In my last post, I explained what happens inside someone’s body during a heart attack.  In this post, I want to share how to prevent heart attacks from occurring.

A heart attack happens when a narrowed, damaged area in an artery (on your heart) becomes a near (or complete) blockage.  Arteries are like flexible pipes that run all through your body, and blood travels through them.  Your blood, which travels through these pipes, carries oxygen and nutrients to every cell in need (and every part of your body is made up of cells).  Healthy pipes help ensure healthy cells.  And healthy cells make up a healthy body.

When part of an artery gets injured, it is similar to a pothole forming in a road. The damage progresses until it’s so bad that repairs must be made.  Since arteries are like pipes (or tunnels), the damage and resulting repair crew can actually block off the pipe (or tunnel), preventing the “traffic” of blood from moving through the tunnel.  When this happens, the cells “downstream” don’t receive blood (or the oxygen and nutrients it carries), and those cells can actually die if the blockage isn’t removed promptly.

https://www.nhlbi.nih.gov/health/health-topics/topics/heartattack

So, in order to prevent a heart attack, you need to prevent that initial damage (“pothole”) from forming in heart arteries.

What causes damage to arteries?

Based on research, a helpful list of damage-causing factors has been compiled.  If you can control (or prevent) these risk factors, you can often prevent a heart attack.

• Smoking
• Diabetes
• High blood pressure (hypertension)
• High cholesterol
• Inactivity (lack of physical activity)
• Obesity/Overweight
• Stress

There are 2 main risk factors that you can’t control: 1) family history, and 2) age (55 or older, especially in women).   If you have a strong family history (parents, siblings) of heart problems, look at the list above and carefully control the things you can change.  

At work, I sometimes talk with people who have a strong family history of heart disease, and they have a very defeatist, there’s-just-nothing-I-can-do attitude.  They essentially resign themselves to “inevitable” heart attacks, stents, heart failure, or a CABG.  This attitude is based on false assumptions.  While some people are more genetically prone to developing the risk factors that cause artery damage, everyone can work to control them!  These people may have to put forth more effort than others, but those risk factors (and resulting artery damage) are not their inevitable destiny.  Additionally, the lifestyle (exercise and eating habits) of families and siblings tend to be very similar.  People tend to eat and exercise like their parents and siblings eat and exercise–and lifestyle largely determines the presence or absence of chronic diseases like diabetes, hypertension, high cholesterol, etc.

Let’s discuss the risk factors that cause artery damage in more detail.

Smoking

Many people know that tobacco use and smoking damage lungs and cause cancer.  Those are both true (I see it all the time at work).  However, smoking and tobacco (cigarettes, cigars, etc.)  don’t just damage lungs.  Nicotine and tobacco use also damage arteries all over your body.  Smoking is a huge cause of artery damage and artery blockages, not only in the heart, but also in the legs (causing peripheral arterial disease and amputations); the brain (causing a stroke); and everywhere else.  If you want to avoid artery damage, you must find a way to quit smoking.  Nicotine is incredibly addictive, but you can quit!  Some people attempt to quit 5-7 times before they are successful.  The most important thing is to keep trying!  Often, a combination of temporary nicotine replacement (gum, patch, lozenge, nasal spray, etc) and support groups/use of hotlines (like 1-800-QUIT-NOW) promote success.  

Diabetes

Diabetes is a disease that causes abnormally high levels of sugar in a person’s blood.  Those high blood sugar levels damage arteries all over the body.  Those damaged arteries, in turn, are the primary reason that diabetics (who don’t control their blood sugar well) develop eye problems; kidney problems; heart problems; and nerve problems (neuropathy).  Learning to eat correctly and exercise adequately in order to control blood sugar levels is essential.  A normal blood sugar is 70-100 (mg/dl) before eating and less than 140 (mg/dl) after eating.  In other words, a non-diabetic person’s blood sugar never goes above 140, even after eating.  The same is not true for a person with diabetes.  In the hospital, we frequently see blood sugar levels 200-300 (or higher).
Medications (and, eventually, insulin shots) also play in role in controlling blood sugars.  But if more people would take their eating habits (especially total carbohydrate intake) seriously, and exercise consistently, they would be able to keep their blood sugar levels within the safe range and spare their arteries and organs (such as eyes, kidneys, and heart).  A registered dietician can provide helpful food counseling and advice.

High Blood Pressure

High blood pressure (hypertension) has been called “the silent killer” because many people don’t feel bad when their blood pressure is too high.  Unfortunately, high blood pressure damages arteries.  It also forces the heart to work much harder to pump blood out to the body.  Imagine pumping air into a bicycle tire that is already full of air and tight–you have to work really hard to pump against that pressure.  Similarly, your heart has to work very hard when your blood pressure is too high.  It’s really important to keep your blood pressure within a normal range–the ideal range is less than 120/80.  The 3 main factors that control blood pressure include:

• Adequate exercise
• Less salt: Eat 2,300 mg (or less) of salt per day (many Americans eat double this amount)
• Anti-hypertensive medications

High cholesterol

Cholesterol is a major component of the plaque that builds up inside artery walls, making them hard, thick, and damaged.  High levels of cholesterol in the blood damage arteries.  High cholesterol levels develop primarily from eating bad fats: saturated fat and trans fat.  Saturated fats are found in animal products: meat and dairy (cheese, yogurt, etc), and some tropical oils (like coconut oil).  Choosing lean cuts of meat and low-fat or fat free milk, cheese, yogurt, sour cream, etc. will lower your intake of saturated fat (and, therefore, decrease cholesterol levels in your blood).  Avoid eating coconut oil, as well. Trans fats are found in fried foods and hydrogenated oils.  Avoid eating those, as well.  Besides decreasing your saturated fat and trans fat intake, exercise decreases cholesterol levels.  Cholesterol-lowering medications are also commonly prescribed to help, as well.

Lack of Physical Activity

If you read each description above, you may have noticed a common theme: adequate exercise is extremely beneficial to your health.  Exercise decreases blood sugar levels; decreases blood pressure; decreases cholesterol levels; decreases stress (yay endorphins!); and decreases total body weight.  Exercise is not optional if you want to be healthy.  But don’t think you have to run a marathon to reap the benefits of adequate exercise.  Start wherever you are. Some physical activity is much better than none.  If you can currently go for a 2-3 minute walk, do that.
Your eventual goal (to work toward) is to clock a solid 10-minutes of physical activity at a time; and you want at least 30 minutes total per day, most days of the week.  This means that 3, 10-minute long walks spread throughout the day are just as beneficial as 1, 30-minute walk.  But once again, just do something.  Start somewhere!  We were made to move.

Obesity

Obesity, though very common, is very hard on someone’s body.  Obesity increases your chances of developing diabetes, high blood pressure, and high cholesterol (which all damage arteries).  It also increases your chances of heart disease, stroke, sleep apnea, and joint problems.  Obesity is having too much fat stored in your body, and it is measured by a person’s BMI (body mass index), a calculation based on someone’s height and weight.

BMI calculator: 

https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

• Overweight: BMI of 25-29.9
• Obese: BMI of 30 or more

Adequate exercise and decreasing the amount of food eaten are the 2 best ways to use up fat stores and reach a healthy weight.  When losing weight, it is important to only lose 1-2 pounds per week; losing more than that means you’re actually losing muscle, not fat.

Stress

Consistently elevated stress levels (and the resulting hormones, like adrenaline) can cause heart problems over time.  Learning effective ways to cope with stress is very important.  Everyone will feel stressed at times, but feeling stressed most of the time just isn’t healthy.  Exercise releases endorphins that make you feel relaxed and happy.  Hobbies can be very helpful.  Learning to intentionally relax muscles and take deep breaths for 5-10 minutes at a time can also decrease stress levels.  Yoga helps manage stress.  Relaxing, instrumental music can also help.  Adequate sleep improves mood, coping, and resiliency.  Also, research has shown that keeping a journal is very helpful.  Try a variety of things and decide what works best for you.

Managing these risk factors will often necessitate changes in lifestyle.  I’m writing a book called Healthy Living and Weight Loss that will offer step-by-step guidance for how to achieve your health goals and have a healthy heart and body.  I always tell my patients to choose one goal at a time, and always make your goal realistic.  If you attempt to change everything at once, you won’t change anything at all.  Pick your top priority and focus on it; then, when you’ve accomplished it, choose the next thing to work on.  Just take it one step at a time!

Copyright 2017 by Laura Richie.  All rights reserved.