The basics of cardiovascular disease prevention

February was American Heart Month, but anytime is a good time to consider your lifestyle and whether you might be at risk for heart disease.

Worldwide, cardiovascular disease is estimated to be the leading cause of death and disability. Research shows that high blood pressure, high blood cholesterol, smoking, obesity, diabetes and physical inactivity are the major risk factors for CVD.

Prevention of heart disease starts early in life. Studies indicate that major risk factors including cigarette smoking, elevated blood pressure, physical inactivity and obesity, are prevalent in childhood and adolescence. Modifying these risk factors early in life decreases the lifetime risk of heart disease significantly.

Smoking cessation is the most important step in prevention of heart disease. Current smoking increases the risk of heart attack by three times when compared with a nonsmoker. The risk decreases significantly even three years after quitting. There are many support services to help you quit including Delaware Quitline. For the quitline, go to http://dhss.delaware.gov/dph/dpc/quitline.html​.

The centerpiece of a healthy lifestyle is a heart-healthy diet and physical activity. The protective effects of regular exercise and general physical fitness have been very well documented. The American Heart Association suggests at least 150 minutes per week of moderate exercise. This includes walking, jogging, swimming or biking. And, remember, if you can't make it to the time goal, something is always better than nothing.

Numerous clinical studies have demonstrated the benefits of reducing your sodium intake and the benefits of healthy eating patterns such as the Mediterranean-style diet. The key elements are to have plenty of fruits, vegetables, whole grains and nuts; to replace butter with healthy fats such as olive oil and canola oil; to limit red meat to no more than a few times a month; and to eat fish and poultry at least twice a week.

All men 35 and older and all women 45 and older should be screened for high blood cholesterol. For people at high risk of CVD, the screening should start at age 20. The higher your blood cholesterol level, the greater your risk for developing heart disease or having a heart attack. Treatment of high cholesterol starts with lifestyle modifications including healthy diet and exercise as mentioned above. Your physician can calculate your 10-year risk of cardiovascular events, and drug therapy could be recommended based on your risk. Among drugs that target blood cholesterol, statins are usually the first line of therapy, and they are shown in numerous studies to decrease the risk of heart attack and cardiovascular death.

All adults should have a yearly checkup with their physician to have their blood pressure checked. High blood pressure increases the risk of heart attack, stroke and congestive heart failure significantly. By committing yourself to a low-salt diet, regular exercise, weight loss, and reduction in alcohol consumption, you can help lower your blood pressure. Ultimately, drugs may be needed to control blood pressure and prevent adverse effects.

To better understand your heart disease risk, take a free, five-minute survey - the Heart Health Profiler - at www.beebehealthcare.org/hearthealthprofiler​.

If you are at risk for heart disease and want to create a personalized plan to improve your health, go to My Life Check via the American Heart Association at http://tools.bigbeelabs.com/aha/tools/mlc/​.

Armin Barekatain, MD, is board certified in cardiology. He is a member of the Beebe medical staff and sees patients at Clinic By The Sea in Lewes and Millsboro. For more information about cardiac and vascular services at Beebe Healthcare, go to www.beebehealthcare.org/cardiac-vascular-services​.