Patricia Guerrero, MD, FACC

Cardiovascular disease is the leading cause of death of men and women in the United States. The most common presentation of cardiovascular diseases are heart attacks (myocardial infarction, MI) and strokes (cerebrovascular accidents, CVA).

Cardiovascular disease can be prevented, in great part, by modifying your risk factors.

The risk factors include:

#1 Non- Modifiable Risk Factors such as age and a family history of premature atherosclerotic vascular disease (MI or CVA under age 65 years)

#2 Modifiable Risk Factors. We will focus in this issue on the modifiable risk factors. Changes in lifestyle and appropriate medical therapy can dramatically reduce the long-term risks of heart attacks and strokes. Recent data also indicates that a healthy lifestyle will also decrease your risk of certain cancers and chronic illnesses such as diabetes and hypertension. In this occasion, we will discuss:

a) Obesity:
A normal body mass index is 18.5-24. Body mass index of 25-30 defines “overweight”. A body mass index of greater than 30 defines obesity in the average population. Maintaining a normal weight will not only decrease your risk of heart attacks and strokes, but will also decrease the risk or need for medications in entities such as hypertension, diabetes mellitus and hyperlipidemia. Determine your BMI and define your target healthy weight.

b) Sedentarianism:
Aerobic exercise decreases the risk of cardiovascular disease. The more active you become, the less the risk. The goal is to perform moderate aerobic exercise at least 5 days of the week for 30 minute intervals in each occasion. The weekly goal is 200 minutes or greater. Exercise need not be formal or structured. Find an activity, or multiple aerobic activities, that you enjoy and do them frequently.

c) Nicotine use:
Cease smoking. There are no known beneficial effects of nicotine. Consult your physician if you need assistance in quitting.

d) Systemic Hypertension (elevated blood pressure):
Monitor your BP at rest at regular intervals. Seek medical attention if you note persistent blood pressure readings above 130/85. The treatment of hypertension includes weight loss, daily aerobic exercise and dietary changes. The DASH diet which is based on the Mediterranean diet has been proven to decrease BP by 5-7 mm HG. If lifestyle changes are not sufficient to maintain a normal blood pressure, you may need medication to further decrease your risk.

e) Diabetes Mellitus:
The marker of this disease is elevated blood sugar (glucose) levels. This disease alone increases the risk of myocardial infarction, strokes and peripheral vascular disease ten times the normal population. See your doctor on a regular basis for screening and therapy.

f) Hyperlipidemia:
This term encompasses elevated LDL (bad) cholesterol; elevated triglycerides and; low HDL levels (good cholesterol). Elevated LDL and triglycerides levels are often the effect of poor diet, lack of exercise and excessive portion sizes. Adopting a heart healthy diet rich in fruits, vegetable, whole grains and fish; and regular exercise may improve abnormal levels and decrease your risks. When this is insufficient, certain medications have been proven to decrease the risk of cardiovascular events. Consult your physician, for recommendations.

In summary, be aware and pro-active in regards to your health. Restoring your heart or brain to normal may not be possible after a heart attack or stroke. The best treatment is to avoid these diseases by prevention with a healthy lifestyle and careful attention to proper therapy of existing illnesses.



May 2008


Click here for a PDF of this article