6 Strategies to Modify Your Risk Factors for Heart Disease

It is important that you work with your cardiologist to identify your risk factors for heart disease. A risk factor is a specific condition or behavior associated with the development of a disease. The more risk factors for heart disease you have, the greater your chance of developing heart disease. Some risk factors such as family history, increasing age, gender, and ethnicity you cannot change. Reducing the risk factors you can change is the key to a healthier heart. 

Let's take a look at the top six strategies you can begin implementing today:

#1: Quit Smoking Cigarettes

Smoking is a major cause of heart and blood vessel disease. The American Heart Association has named cigarette smoking as the most dangerous of the modifiable risk factors for heart disease. Overall, smokers experience a 70 percent greater death rate from heart and blood vessel disease than nonsmokers do. Heavy smokers, defined as those who smoke two to three packs per day, have a death rate of two to three times higher than nonsmokers do.  No cigarettes are considered safe.

The following are some of the effects on the body caused by cigarette smoking:

  • Increased blood pressure
  • Decreased exercise tolerance
  • Increased tendency to develop blood clots
  • Increased LDL (bad) cholesterol and decreased HDL (good) cholesterol
  • Decreased amount of oxygen reaching tissues
  • Damage to and constriction of blood vessels
  • Increased skin wrinkling
  • Increased risk of osteoporosis
  • Increased risk of developing Alzheimer’s Disease
  • Increased risk of developing cancers of mouth, throat, lung, bladder
  • Women who smoke and use birth control pills greatly increase their risk of heart disease and stroke
  • Diabetics who smoke are more likely to develop nerve damage and kidney disease

From Smoker to Ex-smoker

Why is quitting so hard? Nicotine is highly addictive. People often go through withdrawal when quitting. Withdrawal symptoms may include irritability, sweating, headaches, diarrhea, constipation, restlessness, fatigue, or dizziness. These symptoms are usually worst on the second day and gradually decrease with time. People are also accustomed to smoking. It is a familiar part of their daily life. It helps them wake up, relax, “think straight”, and can be a reward. These things make it easy to smoke and hard to quit.

Modify your risk factors for heart disease and start the process of quitting by identifying your personal reasons for smoking. Write a list of reasons to stop smoking and review it frequently.  Write down when you smoke, why you smoke and how you feel at that time.  Do this for a few days, then stop carrying your matches or lighter.  Keep your cigarettes out of your easy reach. If you normally carry them in your pocket or purse, leave them in the car.  Make your access to them more difficult.  This gives you time to think about smoking. Do I really need a cigarette right now? Can it wait? How about chewing a piece of gum instead? This will begin to break the habit of your smoking.

Next, set a target date to quit smoking completely.  You may also benefit from buying cigarettes lower in nicotine and tar the next time you purchase them. Do not buy them until you are completely out of cigarettes.

When your target date arrives, quit smoking completely.  Throw out all cigarettes, lighters and ashtrays. Stay busy and try to avoid situations that your relate to smoking. Use substitutes such as chewing gum, mints, carrots, or celery.  Do deep breathing exercises. Try a new activity, like walking, biking, or yoga, to keep your focus away from smoking.

Usually, the first six months are the hardest.  Most people gain 5-10 pounds during this time and feel discouraged. Remember, the benefits of quitting are greater than the extra few pounds and for most people, this weight gain is tem¬porary.  When people gain weight, it us usually because they start to eat more when they quit smoking. They put unhealthy food in their mouths instead of a cigarette. Watch what you eat, stay physically active, and you might not gain weight.

Quitting is not easy! Most people need help. It is important to have the support of family, friends, and your physician. Contact your physician for more ideas and support. Reward yourself for doing well. Look forward to moving from smoker to nonsmoker.

Firelands Regional Medical Center has partnered with Huron County Public Health, Sandusky County Health Department, and the Ohio Department of Health to offer a Community Cessation Initiative (CCI) - a program that helps connect patients with the best-fit cessation service for their circumstances. Learn more by calling 419-557-6682.

#2: Move Your Body

Your heart is a muscle.  It benefits from regular exercise, just like all of the other muscles in your body.  Being active also reduces stress, lowers your cholesterol, and helps you lose weight.

Regular exercise that increases your heart rate and breathing can reduce the risk of heart disease by increasing the oxygen requirements of the hart, increasing the tone of other muscles, and stimulating circulation.  This type of exercise is called aerobic.  Improvements in fitness result from moderate exercise 15-30 minutes, 5-7 times a week.

Aerobic activities include brisk walking, jogging or running, bicycling, climbing stairs, dancing and swimming - all of which can modify your risk factors for heart disease.

Discuss an exercise plan with your physician. Find an exercise class or an exercise partner to help you stay motivated.  Here are some tips to help make your exercise plan a success.

  • Choose an activity you enjoy
  • Make it fun by asking a friend to join you
  • Begin exercising 5-10 minutes per day
  • Gradually build up to 30 minutes per day on most days.  You can also reach this goal by being active for 10 minutes, three times daily
  • Plan exercise sessions in advance
  • If you experience chest pain while exercising, stop and call your doctor or 911 immediately.
  • Avoid very hot or very cold temperatures
  • Do not wear tight clothing that may restrict blood flow.  The exception to this is support stockings.

Benefits of Exercise

  • Reduces the feelings of stress
  • Gives you more energy and strength
  • Lowers blood pressure and reduces heart attack risk
  • Makes insulin work better and lowers blood glucose
  • Protects bone health
  • Makes you look and feel younger
  • Helps you to sleep better

Monitoring Your Exercise

Your target hart rate (THR) is the safest range of heart beats per minute during exercise.  The lower number in the range is the safest rate for beginners, while the higher number would be your goal as your fitness level improved.  Use this formula to calculate your THR.

220 – Your age = Maximum predicted heart rate (MHR)

Multiply your (MHR) by 50% and then by 85%

Example:  220 – 60 = 160

160 x 60% = 96

160 x 85% = 136

THR range = 96 - 136 beats per minute

Some medications, such as beta-blockers, interfere with the heart rate.  Their job is to keep the heart rate lower.  Many people taking these medications will never reach even the low end of their THR.  In this case, follow the “talk test”.  You should be able to engage in a conversation with someone if he/she is right next to you.  However, you should feel like your heart and lungs are working harder than they do at rest.

Another rule to follow is that you should see at least a 20-30 point increase from your resting heart rate while you are exercising at your moderate to somewhat hard intensity.

Taking Your Pulse

An important aspect of exercising safely is being able to check your pulse.

  • Find your pulse by pressing your fingers on the side of your wrist just below the wrist bone.
  • Using a watch with a second hand, count the number of beats in 15 seconds.
  • Multiply the number of beats in 15 seconds by 4.  This is your heart rate for one minute.
  • Example:  20 beats X 4 = 80 beats per minute

You should check your pulse before and after each exercise session.  Sixty to ninety beats per minute is a normal resting pulse.  Approximately five minutes after you exercise, your pulse should return to 10-20 beats from your pre-exercise pulse.  If the heart rate is too high, this may indicate that you did too much exercise during the exercise session.  You may need to slow down and work up to the fitness level that you want to be.

Exercise Guidelines

  • Always consult with your doctor before beginning an exercise program
  • If possible, walk with a friend and make sure you control the pace
  • Do not exercise if you are sick
  • Wait 1-2 hours after eating to exercise
  • Be sure to carry an identification card with you
  • If you have nitroglycerin, being it with you
  • Avoid exercising outside in extreme temperatures – above 80 degrees F, and below 35 degrees F, or above 75% humidity
  • Have a plan of action and be prepared

Stop exercising if you experience any of the following symptoms.  If your symptoms are not relieved with rest, call your doctor.

  • Pain in the chest, shoulders, arms or abdomen
  • Irregular heart beat or palpitations
  • A sudden very fast heartbeat
  • Unexplained dizziness, fainting or nausea

#3: Lose Weight

How do you know if you are at a normal weight or if you are overweight or obese? There is a special formula called the body mass index or BMI that helps answer that question. You can calculate your BMI by using the chart within this section. You need to know your height and weight to use the chart.  A BMI of 25-29.5 is in the overweight range. A BMI of 30 or greater is in the obese range.  The location of excess body fat is important too. You are at an increased risk for developing heart disease if your BMI is over 25 and our waist is greater than 35 inches for a woman or 40 inches for a man.

Being overweight increases your risk of developing heart disease. However, people who are overweight can prevent or delay their risk of developing heart disease by getting regular physical activity and losing 5-10% of their current weight. If you already have heart disease, you need to control your symptoms and risk factors. Some of the risk factors include family history of heart disease, being overweight, eating a high-fat diet, eating a low-fiber diet, high blood pressure, and adult onset diabetes. Ask your doctor for a diet and exercise plan to help you lose weight. Making gradual changes in your portion sizes and food choices will allow you to lose weight.

If you are overweight, consider changing your eating and exercise habits to a healthier lifestyle. The term “diet” often means a temporary meal plan to lose weight. Once a person stops “dieting,” they often regain the weight that had been lost and more. Calories matter even when you are cutting out fats or carbohydrates. If you are eating more calories than you are burning, you will gain weight. Keep in mind that you need to consume 3, 500 calories less to lose one pound. By cutting back 500 calories per day, you can lose one pound per week and more if you include exercise. Beware of diet programs that promise a “quick-fix” and rapid weight loss. A safe weight loss is 1 to 2 pounds per week. A more gradual weight loss is more likely to be maintained.

Tips to Promote Healthy Eating Habits

  • Make meal planning a priority.  Take a few minutes to pack a lunch of nutritious foods rather than relying on a fast food meal, which is often high in fat and calories. Include fruits and vegetables in your packed lunch.
  • Use the Food Guide Pyramid as a guideline for a healthy meal plan. Watch the number of portions you eat as well as your portion sizes.
  • Be sure to eat plenty of fruits and vegetables since they are naturally low in calories, sodium, fat, and cholesterol, but high in vitamins and minerals.
  • Avoid skipping meals as this often leads to hunger, cravings, and overeating.
  • Eat slowly and without distractions such as watching television, reading, or driving. It is easy to overeat since you are not fully aware of the food you have already consumed
  • A healthy diet is a balanced diet that includes all foods, even occasional sweets or high fat foods. The key is to limit portion sizes, especially when it comes to high fat and higher calorie foods.

#4: Lower Your High Blood Pressure

Your blood pressure consists of two numbers. The top number is your systolic pressure and is reflective of your heart is contracting. The bottom number is your diastolic pressure and is reflective of your heart relaxing. If your blood pressure consistently runs 140/90 or higher, you may have hypertension, also referred to as high blood pressure. The causes of hypertension may be unknown, but may include family history of hypertension, gender, age, race, obesity, and a high salt/high cholesterol diet.  

When your blood pressure is continually elevated, your heart has to work extra hard to pump. When high blood pressure occurs over a long period, the heart tends to enlarge.  After the heart becomes enlarged, it does not pump as effectively as it did before and consequently, heart failure may occur.

High blood pressure may also contribute to hardening of the arteries of the heart and other vessels. High blood pressure may increase the possibility of strokes due to the damage of the blood vessels leading to the brain and may cause kidney damage and congestive heart failure. High blood pressure increases your risk of developing coronary artery disease.

Blood pressure can be modified by changing your dietary habits, exercising, smoking cessation, and taking daily medications prescribed by your physician. Firelands offers free blood pressure screenings throughout the community. Go to www.firelands.com and click on “classes and events” for schedules and locations of these free screenings.

#5: Manage Your Stress in Healthy Ways

When you are under stress, your body produces chemicals that make your heart pump harder and faster.  Too much stress for a long time can raise blood pressure and increases your risk for a heart attack.  Stress management is a learning process.  Here are some tips to help you to be successful in managing stress.

  1. Identify the cause of your stress
  2. Take steps to change stressful situations
  3. Relearn ways to cope with stress in your everyday life

Stress manifests itself in several ways.  There are physical signs of stress, emotional signs, and behavioral signs.  Stress is not completed bad.  Positive stress can motivate you to complete new tasks, meet new challenges, meet new people, and to try new activities.  Listed below are some of the body’s symptoms of stress.

  • Physical signs:  fatigue, low energy level, upset stomach, headache, skin rashes, back pain, muscle aches and stiffness, cold and sweaty hands, and increase or decrease in appetite.
  • Emotional signs:  increased anger and/or hostility; anxiety; restlessness; worry; depression; frustration; irritability; impatience; unhappiness for ne apparent reason; and lack of interest in family, friends or activities.
  • Behavioral signs:  sleeplessness forgetfulness, trouble concentrating, emotional outbursts, grinding teeth, clenching jaw, poor hygiene, trouble sleeping and the desire to be alone.

There are many things you can do to reduce and manage your stress level.  Listed below are some stress reduction techniques.

  • Share problems with friends.  Talking helps release anger and frustrations.
  • Exercise.  Exercise takes your mind off your problems, relaxes tense muscles, and burns stress chemicals
  • Simplify your life.  Say no to extra, unwanted obligations.  Do not rush to get things done.
  • Do not waste energy over being upset over little things.  Accept things you cannot change.
  • Practice positive thinking.  Your thoughts affect your feelings.  Replacing negative thoughts with positive thoughts will reduce your stress.
  • Take steps to get out of debt.  Money troubles are a source of stress for many people.  Make a plan to straighten out any money problems you have
  • Learn how to relax.  Take time to relax every day.  Try meditations, yoga, stretching, relaxation exercises, walking, reading or a new hobby.
  • Set priorities and establish realistic goals.  Stop trying to do too much.
  • Consider a new career. Are your goals changing?
  • Do not use smoking, drinking, overeating, drugs, or caffeine to deal with stress.

#6: Incorporate Relaxation Exercises into Your Day

Relaxation involves your mind and your body.  Watching television, reading a book or talking on the phone is not always relaxing. You need to learn skills to help you relax. The following exercises can be used to help you when you feel stressed.

Deep breathing:  Breathe normally for a few minutes. Concentrate on breathing more with your abdomen and less with your chest. Breathe in deeply through your nose, letting your abdomen fully expand. Hold your breath for 2-3 seconds. Exhale slowly through your mouth, breathing out as completely as possible. Continue this exercise for a few minutes.

Progressive muscle relaxation:  sit or lie down. Start with your right hand, make a fist, and hold it tight for 5 seconds. Release and open the fist, keep it relaxed for 20-30 seconds, then repeat. Concentrate on how your hand feels during this exercise and compare it to how your left hand feels. Repeat this procedure with your left hand, then your shoulders and feet, etc. Practice tightening and relaxing your muscles.  In time, you will be able to relax muscles by thinking about them.