Heart disease is the leading cause of death in the United States. Some risk factors are unavoidable, but there are some simple things you can do to lower your chances of developing this condition by improving your overall health.
In fact, many patients are focused on losing weight but do not ask about how they can lead a healthier lifestyle to prevent illness, says Jeffrey I. Mechanick, MD, Professor of Medicine and Medical Director of the Marie-Josee and Henry R. Kravis Center for Cardiovascular Health at Mount Sinai Heart
“It’s interesting to think about what patients don’t ask,” he says. “They don’t say: How can I be healthier? How can I prevent chronic disease? How can I prevent heart disease? Weight loss is important, but the more significant issue is boosting your overall health.”
In this Q&A, Dr. Mechanick explains how you can start.
What are the major risk factors for heart disease?
Several types of causes, or drivers, can lead to heart disease. Primary drivers are genetics, environment, and behavior. Genetics and some environmental factors are things you cannot change—they are not modifiable. These include family medical history, gender, and heart defects you are born with (called congenital defects). Some primary drivers have to do with the environment you live in, such as exposure to solvents, pesticides, or other pollutants.
Other primary drivers can be changed or are modifiable. These include behaviors, such as tobacco use, being physically inactive, and consuming fatty/sugary foods, and the “built” (or human-made) environment, such as elevators, super-sized portions, and unsafe living conditions, which together fashion someone’s personal lifestyle. Secondary drivers are metabolic in nature and depend on primary drivers, create a risk level for heart disease, and are also modifiable. In other words, smoking; alcohol and drug abuse; not getting regular exercise; eating too much saturated fat, transfat, and cholesterol; being overweight or obese; stress; and irregular sleep patterns can all increase your chances of developing heart disease. Lifestyle issues can lead to metabolic problems, such as developing too much sugar in your blood (abnormal glycemia), prediabetes and type 2 diabetes, high blood pressure (hypertension) and high cholesterol. These metabolic issues increase your chance of developing heart disease.
How can I lower my risk of heart disease?
There are two ways to look at dealing with heart disease. One way is to wait until you have a problem, and then go see a doctor. The doctor will perform blood and urine tests and prescribe medication. Then the doctor will monitor your cholesterol, blood sugar level, blood pressure, and other factors.
The other approach is to prevent heart disease from developing in the first place. For years, doctors have focused on addressing issues such as blood pressure and cholesterol. We didn’t have a mindset for prevention. But now we know there are certain lifestyle choices you can make that can keep you from having to deal with heart disease.
This new mindset involves exercising every day, having healthy eating patterns (including plenty of fruits and vegetables and beans, and avoiding sweets), limiting alcohol consumption, reducing stress, and not smoking. Probably the most important message is not to wait until you have a heart problem, but to think about prevention. You can talk to your doctor about how to make these lifestyle changes. They will make sure you are healthier and have a longer, higher quality life ahead of you
What if I’m at risk of developing heart disease?
You need to take inventory of your risk factors. If there’s a family history, or if you smoke or are overweight or have been in the past, you may want to think about adopting a healthier lifestyle. The challenge with prevention is it takes place over a long period of time. So its value becomes diluted when you think about all the other more pressing issues of life. Because heart disease seems so remote—it’s usually not going to happen tomorrow or next week—people think they can deal with it later. But it’s important to take stock of your lifestyle and focus on prevention. You will reap the rewards.
How do you find a good heart doctor who focuses on preventative health?
I would encourage patients to speak to friends and family. Of course, if you have a doctor to speak to, they may have suggestions. Do a little research and look for strong health programs near where you live. Major medical centers often have programs that specialize in preventive health. You’re going to have to put a little elbow grease into this to locate doctors who are trained in traditional medicine and have expertise in preventive health and preventive cardiology.
How do I talk with the doctor?
First, meet with the doctor for a consultation. It’s important to be prepared. Write down the issues that you think are important, any areas that are of value for you, and any risk factors you may have. Also, write what you want in life so you can have a high-level discussion about what health is. In this way, you will establish a very fruitful, rewarding encounter with your physician that will become a good working relationship.