By Jay Shadow, MD, Cardiologist, Montefiore Health System
NEW YORK - National Heart Health Month comes in February to remind us to keep ourselves and our hearts healthy just around the time we may be abandoning our New Year’s resolutions.
Heart disease is unfortunately the leading cause of death, even in the time of the COVID-19 pandemic, and one of the top chronic conditions affecting our everyday lives. Fortunately, the American Heart Association describes Life’s Essential 8, eight simple principles we can focus on for heart health as we live our lives each day. When thinking of these principles, it is helpful to think of your numbers and your goal number for each category.
Maintain a healthy blood pressure
Do you know your resting blood pressure? Is it at your goal blood pressure? High blood pressure also known as hypertension is a silent, chronic condition that can slowly damage your heart, brain, eyes, kidneys, and other organs. Take some time in February to get to know your numbers. A normal blood pressure is 120/70. High blood pressure is very common with over half of adults over the age of 55 with a blood pressure higher than 140/90 (what is referred to as Stage 2 hypertension).
What causes high blood pressure?
It is a complicated condition that is influenced by many factors, including genes and environmental factors, diet, activity, but the largest cause of hypertension is poor diet, physical inactivity, and excess intake of alcohol. Medications like non-steroidal anti-inflammatories, steroids and oral contraceptives can also increase blood pressure.
If your blood pressure is above normal, it can be managed with diet changes (often low sodium diet) and routine exercise (which can lower blood pressure more than many medications alone). If needed, there are multiple medications available that can be prescribed by your doctor for your individual medical needs. We also have tools like ambulatory blood pressure monitors that help determine your blood pressure trend throughout the day, which may be more useful than checking in the office only.
How many minutes are you active each day? Being active and exercising has many benefits ranging from heart health, improving blood pressure and blood sugar levels as well as lowering risk of cancers. It may also help your mood and lower risk of dementia. Sadly, only about 20-30% of people under 65 years old are as physically active as federal guidelines recommend – which is 150 minutes of exercise, several times during the week. This can be walking, running, dancing, swimming – anything to use your muscles and increase your heart rate. There is newer evidence suggesting any amount of exercise has some benefits. So, get moving! As the days get longer and Spring approaches, think about setting some time each week to be more active.
Eat a healthy diet
How many servings of fruits and vegetables do you eat? If you are what you eat, what are you? There are many diets out there. I think the best option is a healthy one that you can sustain for years. As many find with their new year resolutions, a month later, old habits come back. In general, we recommend increasing your vegetable intake (especially leafy green ones like spinach) to more than five servings per day, limit your meal portions and avoid processed foods. The Mediterranean diet is a well-studied diet full of vegetables, nuts, lean fish, and olive oil. A whole food plant-based diet may be an even better choice for heart health. We have doctors, nutritionists and community educators who would be happy to go over the heart health benefits of these diets and give examples on how to tweak your daily menu and routine to be as healthful as possible. The key here is to find the diet and routine that you can sustain for you and your family.
How many cigarettes do you smoke? The best number is zero. Smoking cigarettes has many negative effects on your health and especially the heart. It can lead to heart attacks, lung cancer and other disease.
More than 1 out of 10 people smoke, putting them at risk of these conditions. Stopping smoking is challenging, but we are here to help and coach you using tools like nicotine gum and patches, medications to cut down cravings and tips on how to keep your hands busy. Fortunately, in the years after stopping smoking, arteries in the body can return to normal. The goal here is 0 cigarettes.
How many hours of sleep do you get?
In 2022, sleep was added to the AHA Life’s Essential 8. Lack of sleep, poor sleep due to medical conditions like obstructive sleep apnea or even changing the clocks for daylight saving time can trigger cardiac events like an arrhythmia, heart attack or raising your blood pressure. Good quality sleep that is long enough is the goal. Probably near eight hours, but everyone has different needs. We recommend good sleep hygiene - just like you keep your body clean, keep your sleep clean by limiting screens in the hour before bed, keep your bed as a protected place that you can associate with sleep, avoid alcohol before sleep and make time in your schedule to get the hours you need.
The last 3 of Life’s Essential 8 are to manage weight, control cholesterol and manage sugar control. All of these can be managed with diet and exercise (see above) and then if medications are needed, we have tools that can help.
My colleagues and I at Montefiore Medical Center concentrate on these areas each day with our patients to prevent heart disease and prevent future cardiovascular events, like a heart attack. You can use these guiding principles to fight heart disease and we’re happy to use our years of training to fight for you.
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