Preventing Heart Attack

Heart disease is the number one killer of men and women in the United States. For those over 65 years of age, the risk is even greater: eight out of ten people who die of heart disease are 65 or older. Although these statistics sound dire, take heart: With these strategies, you can help your loved ones reduce their risk -- and reduce your own at the same time.

1. Know the early warning signs and seek treatment right away.

Some typical symptoms of a heart attack include:

• Chest pain (angina)
• Shortness of breath
• Palpitations (skipped beats or a racing or pounding heart)
• Leg swelling
• Bluish skin color (cyanosis)
• A prolonged, unexplained cough
• Coughing up blood
• Persistent fatigue or feeling unwell
• Passing out

But sometimes the symptoms aren't so obvious. The pain of a heart attack may feel like really bad heartburn or even the flu. And the symptoms of a second heart attack may not be the same as those for the first. If you or someone close to you has already had a heart attack, don't hesitate to seek emergency medical treatment at the first sign of possible trouble.

2. Talk to the doctor about medications that might increase risk.

Hormone replacement therapy, rosiglitazone (for diabetes), and COX-2 inhibitors (for controlling arthritis pain) are all examples of medications that may increase the risk of heart attack. Review all medications with a doctor and ask if there are less risky alternatives.

3. Control blood pressure.

High blood pressure is a major risk factor for heart attack. If your loved one has been diagnosed with prehypertension (120/80 mm Hg to 139/89 mm Hg) or hypertension (140/90 mm Hg or higher), his blood pressure should be treated.

The doctor will prescribe the appropriate medications, but his blood pressure needs regular monitoring. Although it can be a bit tricky to use, an inexpensive manual cuff (starting at about $12 at your local drugstore) is a great way to monitor blood pressure at home.

But if you can't get the hang of it, you may want to consider investing in a blood pressure machine. The machine is a bit more expensive (between $70 and $150); it's also available at your local drugstore.

4. Keep "bad" cholesterol levels low.

Another major risk factors for heart attack is a high bloodstream level of LDL, or "bad" cholesterol. Ideally, total cholesterol should be no more than 200 mg/dL (milligrams per deciliter), and no more than five times the level of HDL or "good" cholesterol; LDL levels should be below 70 mg/dL. Make sure cholesterol levels are checked regularly and treated if necessary.

Following a low-fat diet and exercising regularly may help, but it might not be enough. If cholesterol levels don't respond to lifestyle changes, medication might be necessary.

5. Make sure diabetes is under control.

Three out of four people with diabetes will eventually die of some type of heart or blood vessel disease. But by keeping blood sugar under control and taking any recommended medications, a diabetic can reduce his risk.

If you can your loved ones are lucky enough not to have diabetes, it's important to avoid developing the disease by exercising regularly and maintaining a healthy weight.

6. Follow a heart-healthy diet.

The American Heart Association offers specific dietary guidelines for reducing the risk of heart attack.

The best bet is a diet rich in whole grains, vegetables, fruits, fish, poultry, lean meats, and low-fat or fat-free dairy products.

A good rule of thumb: Limit daily intake of fat (total fat between 25 and 35 percent of daily calories, saturated fat less than 7 percent, and trans fat less than 1 percent), cholesterol (less than 200 milligrams per day if LDL levels are high, less than 300 milligrams per day if they aren't), and sodium (less than 1,500 milligrams per day for high blood pressure, less than 2,300 milligrams per day otherwise).

Women should consume no more than one alcoholic beverage per day, men no more than two. And all adults should each eat 25 to 30 grams of dietary fiber every day.

7. Encourage regular exercise.

Exercise is essential for general cardiovascular health and is key to preventing a heart attack. But how much exercise is enough?

The Centers for Disease Control and the American Heart Association recommend accumulating at least 30 minutes of moderate-intensity physical activity at least five days a week on most days.

This doesn't mean you and your loved ones need to do half an hour of aerobics five days a week; instead, aim for short bursts of activity throughout the day.

Just parking farther away from the store and walking the extra distance, or taking the stairs instead of the elevator, can quickly add up. But before beginning any exercise program, be sure to talk to a doctor about any restrictions you or your loved ones may have.

8. Achieve and maintain a healthy weight.

Being overweight or obese is a major risk factor for heart disease. The best way to determine whether you or your loved ones are overweight or obese is to calculate body mass index, or BMI. You can calculate BMI at the Centers for Disease Control and Prevention's website.

People with a BMI of 25.0 to 29.9 are considered overweight; people with a BMI of 30.0 or greater are considered obese.

If you or someone close to you meets either of these criteria, talk to a doctor about setting safe weight-loss goals.

The best way to lose weight is by limiting calories and increasing activity, but if that approach is unsuccessful, counseling or even medical intervention may be necessary.

9. Stop smoking.

Smoking is one of the biggest risk factors for heart attack. If you or your loved ones smoke, quitting can reduce risk of heart attack by 50 percent or more. But recognize that stopping smoking isn't easy. Here are a few ways you can help those close to you:

• Ask them what they think would make it easier for them. They may have suggestions you haven't thought of.
• Encourage them to talk about their feelings and what they're going through. Smoking may be a comforting lifelong habit; let them mourn a little.
• You may be tempted to nag or yell if they slip up, but it's more effective to remind them that you love them no matter what. Be positive and encouraging -- and vent your frustration to a friend instead.
• Help them avoid situations that trigger the desire for a smoke. If they're used to enjoying a cigarette after meals, try going for a short walk outside instead.
• Be understanding as they go through withdrawal symptoms. Try not to take it personally if they're especially irritable, short-tempered, and tired.
• Quit smoking yourself. If you must smoke, don't smoke around your loved ones. Not only will it make quitting more difficult for them, but the secondhand smoke will increase their risk of heart attack.

If your loved ones find it too difficult to quit on their own, talk to their doctor. Nicotine replacement therapy, support groups, and counseling may all be helpful.

10. Manage stress and depression.

Your loved ones' emotional and psychological state can have a very real effect on their physical health. An important aspect of maintaining good cardiovascular health and avoiding heart attack is minimizing stress, anger, and depression. If one of your parents live alone, for example, he or she may feel disconnected and alone.

Encourage him or her to get out, make new friends, or simply engage in stimulating activities. A local church or community center is an excellent place to connect with other older adults.

Perhaps someone close to you is already a social butterfly but still seems to be having difficulty with his mood. Try these stress-busting strategies:

• Cut back on caffeinated beverages and alcohol.
• Try meditation or yoga.
• Play relaxing music.
• Go for a walk outdoors.

If you've tried everything and still feel concerned about a loved one's mood, talk to his doctor. Depression is a serious but treatable illness.