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One of the most important ways to lower your risk for heart attack and stroke is to keep your cholesterol in check. But did you know that you could be at risk for cardiovascular disease even if your numbers are near normal?
New guidelines from the American Heart Association recommend relying on more than just the absolute cholesterol numbers. Today, cardiologists are looking at the bigger picture and calculating what is known as the Atherosclerotic Cardiovascular Disease Risk. The goal is to predict how likely the patient is to develop heart disease in the next 10 years. This means that people who have just mild elevations in their cholesterol numbers may still need to be treated with lifestyle modifications and cholesterol-lowering drugs called statins.
“Despite our best efforts to increase awareness and prevention, cardiovascular disease remains the number one killer of both men and women in the U.S.,” says Dr. Liliana Cohen, a cardiologist at Summit Medical Group. “For years, we have seen patients come in that have heart attacks with near normal cholesterol levels. By focusing more on total risk, not just the cholesterol numbers, we can target individuals that may have been missed before.”
Today, in addition to cholesterol levels, doctors are looking at other factors that increase risk. Critical red flags include: a previous history or family history of heart attack or stroke, high blood pressure, diabetes, advanced age, gender, smoking, and race.
There are two main types of cholesterol in the body. LDL (low-density lipoproteins), often referred to as “bad” cholesterol, is a waxy plaque-like substance that builds up over time, clogs the arteries, and can lead to heart disease. While HDL (high-density lipoproteins), the so-called “good cholesterol,” helps the body remove these excess fatty deposits. Ideally, LDL levels are low and HDL levels are high.
Nearly one in three adults in the U.S. have elevated levels of LDL. In addition to making healthy lifestyle changes, patients who have high cardiac risk may benefit from medications called statins that lower the build-up of this bad cholesterol in the body.
Women are still presenting later than men, notes Dr. Cohen. “They are less likely to come to a physician with symptoms or into the emergency room when they have a heart attack. The medical community also underestimates the risk of heart disease in women.” To help identify women who are at risk, Summit Medical Group is offering a Women’s Heart Disease Program, located in West Orange. Patients who are identified as having moderate to high risk factors for heart disease by a primary care physician or OB-GYN are encouraged to make an appointment.
Individuals who are not at risk and do not show signs of cardiovascular disease should have an annual assessment with their primary care physician. In families with a strong history of heart attack and stroke, testing should begin in early adulthood.
“These new guidelines highlight the importance of a more individualized approach to treatment. Depending on the overall picture, some patients may no longer meet criteria for medical therapy, while other patients may benefit from more aggressive treatment at an earlier age,” explains Dr. Cohen.
It is important that patients and physicians work closely to prevent cardiovascular disease. Lifestyle modifications such as exercising regularly and eating a heart-healthy diet can reduce the need for medication.
1. Get Moving
The American Heart Association recommends 150 minutes of moderate intensity exercise or 75 minutes of vigorous exercise each week.
Dr. Cohen’s Tip: “Moderate intensity means you are breaking a sweat and are unable to carry on a conversation.”
2. Eat the Rainbow
Fill your plate with whole grains and heart-healthy fruits and vegetables. Reduce saturated fat by limiting dairy and red meat to once a week. Avoid processed foods that contain added salt. Eat fish twice a week.
Dr. Cohen’s Tip: “Fish oils have not been proven to be beneficial but eating fish twice a week will help.”
3. Watch Your Weight
Being overweight or obese will increase your risk for cardiovascular disease. Diet and exercise can help you shed excess pounds.
4. Quit Smoking
Make a plan to quit smoking and inform your family and friends. After only one year, your risk of developing heart disease is cut in half.
Dr. Cohen’s Tip: “If you have tried to quit and failed, ask your doctor for support. Summit Medical Group has smoking cessation programs that can help you kick the habit.
5. Drink in Moderation
Excess alcohol can lead to cardiovascular disease and stroke. Limit wine and other spirits to no more than one drink a day for women and two for men.