I know there are many factors that can increase my risk of heart disease. Can you tell me what they are and what are the best ways I can ensure a healthier heart?
— Trevor, Buhl
Answered by Dr. Mark Crandall, St. Luke’s Clinic, Cardiology:
Smoking definitely increases the risk for heart disease and is one of the most important things we discuss with patients. Even second-hand smoke can increase the risk for heart attacks. There are some very interesting studies in cities and states that have enacted smoking bans in public buildings that have shown the rate of hearts attacks have gone down after those laws were passed.
Another risk factor is high blood pressure, also known as the silent killer because many people don’t have any symptoms until there is a stroke or a heart attack. A blood pressure of 120 over 80 is normal. A blood pressure of 140 over 90 is when medication is likely to be prescribed, though our goals are slightly lower in patients with diabetes. Many people underestimate the benefit of a low salt diet and in exercising to help lower blood pressure. Even if you have a genetic predisposition to high blood pressure, maintaining a healthy weight and getting enough exercise will still have a large impact.
Cholesterol is the next major cardiac risk factor. Cholesterol levels can be confusing, but the most important one is the LDL cholesterol, or the “bad” cholesterol (think Lousy or Lethal for LDL). Your goal LDL cholesterol is determined by your doctor and may range from 70 in a patient with diabetes who has had multiple heart attacks to 160 for a young healthy patient. For most people, the goal LDL is less than 130. The other important cholesterol is the HDL cholesterol, or “good” cholesterol (think Healthy for HDL). This should be over 40, and is especially impacted by weight loss and increased exercise.
Other risk factors include a family history of heart disease, sedentary lifestyle, age, diabetes, and obesity, especially if you carry your weight in your abdomen. I believe that anyone over age 35 should know a handful of key numbers we use to estimate and lower the risk for having a heart attack: weight, body mass index, blood pressure, cholesterol, and fasting blood glucose.
If you have not had those things checked I would recommend meeting with your primary care physician. He or she will be able to discuss whether you need further testing or need to be referred to a cardiologist. Lowering your risk factors for heart disease is not a one time event or something that is done or thought about once or twice a year. It is a pattern of daily healthy choices that when added together over time will substantially lower your risk of heart disease.
Disclaimer: The content of this article is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Do not stop or delay seeking treatment because of something you read in this article. Further, the views or opinions expressed in this article are for informational purposes only and do not necessarily represent those of St. Luke’s. Reliance on any information provided by St. Luke’s, St. Luke’s employees or others supplying information for the column at the invitation of St. Luke’s is solely at your own risk.