Patients and Clinicians Unite Part One: the ABCs of Heart Disease

Do you know that heart disease is the leading cause of death in the U.S.? Living in the technological era, we’re at a unique point when patients and clinicians can partner together to turn the tables on heart disease. In this two-part article, we’ll first briefly review the heart disease prevention must-knows and address the contentious topic of cholesterol management. In part two, we’ll discuss individualized approaches to treatment and offer suggestions about where patients can get reliable information on preventing heart disease. The power is ultimately in the patient’s hands. We strive to equip you with the latest, best information for heart disease prevention and good health.

Do You Know Your ABCs by Heart?

Our Ciccarone Center physicians and clinical staff members use an ABCs model for prevention – the Centers for Disease Control and Prevention has similar ABCs – as a simple and memorable way to teach our patients how to prevent heart disease. The Ciccarone ABCs of heart disease risk include A for age, B for blood pressure, C for cholesterol and cigarette smoking, D for diabetes and E for exercise (lack of). With each of these factors comes a heightened risk of developing heart disease that add together to increase your risk. Of course, we don’t live in “Back to the Future,” so we’re stuck with aging. But that doesn’t mean we can’t control what we do as we move through life.

[See: The Facts on Heart Disease.]

Now We Know Our ABCs – Now it’s Time for Clarity

We’ve identified the ABCs, but now let’s explain what they mean. As a person gets older (A for age), they experience an increased risk of heart disease.

B for blood pressure, C for cholesterol (and cigarette smoking, but we’ll get to that shortly) and D for diabetes can all be regulated in part by a healthy diet. The majority of your fat intake should be from unsaturated fats (those from plants), a limited portion should come from saturated fats (those in meats and cheeses), and trans fats (from processed foods) should be avoided altogether. This will help keep cholesterol levels in check.

Dietary fibers and protein are essential to your diet. Fiber can help lower cholesterol and blood glucose levels, which can aid in preventing diabetes. Fiber can be found in beans, vegetables, nuts, oats, citrus fruits, barley and other foods.

Fish is a fantastic source of protein. It’s loaded with omega-3 polyunsaturated fats, which help lower triglycerides (a blood fat) and modestly lower blood pressure.

When eating carbs, keep in mind that some are much healthier than others. Choose whole-grain rather than processed and refined carbs.

As for drinks, limit your intake of soda, juice and other sugary drinks. If you drink alcohol, drink it in moderation. According to the Department of Health and Human Services’ Dietary Guidelines for Americans, that means one alcoholic drink per day for a woman and two alcoholic drinks per day for a man. Try to eat a wide variety of foods, including nuts and a lot of dark green, leafy vegetables. Keep your diet diverse, and consume everything in moderation. Remember: You are what you eat. In an ode to a fitness guru mantra with our own personal spin: Flavor may fade, but heart health is forever.

Coming back around to the second part of C, for cigarette smoking: You should quit or abstain from smoking, and keep far away from cigarettes for good.

The last letter to elaborate on is E, for exercise. Exercise, along with deep breathing and other relaxation techniques, can be used to control stress and safeguard your heart. Don’t bottle up prolonged stress or cope with it in an unhealthy way, such as excessive eating and drinking alcohol. Instead, move your body and get it out. Go hard at the gym, and even in bed.

A normal body mass index range is between 18.5 and 24.9. Exercising, in addition to eating healthy, can help you to stay within this range. Attempt to exercise according to CDC guideline recommendations: 150 minutes of moderate-intensity exercise a week, or 30 minutes per day at least five days a week.

Sometimes you want to just sit on the couch and watch Netflix after a long day of work, right? Instead, try using Netflix as your motivation – let it be your post-workout reward. Or, try watching TV while you are at the gym, as long as you maintain your effort while exercising. (New motto: “Netflix and fit?”)

Before working out, most healthy people can get simple medical clearance for moderate-intensity exercise from their physician. However, if you have a history of chronic disease, such as heart disease, diabetes, kidney disease, cancer, etc., you should first consult your doctor to be sure it’s safe for you to exercise.

Once you get exercising, chart your efforts. Keep track of how you do, set goals and be proud of yourself. Love your body, your heart and your health. Try to avoid doing the same workout; move different muscles, switch up your cardio. Revel in your workout, and get into it with your body and soul. You’ll look and feel better if you enjoy yourself. And you’re putting the time in anyway, so you might as well have fun while you’re at it!

For more on the ABCs and further reliable information pertaining to heart health and disease prevention, please visit the website to the Johns Hopkins Ciccarone Center.

[See: The 12 Best Heart-Healthy Diets.]

C for Contentious Cholesterol

Let’s hone in on the contentious C word: cholesterol. Some people are suspicious of eating foods with cholesterol, while others are doubtful of the dangers of cholesterol. You may have been told to run away from egg yolks and heard from others at the other end of the spectrum to eat all the yolks you want. Cholesterol skeptics write that cholesterol isn’t a major, principal cause of heart disease, whereas panels of experts from science-based organizations have guidelines focused on lowering cholesterol to prevent heart disease. To make sense of this, let’s get into multiple parts of the bigger picture.

There are two main types of cholesterol that you often hear about when considering heart health: high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). HDL-C is considered the safer cholesterol of the two and is commonly referred to as “good cholesterol,” whereas LDL-C, known as “bad cholesterol,” has a bad rap, and for a good reason. High LDL-C levels cause heart disease and death.

But cholesterol alone doesn’t contribute to a person’s susceptibility to heart disease, as reflected in the ABCs above. For example, you could have a person with a modestly elevated LDL-C and multiple other risk factors, like high blood pressure and family history of disease, versus a younger person with somewhat higher LDL-C levels but who is otherwise healthy. Over the next 10 years, the older person with multiple risk factors will be at considerably higher risk because his or her overall risk factors exceed the severity of those of the otherwise healthy person, despite the higher LDL-C.

[See: The Best Foods for Lowering Your Blood Pressure.]

Take-home messages:

• As you get older, your risk of heart disease increases. The ball is in your court to learn about your heart disease risk factors and control them as you age.
• High levels of LDL-C (“bad cholesterol”) cause heart disease and death, but cholesterol is just one of multiple risk factors contributing to development of heart disease.
• Keep all of the ABCs in mind! In addition to age, they are blood pressure, cholesterol, cigarette smoking, diabetes and exercise (lack of).