Lifestyle Changes

The lifestyle choices to keep your heart healthy are similar to what you should do to help prevent many other diseases, such as diabetes and certain types of cancer. If you have coronary heart disease or are at high risk to develop it, you should do the following:

• Eat plenty of vegetables and fruits while avoiding trans fats and saturated fats.
  
• Keep blood pressure in the normal range, ideally with a systolic blood pressure of less than 120 millimeters of mercury (mm Hg).
  
• Don't smoke.
  
• Get your low-density lipoprotein, or LDL (bad), cholesterol under 100 milligrams per deciliter (mg/dL) and perhaps as low as 70 mg/dL. This usually requires medications such as a statin drug.
  
• Maintain a healthy weight.
  
• Strive to keep your blood sugar levels normal.
  
• Manage stress.
  
• Become more physically active, and make daily exercise a priority at an intensity level recommended by your doctor.
  

High LDL cholesterol is one of the major risk factors for heart disease, and the risk increases as the bad cholesterol level rises. Other major risk factors are smoking, high blood pressure and diabetes. Your cholesterol level is determined by your genetic makeup and the amount of saturated fat and cholesterol in the foods you eat. The liver manufactures cholesterol, so even if you never eat cholesterol, your body can make all it needs.

Several factors contribute to high blood cholesterol:

Diet: Reduce your blood LDL cholesterol level by eating less fat, particularly saturated fat (as found in whole milk, cheese and meat). Low cholesterol foods are important, too. Studies have shown that your total cholesterol and your bad cholesterol levels may begin to drop two to three weeks after you begin your lower you intake of fat, calories and cholesterol.

A healthy diet:

• Contains healthy fats. Once you've cut way back on saturated fats and trans fats (the unhealthy fats), you can start adding healthy fats to your diet. Healthy fats are polyunsaturated and monounsaturated.
  
• Contains healthy sources of carbohydrates. Eat more whole grains — foods like whole-wheat bread, brown rice and oatmeal — to help lower cholesterol, improve blood sugar and insulin levels, control weight, protect the heart, guard against diabetes and keep your digestive system healthy.
  
• Relies on healthy sources of protein. For a healthier heart, cut back on red meat and switch to fish. Why? The good fats in many types of fish help protect the heart against erratic rhythms and may prevent blood clots. The American Heart Association now recommends that people eat fish (especially fatty fish) at least two times per week. Beans, nuts and seeds are also excellent sources of protein.
  
• Includes plenty of fruits, vegetables and whole grains. These foods have more powerful effects on your health than most pills.
  
• Tastes great. If it doesn't, you probably won't stick with it for long.
  

Weight control: Obesity increases triglyceride and total blood cholesterol levels, blood pressure and the risk of developing diabetes.

Exercise: Regular exercise may help a person control weight, lower blood pressure and increase the level of high-density lipoprotein, or HDL (good), cholesterol.

Genetic factors: Lowering your LDL cholesterol levels through diet often is not enough to reach your goal. Many people are genetically programmed to produce cholesterol in the liver no matter how strictly they follow a diet. They require cholesterol-lowering drugs to get their levels in shape.

Sex/age: Coronary heart disease is the leading cause of death and disability for both men and women in the United States. Traditionally, coronary heart disease has been associated much more with older men than women. However, today, the importance of lifestyle changes is recognized for both sexes at all ages.

Alcohol: In some people, modest amounts of alcohol can increase the amount of good cholesterol (HDL). Modest intake means two or fewer drinks per day for men and one drink per day for women. There is good evidence that moderate alcohol intake lowers the risk of coronary artery disease, whether or not the protection is due to increasing HDL levels. However, alcohol provides "empty calories" that can add to your weight. Because drinking can have serious adverse effects, present guidelines do not recommend drinking alcohol as a way to prevent heart disease.

Smoking: Smoking damages the heart by raising blood pressure, damaging blood vessels, promoting the buildup of fatty plaque in arteries, lowering levels of "good" cholesterol, making the blood more likely to clot and depriving the heart of oxygen. Quitting smoking is the best thing you can do to prevent a heart attack.

Stress: Stress can increase chemicals within the body that may increase the risk of a heart attack. These fight-or-flight stress hormones, such as cortisol and epinephrine, excite the heart and make it work overtime.