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The topic most patients hate to hear from their medical provider is that they need to change their “life style.” Why is this? There is over whelming evidence that life style modification SAVE LIVES! Numerous medical studies have reconfirmed the American Heart Association’s stance that reducing modifiable risk factors and improving treatments will lead to a reduction in coronary heart disease. The risk factors for heart disease that we should have control over are; cigarette smoking, obesity, physical inactivity, high cholesterol, hypertension (high blood pressure) and diabetes mellitus. Either the education about the prevention is not communicated clear to our patients, or as I believe, the human condition prevents people from making changes. Face it, many of us do not like change. Obesity is an epidemic in adolescents and young children. We find excuse after excuse why we can not exercise, eat right and why we need to have that drink or cigarette or both. We say, “I am to busy or my life is to stressful right now to make any changes”. This is a defeatist attitude and an ingrained philosophy in many of us which can shave as much as a decade off of our life, especially those of us with multiple risk factors. So, what in the world can all of us do? Because, I have been talking about everyone, Doctors, Nurses, Administrative Staff, Technicians and 1st and foremost our Patients; I think the answer is simple - yet, extremely hard. We must develop and improve self-control and will-power no matter how busy or stressed we may be. As with anything, it takes PRACTICE and TIME to do this. I have read and believe for anything to become a routine you must practice it for at least 4 to six weeks without fail. Step 1: Decide in your heart, mind, and soul that you must get off of this Merry-Go-Round of Self Destruction and take control of your health and life! You may have no risk factors or you may have many Coronary Heart Disease Risk Factors. The key is Prevention. You will NOT be successful until YOU decide to do this. So do it! Get healthier! See your Primary Care Provider and get started. Step 2: Under the guidance of your provider start modifying those risk factors that you have control over. So how about a little motivation from the scientific facts? Click here to learn about the vice that interests you the most . . .
Cigarette Smoking: An addictive habit, no doubt! There are smoking cessation programs and medications available to help you stop smoking. Some have a 60% to 80% success rate. That is very good odds.
So here’s the good news . . . Obesity: Being overweight or obese (extremely overweight) has become all too common in the United States. Today, nearly two-thirds of American adults (about 200 million people) are overweight or obese. Even more concerning is that approximately 15 percent of children and adolescents are overweight, compared to just 4 percent a few decades ago, and another 15 percent are at risk for being overweight. An alarming number of children are obese and developing diseases normally seen in adulthood. Overweight adolescents have a greatly increased risk of dying from heart disease in adulthood. Even our youngest citizens are at risk. About 10 percent of preschoolers weigh more than is healthy for them. There is growing evidence of a link between "couch potato" behavior and increased risk of obesity and many chronic diseases. People who are overweight or obese have a greater chance of developing many medical conditions, including: Diabetes, High Blood Pressure (also known as Hypertension), High Cholesterol (also known as hypercholesterolemia) Stroke, Congestive Heart Failure, Gallbladder disease, Arthritis, Breathing problems, Sleep Apnea, Gout, Breast Cancer, Colon Cancer, Uterine Cancer (endometrial cancer). The good news: Even a small weight loss (just 10 percent of your current weight) will help to lower your risk of developing those diseases. It is hard to overstate the dangers of an unhealthy weight. If you are overweight, you are more likely to develop forms of heart disease such as heart attack, congestive heart failure, sudden cardiac death, angina (chest pain), and abnormal heart rhythm, even if you have no other heart disease risk factors. The more overweight a person is, the more likely he or she is to develop heart disease. In addition, people with more body fat have higher blood levels of substances that cause inflammation. Inflammation in blood vessels and throughout the body may increase the risk for heart disease. Do you need to lose weight to lower your risk of heart disease? You can find out by taking three simple steps: 1. Determine your Body Mass Index (BMI) You can do this by going online and typing in a search window BMI calculator or talk with your health provider. Do You Need to Lose Weight? Determine Your BMI Review Your Risk
If you're a man, being age 45 or older is also a risk factor for heart disease. For a woman, being age 55 or older or having gone through menopause increases the risk. If you aren't sure whether you have some of these risk factors, ask your doctor. [Top] Physical Inactivity: A sedentary lifestyle doubles the risk of heart disease. A physically inactive lifestyle also increases the risk of stroke, diabetes, and becoming overweight or obese. Even a moderate amount of regular exercise has enormous health benefits, yet 60 percent of Americans are not even moderately active. Astonishingly, an accumulative amount of activity of at least 30 minutes over the course of the day and done at least 5 of 7 days a week will have a distinct beneficial effect on the body. National guidelines advise children and adults to accumulate 30 minutes of activity on most days. There are many creative ways busy people can accumulate that much activity. For instance, take the stairs whenever possible (5 minutes), park a few blocks from your destination so that you have to walk the rest of the way (10 minutes), take a brisk family walk after dinner (15 minutes), mow the lawn (15+ minutes). You'll see that it adds up.
Exercise also helps you lose weight. If a person weighing 200 lbs. consumes the same amount of calories as usual but adds a daily brisk walk of 1.5 miles, he or she will lose about 14 lbs. in a year! Types of exercise: The best exercise for heart health is aerobic activity that increases blood flow to the muscles and heart. Start with moderate activities, 30 minutes daily, which is adequate for developing moderate fitness and reducing heart disease risk. For higher fitness levels (and an additional small advantage in risk reduction), alternate more vigorous activities with moderate activities. Caution: If you have a high risk of heart disease, a history of heart disease, diabetes, or other serious health problem, get your doctor's guidance before beginning or increasing an exercise program. You may need to start at a very low pace to include no impact activities, depending on your health state.
Steps You Can Take Today:
High Cholesterol: Your blood cholesterol level has a lot to do with your chances of getting heart disease. High blood cholesterol is one of the major risk factors for heart disease. A risk factor is a condition that increases your chance of getting a disease. In fact, the higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Heart disease is the number one killer of women and men in the United States. Each year, more than a million Americans have heart attacks, and about a half million people die from heart disease. How Does Cholesterol Cause Heart Disease? High blood cholesterol itself does not cause symptoms, so many people are unaware that their cholesterol level is too high. It is important to find out what your cholesterol numbers are because lowering cholesterol levels that are too high lessens the risk for developing heart disease and reduces the chance of a heart attack or dying of heart disease, even if you already have it. Cholesterol lowering is important for everyone—younger, middle age, and older adults; women and men; and people with or without heart disease. What Do Your Cholesterol Numbers Mean?
HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and is considered a major risk factor because it increases your risk for developing heart disease. HDL levels of 60 mg/dL or more help to lower your risk for heart disease. Triglycerides can also raise heart disease risk. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people. What Affects Cholesterol Levels? Diet. Saturated fat and cholesterol in the food you eat make your blood cholesterol level go up. Saturated fat is the main culprit, but cholesterol in foods also matters. Reducing the amount of saturated fat and cholesterol in your diet helps lower your blood cholesterol level. Things you cannot do anything about also can affect cholesterol levels. These include: Age and Gender. As women and men get older, their cholesterol levels rise. Before the age of menopause, women have lower total cholesterol levels than men of the same age. After the age of menopause, women's LDL levels tend to rise. What Is Your Risk of Developing Heart Disease or Having a Heart Attack? Step 1: Check below to see how many of the listed risk factors you have; these are the risk factors that affect your LDL goal. Major Risk Factors That Affect Your LDL Goal
* If your HDL cholesterol is 60 mg/dL or higher, subtract 1 from your total count. Step 2: How many major risk factors do you have? If you have 2 or more risk factors in the table above. Step 3: Use your medical history, number of risk factors, and risk score (your provider can help you determine this) to find your risk of developing heart disease or having a heart attack in the table below.
* Means that more than 20 of 100 people in this category will have a heart attack within 10 years. [Top] Lowering Cholesterol With Therapeutic Lifestyle Changes (TLC) TLC is a set of things you can do to help lower your LDL cholesterol. The main parts of TLC are: The TLC Diet. This is a low-saturated-fat, low-cholesterol eating plan that calls for less than 7 percent of calories from saturated fat and less than 200 mg of dietary cholesterol per day. The TLC diet recommends only enough calories to maintain a desirable weight and avoid weight gain. If your LDL is not lowered enough by reducing your saturated fat and cholesterol intakes, the amount of soluble fiber in your diet can be increased. Certain food products that contain plant stanols or plant sterols (for example, cholesterol-lowering margarines) can also be added to the TLC diet to boost its LDL-lowering power. Weight Management. Losing weight if you are overweight can help lower LDL and is especially important for those with a cluster of risk factors that includes high triglyceride and/or low HDL levels and being overweight with a large waist measurement (more than 40 inches for men and more than 35 inches for women). Physical Activity. Regular physical activity (30 minutes on most, if not all, days) is recommended for everyone. It can help raise HDL and lower LDL and is especially important for those with high triglyceride and/or low HDL levels who are overweight with a large waist measurement. Foods low in saturated fat include fat-free or 1percent dairy products, lean meats, fish, skinless poultry, whole grain foods, and fruits and vegetables. Look for soft margarines (liquid or tub varieties) that are low in saturated fat and contain little or no trans fat (another type of dietary fat that can raise your cholesterol level). Limit foods high in cholesterol such as liver and other organ meats, egg yolks, and full-fat dairy products. Good sources of soluble fiber include oats, certain fruits (such as oranges and pears) and vegetables (such as brussels sprouts and carrots), and dried peas and beans.
[Top] Hypertension The following table indicates the hazards of high blood pressure:
People with hypertension are 2-3 times more likely to have a heart attack than those with normal blood pressure. 45% of people with high blood pressure are unaware that they have it. Of those who are aware, fewer than half are being treated. People with uncontrolled high blood pressure are 7 times more likely to have a stroke than people with controlled high blood pressure. Hypertension is the major risk factor for stroke. 25% of people currently undergoing kidney dialysis can blame high blood pressure for their kidney damage. High blood pressure also damages many other organs such as the Heart, blood vessels which can cause a Heart Attack or Stroke. It effects the Kidneys, Eyes and peripheral circulation. If 75% of overweight people (not obese yet) with hypertension where to loose just 20 pounds or more can often achieve normal blood pressure besides reducing their blood LDL and elevating their blood HDL-cholesterol.[Top] Summary In conclusion, there are many lifestyle modifications that can be implemented through a supportive collaboration between the primary care provider and his or her patients. We must re-enforce these lifestyle modifications at every single visit. The smallest victory in any of these areas is a success. But the real dramatic improvement occurs when the patient becomes genuinely engaged in the care and treatment of his or her diseases. This includes taking and documenting blood sugar and blood pressure readings and bringing these results to each visit. In addition, one of the most important things is for the patient to provide a complete list of all meds both prescription and over the counter that he or she is taking and bring to every visit. If the patient still has any questions about coronary artery disease risk factors, just discuss their concerns and provide educational material to provide further clarification. Bottom line, if the patient tries their best to achieve and maintain optimal control of their personal risk factors such as; blood pressure, diabetes, hyperlipidemia, loose weight through wise food choices, aerobic exercise, and stop smoking, they can dramatically lower their risk factors for coronary artery disease and live a longer and healthier life.
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