Are You a Heart Attack Waiting to Happen?

By Jonathan Reiner, M.D.
Co-author of Heart: An American Medical Odyssey
This year more than 500,000 Americans will experience their first heart attack. Here's how to lower your risk immediately.

If you smoke, stop. Cigarette smoke contains more than 7,000 chemical substances, including toxins like hydrogen cyanide, benzene, and arsenic. Smoking increases blood pressure, coronary plaque deposition, and the propensity for blood to clot, creating a perfect storm that substantially increases the risk of a heart attack. Not surprisingly, active cigarette smokers are twice as likely to have a heart attack than people who have never smoked and experience their first heart attack five to ten years earlier. Quitting cigarettes will lower your heart attack risk to the level of people who have never smoked.

Know your cholesterol. Cholesterol is a naturally occurring substance necessary for the function of cells and the production of essential hormones and other substances. Cholesterol is transported in the blood within a protein called LDL ("bad cholesterol) and cleared from the blood with the help of HDL ("good cholesterol"). People who have high levels of cholesterol, particularly LDL, have twice the risk of developing heart disease than those with normal cholesterol levels. Have your cholesterol checked at least once a year, and if it is elevated talk to your doctor about strategies to lower your LDL, including a low fat diet, exercise, and medications. Many studies have shown that lowering your LDL will reduce your chance of having a heart attack.

Treat your high blood pressure. High blood pressure (hypertension) is defined as a systolic pressure greater than 140 mmHg and/or diastolic pressure greater than 90 mmHg. While most people with hypertension have no symptoms, over time elevated blood pressure can injure the arteries and increase your risk of a heart attack and stroke. Reducing your consumption of salt, exercising regularly and losing weight can help lower your blood pressure. When these lifestyle changes aren't enough, there are many well-tolerated medications that can help.

Eat smart. People who consume a diet high in saturated fats (from foods such as red meats, pork, lamb, and butter) have higher cholesterol levels and a greater risk of heart attack than those who eat a more Mediterranean diet. Consider a daily diet similar to that found in Greece and southern Italy, which emphasizes olive oil, fish, fruits, vegetables, and legumes.

Get off the couch and get moving. Regular exercise (at least 30 minutes per day, 5 days per week) will lower your blood pressure, increase your HDL ("good cholesterol"), and decrease your weight. If you have diabetes, exercise can improve your blood glucose levels. Walk, jog, bike, swim, dance, spin-you'll look and feel better and live longer.

In Heart (out Oct. 22), former Vice President Dick Cheney and his longtime cardiologist, Dr. Jonathan Reiner, share the story of Cheney's thirty-five-year battle with heart disease-providing insight into the incredible medical breakthroughs that have changed cardiac care over the last four decades.

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