Lifestyle Changes to Prevent Heart Disease

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Lifestyle Changes to Prevent Heart Disease

Question:

I am a 52-year-old man with a family history of heart disease. My doctor says my blood pressure and cholesterol are great. My latest LDL cholesterol was 98 and my HDL was 45. I exercise regularly and I try hard to stick to a Mediterranean type diet. Is there anything else I should do?

Answer:

Congratulations! You've already got the primary lifestyle approaches to a healthy heart covered (assuming that you don't smoke!) From a scientific standpoint, the evidence on how much you would gain from doing even more is unclear.

But your question suggests that you are the type of person who may be willing to take things to the next level, so here are some ideas. First, I would start with increasing your duration and intensity of exercise.

Basic recommendations say that we should all get a minimum of 150 minutes of moderate intensity physical activity per week (not all at once). However, most experts suggest 45 to 60 minutes most days of the week to achieve a level of fitness optimal for promoting cardiovascular health.

For someone like you, I'd recommend incorporating a mix of the following activities into your workout routine:

• Endurance aerobics

• Interval training with short bursts of high intensity exercise

• Resistance training using machines and/or free weights

Regarding your diet, the choice of a Mediterranean style diet is a perfect place to start. You want to have at least 5 servings of fruits and vegetables daily—and you may want to aim higher, for example, 8 to 10 servings a day. Keep red meat to a minimum. Fish, especially those rich in the omega fats, appear to be best. If you do drink alcohol, a glass or two of red wine per day might be the best choice.

Since your blood pressure is normal, salt restriction is not mandatory, but there is no down side to moderating your intake of sodium.

Since you area male older than age 45, many doctors would advise taking daily aspirin, as long as you are not at risk of internal bleeding. A baby aspirin (81 milligrams) is sufficient.

Study data show that most of the vitamin supplements we thought might help prevent heart disease (vitamin E, for example) offer little benefit. The one exception is vitamin D. Although the evidence is still considered preliminary, I personally take 1,000 units of vitamin D daily.

A more recent risk factor to consider is C-reactive protein (CRP). CRP is a marker of inflammation. A blood test can look for subtle increases in CRP that are associated with a higher risk of coronary artery disease and heart attacks. With a high CRP and a strong family history of heart disease at a young age, your doctor may suggest taking a statin, even though your LDL cholesterol is normal.

Definitely keep up your efforts, and work with your doctor to fine tune a strategy to keep heart disease at bay.

Last updated:	June 02, 2009