularly. *
Compared with their active sisters, sedentary women run up to double the risk of heart disease and stroke. Exercise offers many benefits: it strengthens the heart muscle and makes it a more efficient pump, keeps weight in check, controls blood pressure and blood fat levels and helps to reduce stress -- all cardiac risk factors. It also raises high-density lipoprotein (HDL), the "good" cholesterol that whisks fat away from arterial walls. In 2000 the long-standing Nurses Health Study out of the United States reported the need for more than three hours of moderate aerobic exercise a week to lower your risk, says King. The Heart and Stroke Foundation of Canada recommends at least 30 minutes of brisk walking a day.
3. Eat a heart-healthy diet.
The best recipe for heart health is a varied regimen rich in fibre and low in saturated fats. "Heart-healthy eating can help maintain a healthy weight, which in turn reduces the risk of high levels of blood fats -- cholesterol and triglycerides -- blood pressure and blood sugar," says Susie Langley, a clinical dietitian in Toronto. Select wholesome and unprocessed foods that are low in refined starch and sugar, saturated fats and sodium. Get plenty of fibre from whole grains, legumes, vegetables and fruits and choose lower-fat dairy products and leaner meats. Pass on fatty meats, deep-fried foods as well as excess cheese, butter and cream.
Twice a week, aim to eat deep-coloured fish such as salmon, tuna and sardines, which are rich in heart-healthy omega-3 fatty acids. Also steer clear of plaque-promoting trans fats found in commercially baked goods, potato chips and french fries. "But don't forget the heart-friendly fats in walnuts and flaxseeds, and in soya, canola and olive oils," adds Langley.
4. Maintain a normal blood pressure.
High blood pressure forces the cardiac muscle to work harder and become thicker, stiffer and less efficient at pumping. "Controlling her blood pressure could enable a 35-year-old woman with hypertension to protect herself from dying one to six years early," says Corinne Hodgson, a Burlington, Ont.-based health statistics consultant. "Blood pressure should be kept below 140/90 -- even lower if you have other cardiac risk factors," adds Arthur. A healthy weight, regular exercise and limiting your alcohol intake can help maintain a normal blood pressure. "Have your pressure checked at least once a year by your physician, more often if you have risk factors for hypertension or heart disease," says Pipe.
*5. Keep blood fats in check. *
High blood levels of cholesterol, which is a fatlike substance, and other blood fats help form artery-clogging plaque. An especially dangerous combination is a high level of the "bad" low-density lipoprotein (LDL) cholesterol that carries fat to arterial walls and a low level of the "good" HDL cholesterol that whisks fat away to the liver for elimination. The current norm is a maximum of 5.2 millimoles of cholesterol per litre of blood in people with no other cardiac risk factors, or 4.2 in the presence of other risk factors. A healthy weight, heart-friendly diet and plenty of exercise tame blood fat levels.
*6. Watch your weight. *
Excess body fat -- especially in the waist area -- increases the heart's workload and can elevate blood pressure and cholesterol. "It also decreases the body's response to insulin in a condition called insulin resistance, a risk factor for diabetes and heart disease," says Abramson.
7. Keep diabetes at bay.
Diabetes can quadruple your risk of cardiovascular disease because it usually involves abnormal levels of blood fats that can promote plaque formation. A healthy weight (with a particular focus on reducing abdominal fat), low-fat, high-fibre diet and exercise are your allies. Your doctor will tell you if you need early blood sugar testing based on your diabetes risk factors. Current guidelines recommend testing at age 40 and then every three years.
*8. Curb your alcohol intake. *
Too much alcohol can increase weight, blood pressure and blood fat levels. Women should consume no more than one unit per day: 1.5 ounces of spirits, 5 ounces of wine or 12 ounces of beer, says Langley.
9. Manage your mental health.
For most people, the important thing is how they react to the stressors of everyday life. "If your response is to smoke more, drink more and overeat instead of, say, going for a brisk walk, your heart disease risk will go up," says Abramson. And if you suffer from chronic depression and anxiety and are prone to anger, get help: researchers report links between heart disease and these conditions.
*10. Avoid long-term hormone replacement therapy (HRT). *
In 2002 the Women's Health Initiative Study reported a small but significant increase in heart disease, blood clots and strokes in women taking daily combined estrogen-progestin HRT for more than four years. "For preventing heart disease, you'd be better off going for a brisk walk three times a week," says Abramson.
Making changes to your lifestyle may be tough in the beginning, but there are many rewards. You'll feel better, have more energy and lower your risk of stroke, cancer, type 2 diabetes, osteoporosis and heart disease. As an added bonus, King says: "Your new healthier diet and lifestyle can improve the well-being of your entire family."
• Not her real name.