Prescription for Improved Cardiac Health

  1. EXERCISE: Exercise at least five times per week for 30 minutes. Walking is one of the best forms of exercises. Do something which will increase your pulse rate equal to 70-75% of your maximal heart rate. (This number is obtained by subtracting your age from 220 and then multiplying by 70% or 75 %.)
  2. IDEAL BODY WEIGHT: Maintain an ideal body weight. If you are a female, your waist circumference should be less than 35 inches. If you are a male, your waist circumference should be less than 40 inches. Your body mass index (BMI) should not be greater than 25. If your BMI is over 30, you are obese. To calculate your BMI go to www.nhlbisupport.com/bmi/. If you need to lose weight, we recommend losing no more than 2 pounds a week. Weight Watchers is one of several good options to choose from to attain your goals. Avoid fad diets.
  3. QUIT SMOKING: If you smoke, quit. Smoking significantly increases your risk of developing cardiovascular disease. When you are ready to make a quit attempt, we will discuss options to assist you with quitting. We will encourage you to quit smoking at every office visit if you continue to smoke. The American Cancer Society has good information on their website as well as a toll free phone number to assist with this at www.yesquit.com/.
  4. ADEQUATE SLEEP: Obtain adequate sleep. Most people need 7-8 hours of sleep a night. If you are having difficulty sleeping along with excessive daytime sleepiness, you may have sleep apnea. We will consider evaluation for this disorder if your symptoms indicate you may have this condition. Sleep apnea can increase your risk of high blood pressure, obesity, stroke, abnormal heart rhythms, diabetes, and even heart failure.
  5. ALCOHOL: If you drink alcoholic beverages, drink in moderation. We recommend 1 drink/day for women and 2 drinks/day for men. There is some research indicating that this can protect your heart. Avoid alcohol if you have a family history of alcoholism.
  6. HERBS & SUPPLEMENTS: Inform us if you are taking herbs and supplements. These are not monitored by the FDA, so there is no guarantee of the quality of the supplements you take. Fish oil tablets are a supplement you may want to consider. Evidence from some studies suggest that taking 1 gram/day EPA and DHA (which is in these tablets) can reduce death from cardiac causes.
  7. ASPIRIN: Low dose aspirin (81 mg) lowers your risk for heart attack and stroke. You should consider taking this over-the-counter medication if you are a man older than 50 or a post-menopausal woman. Take aspirin f you are younger than this and have any of these risk factors: cigarette smoking, hypertension, high cholesterol, diabetes, obesity, or a family history of early heart disease. If you have a history of stomach ulcers, bleeding problems, or gastrointestinal disorder, discuss this with your provider before taking aspirin.
  8. FISH: Eat more fish (preferably fatty) at least twice a week. Include flaxseed oil, canola, and soybean oil in your diet. Fish is rich in omega 3 fatty acids which have been shown to reduce the incidence of cardiovascular disease. Consider one fish oil tablet a day if you are at intermediate to high risk for heart disease.
  9. REDUCE CHOLESTEROL: Reduce your intake of cholesterol by following a heart healthy diet. If you have elevated cholesterol, you have increased risk of coronary artery disease. Reduce your intake of red meat, eggs, fried food, and whole dairy products. Choose more lean meats and poultry without skin. There are many good websites you can visit with information on this diet including www.mayoclinic.com/health/heart-healthy-diet/NU00196.
  10. REDUCE SALT: Reduce your intake of salt. Consume no more than 2,300 mg of sodium/salt per day. Salt consumption can make it difficult to control your blood pressure.
  11. ERECTILE DYSFUNCTION: Erectile dysfunction is not uncommon among male patients. It can be a symptom of heart disease. Do not be afraid to discuss this concern with us. There are treatment options for this condition.
  12. TESTOSTERONE LEVEL: Men, know your testosterone level. A low testosterone level is associated with a low HDL which protects your heart.
  13. DEPRESSION: Depression increases the risk for coronary artery disease. Feeling tired or sad, experiencing loss of pleasure in life, having an increased or decreased appetite and being discouraged about the future are some symptoms of depression. Seek treatment of depression if this is present.
  14. VITAMIN D: Know your vitamin D levels and get treatment if these are low. Low levels can increase the risk of cardiovascular disease. Try to be in the sun for 15 minutes/day.
  15. CAC SCORE & CIMT: Consider a screening cardiology exam such as coronary artery calcium (CAC) score or carotid intima-media thickness (CIMT) to evaluate your risk for CAD.