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Am I Doing All I Can to Avoid a Heart Attack?

I eat right, exercise and don’t smoke. Does that mean I’m in the clear?

Photo credit: Trunk

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Q: As a woman in my mid-40s, I want to make sure I’m doing everything I can to lower my risk of heart disease so I can live a long and healthy life. I eat a healthy diet (lots of vegetables and whole grains and very little junk food); I do a 3-mile morning run at least five days a week; I don’t smoke; and I’m not overweight. All this means that my risk for heart disease is low, right?


"Midlife Mom"

Dear Midlife Mom:

First of all, I want to commend you on your heart-healthy lifestyle. Everything you’re doing (or not doing) is definitely helping to lower your risk of developing heart disease.

Still, there are a few other risk factors that you didn’t include, and these are just as important, if not more so, than the lifestyle factors you mentioned.

The first is high cholesterol. Did you know that not all cases of high cholesterol are due to lifestyle changes? Some are inherited. In fact, one in 300 people have what’s known as familiar hypercholesterolemia, which is a genetic disorder that results in extremely high cholesterol levels. If you have this genetic disorder, you can eat a really healthy diet and still develop dangerously high cholesterol. That’s why we now recommend that all patients get a cholesterol panel of blood tests starting as young as 4 years of age.

Another risk factor is hypertension, or high blood pressure. Again, hypertension is often due to lifestyle factors such as obesity and smoking, but that’s not always the case. Some people have a genetic predisposition to developing high blood pressure as they age, and this can happen no matter how much you exercise or what you eat. So having your blood pressure checked regularly is also important. Normal blood pressure is around 120/80.

And then there’s family history, which in my opinion trumps all the other risk factors. The reason I say that is because there are a lot of genetic interactions involved with heart disease that we still don’t fully understand. When we say family history, we’re primarily talking about immediate family members (your mother, father, siblings, children). But those aren’t the only family members that matter. If your only relative with heart disease is an aunt or uncle, it’s certainly worth making sure that you don’t have early signs of heart disease.

Depending on your family history and the results of your cholesterol and blood pressure screenings, you may be a candidate for a coronary calcium screening test. This is a 20-minute CT scan that takes a snapshot of your arteries to see if there is any plaque. The results of this test can help us determine whether someone would benefit from taking cholesterol lowering medication, and possibly seeing a cardiologist for further diagnostic tests.

It’s great that you’re doing so many heart-healthy things, like not smoking, eating right, watching your weight and getting regular exercise (the American Heart Association recommends 30 minutes at least five days a week). If you combine that with an annual doctor’s visit to check your key numbers and go over your family history, you’ll be setting yourself up well for great long-term heart health.

“Some people have a genetic predisposition to developing high blood pressure as they age, and this can happen no matter how much you exercise or what you eat.”
Benjamin Hirsh, MD
Dr. Benjamin Hirsh, Cardiologist | Photo credit: The Well

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Published January 2nd, 2018

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