Risk Factors
An estimated 25% of all Americans have one or more risk factors for heart disease, increasing their risk for heart attack. Most risk factors for heart disease are related to lifestyle. Some risk factors, (such as age, gender, and ethnicity) cannot be changed. Nevertheless, overall risks can be reduced with healthy lifestyle changes. [For more information on heart disease, see In-Depth Report #3: Coronary artery disease.]
Guidelines for Preventing Heart Disease and StrokeThe American Heart Association's guidelines for preventing heart disease recommend: Improve Cholesterol. People with at least two risk factors and a 10-year risk for heart disease or stroke of more than 20% should aim for LDL levels of less than 100 mg/dl. Statins are now used in more cases. Keep Blood Pressure Low. People in normal health should have a blood pressure reading of 120/80 mm Hg or less. According to new guidelines, blood pressure readings of 120/80 are considered normal, readings of 140/90 or higher indicate hypertension, and readings in between the two are called pre-hypertension. Patients with diabetes or chronic kidney disease should maintain blood pressure readings of 130/80 mm Hg or less, while others should be no higher than 140/90 mm Hg. Exercise. Everyone in normal health should engage in at least moderate physical activity for a minimum of 30 minutes on most -- if not all -- days of the week. Healthy Diet. Everyone should aim for a diet that contains a healthy balance of fruits, vegetables, grains, fish, nuts, legumes, poultry, lean meat, and low-fat dairy items. Avoid saturated fats and trans-fatty acids. Quit Smoking. Also avoid exposure to second-hand smoke. Maintain Weight. People should aim for a BMI index of 18.5 to 24.9. Take Aspirin. People at high risk for heart disease should take a low-dose aspirin every day, unless they have medical reasons to avoid aspirin. Control Diabetes. People with diabetes should aim for fast blood glucose levels of less than 110 mg/dl and hemoglobin A1C of less than 7%. Control Atrial Fibrillation. People with atrial fibrillation should use anticoagulants to reduce the risk for blood clots. Managing Acute Coronary SyndromeThe approach for managing acute coronary syndrome involves lifestyle changes and medications. Experts have come up with a mnemonic device (ABCDE) for remembering the factors that are fundamental for management of acute coronary syndrome: A. Antiplatelets, anticoagulants, and ACE inhibitors B. Blood pressure and beta-blockers C. Cholesterol-lowering drugs (typically statins) and cigarettes (stopping) D. Diet and diabetes control E. Exercise and education |
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