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10 tips for a healthy heart The low-drug or no-drug approach
PREVENTION

1
Red heart bowl with cereal in it
Eat plenty of fiber and good fat. New research suggests that inflammation of the arteries may be as big a risk factor for heart disease as clogging with cholesterol deposits. And a high-fiber diet featuring plenty of beneficial fats proved better at controlling that damaging inflammation than the standard low-fat diet, according to a recent two-year clinical trial. (Participants also found it tastier and more filling.) Good sources of fiber include fruits, legumes, nuts, whole grains, and vegetables. Best of all: the soluble fiber from barley, beans, and oats. As for fat, choose high-omega-3 but low-mercury fish such as salmon, sardines, and trout, and vegetable oils such as canola, olive, safflower, and soybean. Stay away from trans fats, which move cholesterol numbers in the wrong direction. The Nutrition Facts label on packaged food now includes the trans-fat count.

Read more about the benefits of a heart-healthy diet plus tips on how to fit them into your life.


2
Lay off cholesterol and salt. Anyone diagnosed with an elevated level of LDL (bad) cholesterol should consume less than 200 milligrams of cholesterol a day. That's the amount in one egg yolk, 8 ounces of skinless chicken breast, or 10 ounces of lean sirloin. As for salt, if you have high blood pressure or are at risk of developing it, cutting back on salt could reduce your risk of a heart attack by 25 percent or more. Your goal should be less than 2,300 mg of sodium a day, which is about a teaspoon of salt.

Find out more tips on non-drug ways to lower your cholesterol.


3
Lose the gut. Even if you are not significantly overweight, carrying extra fat around your middle is bad, bad, bad. It raises blood pressure, adversely affects blood lipids, causes insulin resistance, and produces substances that inflame the arteries. The critical point is a waist measurement of 40 inches or more for men, or 35 inches for women, regardless of height. Sadly, no amount of crunches can spot reduce belly fat. The only way to get rid of it is to lose weight overall, preferably through a combination of diet and exercise.

Get some more practical tips to plan your own do-it-yourself diet.


4
Red heart dumbells
Huff and pump. Name a cardiac risk factor, and regular aerobic and strength exercise can improve it—including arterial inflammation. Updated recommendations from the American Heart Association and the American College of Sports Medicine call for at least 30 minutes of moderate-intensity aerobic activity, such as brisk walking, five days a week, or 20 minutes of vigorous activity, such as jogging, three days a week. Strength training, in addit ion to improving overall fitness, improves fat-burning capacity by increasing muscle mass. Do a strength workout twice a week, on non-consecutive days to give your muscles time to recover. Include a couple of sets of exercises involving the major muscles in the arms, legs, and torso, and use weights or bands resistant enough that you can complete only 8 to 12 repetitions. If you're over 45, already have some kind of cardiovascular problem, or haven't exercised regularly for years, see a doctor before lacing up your workout shoes.

Find out more about staying active and fit.


5
Calm down. Negative emotions, such as stress or panic attacks, trigger the release of hormones that can threaten your heart; studies show that people who experience those troubles have more heart attacks and strokes than calmer, more cheerful types. Curbing negative emotions is almost as good for your heart as proper diet and exercising. For stress, try yoga, tai chi, meditation, and measured breathing. Regular aerobic exercise helps ease depression. If you can't shake negative emotions and they are interfering with your functioning, seek professional counseling.

For more ideas, try these stress-reduction strategies.


6
Drink a little, but don't smoke. Drinking a little bit of alcohol—one drink a day for women, one or two a day for men—can raise HDL (good) cholesterol and reduce inflammation and blood clots. But more than that can cause heart problems. As for smoking, don't. Cigarette smokers have twice the heart attack risk of nonsmokers. If you can't quit on your own, try a nicotine replacement product and, if necessary, add the prescription antidepressant bupropion (Zyban and generic).

Read more about ways to stop smoking.


7
Know your CRP number. Elevated levels of C-reactive protein, or CRP, serve as a marker for artery inflammation, even if you have no other symptoms. Ask your doctor to include the inexpensive blood test for CRP the next time your cholesterol is checked. (And be sure to floss. To find out why, see Dental care: Preventing gum disease.)

Here are some more ways to control inflammation for your heart’s health.


TREATMENT

8
Avoid CT angiography. This high-tech test uses an ultrafast CT scanner to create a three-dimensional image of coronary arteries. However, it rarely provides any useful information for people without symptoms such as angina, while exposing them to as much as 325 times the radiation of a regular chest X-ray. People who already have angina are going to require the traditional "gold standard," angiography, to measure the number and extent of blockages, regardless of the outcome of a CT test, so there's no need to go to the expense and radiation exposure in the first place.


9
Heart-shaped puzzle
Weight loss, exercise, stopping smoking, and taking cardiovascular medications can work as well as angioplasty.
Hold off on angioplasty. If an angiogram reveals severe narrowing in more than two major coronary arteries, you will need bypass surgery. If blockages are less severe, immediate angioplasty is not a good idea. It triggers a heart attack in 1 to 2 percent of patients. Instead, treat the angina with weight loss, exercise, and stopping smoking, and with cardiovascular medications. Research suggests that for most people, those measures are as effective as angioplasty for relieving angina pain, while lowering the risk of heart attack or stroke. (However, angioplasty is a lifesaver for people who have just had a heart attack or who have heart pain increasing in severity and frequency, or occurring at rest.)

Read our guide on common tests for heart pain.


10
Know your symptoms. Almost everyone knows that chest pain and shortness of breath are symptoms of heart attacks, according to a survey published in February by the U.S. Centers for Disease Control and Prevention. But in this survey of 71,994 adults, only 48 percent knew that pain or discomfort in the jaw, neck, or back can be a heart attack symptom. Only 62 percent recognized another symptom, feeling weak, light-headed, or faint. Eighty-five percent knew about the fifth symptom, discomfort in the arms or shoulders. If you experience any of those symptoms, call 911 for an ambulance to the emergency room; getting treatment within an hour can greatly increase your chances of a good recovery. While waiting for the ambulance to arrive, chew and swallow one 325-mg regular aspirin or four low-dose (81 mg) aspirin to prevent blood clots from forming.

Find out more on the warning signs of heart failure.

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