You’re not overweight. So, heart disease is no threat. Right?
“Wrong,” says Cleveland Clinic cardiologist Arman Askari, MD. “Thin isn’t necessarily synonymous with healthy.” Carrying too many pounds does put a stress on your heart, causing it to work harder to carry and nourish that excess weight.
“While it’s true that being overweight is a risk factor for heart disease, weight is only a small part of the picture,” Dr. Askari explains. Sometimes, being thin carries a false sense of security. “While it’s true that thin people may be more prone to lead active, healthy lifestyles, I’ve also seen all types of people – from a 39-year-old smoker or a buff, pro beach volleyball player – come in with heart attacks,” he says. “Coronary artery disease doesn’t discriminate fat or thin, male or female.”
The bigger picture
When trying to live a heart-healthy lifestyle, it’s important to begin with a more comprehensive look at all of the risk factors for heart disease – or conditions that increase a person’s risk of developing heart disease.
“It’s important to know that some risk factors cannot be changed while others can be modified or treated,” Dr. Askari says. “The more risk factors you have, the more likely you are to develop heart disease.
Know the basics
These factors for heart disease are ones beyond your control. They include:
- Increasing age – Heart disease becomes more likely as you get older. About 85 percent of people who die of heart disease are age 65 or older.
- Male gender – Men have a greater risk of heart attack then women.
- Menopause – After menopause, a woman’s risk of heart disease increases and approaches the level of a man’s.
- Family history – Your risk of heart disease increases if your parents, brothers, sisters or children have the disease.
- Race – The risk of cardiovascular disease is higher in Blacks, Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This increased risk is partly due to higher rates of high blood pressure, obesity and diabetes in these populations.
What you can do
Not all risk factors, however, are set in stone. “Focus on those factors that you can change,” advises Dr. Askari:
Stop smoking – Smoking is the most preventable risk factor for heart disease. Eliminate the use of all tobacco products – and stay away from other’s smoke.
Lower your total cholesterol, LDL (bad) cholesterol & triglyceride levels – It is recommended to have your cholesterol level checked as early as age 20 or earlier if you have a family history of high cholesterol. The cholesterol profile includes an evaluation of total cholesterol, HDL, LDL and triglyceride levels. Your health care provider can tell you how often to have your cholesterol tested.
Raise your HDL (good cholesterol) – HDL cholesterol takes the LDL (bad) cholesterol away from the arteries and back to the liver where it can be passed out of the body. High levels of HDL seem to protect against cardiovascular disease.
Lower high blood pressure – High blood pressure increases the workload of the heart and kidneys, increasing the risk of heart attack, heart failure, stroke and kidney disease.
Control diabetes – People with diabetes, especially women, have a higher risk of heart disease because diabetes increases other risk factors, such as high cholesterol, LDL and triglycerides; lower HDL; and high blood pressure. Keeping diabetes under control is critical to reducing your risk.
Maintain a healthy body weight – While being thin isn’t a panacea, research has shown that being overweight contributes to the onset of cardiovascular disease. That makes it important that you achieve and maintain a desirable weight.
Exercise – The heart is like any other muscle – it needs a workout to stay strong and healthy. Exercising helps improve how well the heart pumps blood through your body. Aim for moderate exercise 30 minutes a day, on most days.
Follow a heart-healthy diet – Whether you’re aiming to prevent heart disease or trying to prevent further heart damage, following a “traditional Mediterranean diet” has been shown to have a heart-protective effect. Aim for a diet rich in fruits, vegetables, legumes and whole grains and that include fish, nuts and low-fat dairy. Also choose vegetables oils rich in monounsaturated fats and low in saturated fats and avoid of products that contain hydrogenated and partially hydrogenated vegetable oils.
Last but not least
While not traditional risk factors, the following are thought to contribute to overall risk for heart disease:
Individual response to stress – Some researchers have noted a relationship between cardiovascular disease risk and stress. This is because stress can raise blood pressure, which is a risk factor for heart disease, Dr. Askari explains. Try managing stress by practicing relaxation techniques, learning time management, setting realistic goals, guided imagery, massage, Tai Chi or yoga.
Drinking too much alcohol – Too much alcohol can lead to increased blood pressure, heart failure and stroke. It is also linked to high triglycerides, irregular heart beats, obesity, and cancer. However, research also has shown that those who drink one to two drink per day (4 oz. of wine, 12 oz. of beer, or 1-1/2 oz. of 80-proof spirits) may have less risk. However, also know that too much alcohol is detrimental to your heart because it damages the myocardium, Dr. Askari cautions.
“Just remember, it’s not one thing – whether its weight, how much you exercise, or what you had for dinner last night – that determines your heart health,” Dr. Askari concludes. “It’s balancing of a whole host of factors that make up the big picture.”
For your evaluation for risk factors and current prevention strategies for heart disease, call the Preventive Cardiology and Rehabilitation Program at 216.444.9353 (or toll-free at 800.223.2273, extension 49353).
