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Healthy for life: Heart health

Countless Americans have heart disease — but most of the factors that put them at greatest risk can be addressed. Here’s how.

  1. What is heart disease?
  2. How common is heart disease?
  3. What are the risk factors for heart disease?
  4. What is blood pressure, and how does it relate to heart disease?
  5. What is obesity, and how does it relate to heart disease?
  6. What is cholesterol, and how does it relate to heart disease?
  7. What are triglycerides, and how do they relate to heart disease?
  8. What is hemoglobin A1c, and how does it relate to heart disease?
  9. Can smoking lead to heart disease?
  10. Can exercising help me fight heart disease?
  11. Can a healthy diet help me fight heart disease?
  12. When can I start fighting heart disease?

Place your hand over your heart. The fact that it’s beating right now is pretty amazing, right? As it beats, it’s pumping blood throughout your entire body. It’s also vital to areas of your health such as heart rate and blood pressure.

In short, your heart is super important to the rest of your body — and keeping it healthy is a big deal.

You might be surprised to learn, then, that millions of Americans have heart disease. In fact, it’s the leading killer of men and women across most racial and ethnic groups in the United States.

Below, find out what you can do to promote your own heart health.

What is heart disease?

Several diseases can affect the heart, but the term “heart disease” usually refers to coronary artery disease (CAD), the most common type. CAD occurs when the arteries that bring oxygen-rich blood to your heart become narrowed by a buildup of a sticky substance called plaque. If the plaque breaks loose, it can form a blood clot in an already narrowed artery, blocking the flow of blood.

That can result in a heart attack (aka a myocardial infarction), which can cause permanent damage to the heart muscle and may result in death. It can also lead to heart failure, which means the heart can no longer pump enough blood to support your other organs.

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How common is heart disease?

About 5% of U.S. adults ages 20 and older have CAD, and more than 800,000 Americans suffer heart attacks every year. That’s about 1 every 40 seconds. Although 80% of the people who die from CAD are 65 or older, it can happen to adults of any age.

“Heart disease is driven by our environment and our food supply and our sedentary lifestyle,” says Donald Lloyd-Jones, M.D. He’s a cardiologist and chair of the Department of Preventive Medicine at the Northwestern University Feinberg School of Medicine in Chicago, as well as the 2021–22 president of the American Heart Association. But, Dr. Lloyd-Jones adds, many of the risk factors are things we are largely in control of, so it’s up to us to understand how they affect our health and what we can do about it.

What are the risk factors for heart disease?

There are some risk factors you can’t do anything about — including getting older and having a family history of heart disease — but you can address many of the other risk factors, including the big 3:

  • High blood pressure (aka hypertension)
  • High cholesterol
  • Smoking

Although half of all Americans have at least 1 of those risk factors, there are steps you can take to reduce the risk.

Other risk factors include:

  • Lack of exercise
  • Obesity
  • Unhealthy eating habits
  • Secondhand smoke exposure

Let’s take a closer look at some of the main risk factors for heart disease.

What is blood pressure, and how does it relate to heart disease?

Your blood pressure reading contains 2 numbers:

  1. Systolic pressure (the top number), which measures the pressure in your arteries when your heart is beating.
  2. Diastolic pressure (the bottom number), which measures the pressure in your arteries when your heart is resting.

High blood pressure makes your arteries less elastic, which reduces blood flow and puts you at risk of developing heart disease and/or having a heart attack or stroke.

Despite the potential risks, you can’t feel that your blood pressure is high unless it’s extremely elevated, according to Stephanie Moore, M.D. She’s a cardiologist at the University of Louisville School of Medicine. That’s why she advises her patients to keep track of their blood pressure.

“If you are over the age of 40, you should know what your blood pressure is,” says Dr. Moore. “If you’re over the age of 50, you should check your blood pressure at least twice a week and write it down. And when you go see your doctor, take those blood pressure readings in.”

Digital blood pressure monitors are widely available and make it easy to check your blood pressure at home. To get an accurate reading, sit with your arm supported, your upper arm at heart level and your feet flat on the floor. Avoid stress, caffeine, tobacco and exercise for 30 minutes before measuring your blood pressure.

What is a healthy blood pressure reading?

Let’s say you want to take your blood pressure for the first time. What does a normal reading look like versus a high one? Here’s what to look for:

  • Normal blood pressure is less than 120/80 mm Hg (your doctor might say “120 over 80”).
  • High blood pressure (also called hypertension) is 130/80 mm Hg or higher.
  • Elevated blood pressure is anything between 120 to 129 systolic blood pressure and less than 80 mm Hg diastolic.

What is obesity, and how does it relate to heart disease?

“Overweight and obesity are defined as abnormal or excessive fat accumulation that presents a risk to health.”

Both conditions make your heart have to work harder. Moreover, obesity contributes to the likelihood that you have other risk factors, including:

  • Type 2 diabetes
  • High blood pressure

Being obese or overweight may also make you less likely to exercise, which can contribute to heart disease, since exercise helps strengthen your heart.

How do you measure obesity?

The most common measure is body mass index (BMI), which is a single number based on your height and weight. Here’s the range of scores for adults:

  • Underweight: less than 18.5
  • Healthy weight: 18.5 to 24.9
  • Overweight: 25 to 29.9
  • Obese: 30 or above

Although BMI is an important number, Dr. Lloyd-Jones cautions that it may not be the best way to track your weight. “If more of your weight is packed around the middle of your body, it’s less healthy,” he says. “It’s better if it’s in your legs and arms, where there’s muscle mass, and less in your abdomen, where it’s more likely to be fat mass.”

In fact, the National Library of Medicine says that people with apple-shaped bodies (waist is bigger than hips) have an increased risk of heart disease and type 2 diabetes compared with those with pear-shaped bodies.

What is cholesterol, and how does it relate to heart disease?

Cholesterol is a fatty, waxy substance in your body’s cells. The body makes all the cholesterol it needs, but many common foods also contain it. Those include:

  • Butter
  • Cheese
  • Cow’s milk
  • Egg yolk
  • Meat
  • Yogurt

If you tend to eat a lot of dairy products, for example, it can put you at risk of having elevated or high cholesterol levels.

Having too much cholesterol in your blood can contribute to the formation of plaque and the narrowing of your arteries. That could lead to a condition in which cholesterol and other substances build up on the artery walls (atherosclerosis). That can cause health problems like:

  • Blood clots
  • Heart attack
  • Stroke

Like high blood pressure, atherosclerosis doesn’t usually cause any noticeable symptoms unless it’s advanced, which is why knowing your cholesterol levels is important.

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What is a healthy cholesterol level?

Your doctor can test your body’s cholesterol level with a simple blood test. That will provide you with 3 important numbers:

  1. Your total cholesterol level
  2. Your LDL (low-density lipoprotein) level
  3. Your HDL (high-density lipoprotein) level

Your LDL level is sometimes called “bad” cholesterol, and HDL is sometimes called “good” cholesterol. Here’s how your cholesterol numbers break down:

  • Total cholesterol
  • Desirable: less than 200 mg/dL
  • Borderline high: 200 to 239 mg/dL
  • High: 240 mg/dL and above
  • LDL (“bad”) cholesterol
  • Optimal: less than 100 mg/dL
  • Near optimal: 100 to 129 mg/dL
  • Borderline high: 130 to 159 mg/dL
  • High: 160 to 189 mg/dL
  • Very high: 190 mg/dL and above
  • HDL (“good”) cholesterol
  • A score of 40 or more for women and 50 or more for men is good

What are triglycerides, and how do they relate to heart disease?

Triglycerides are the most common type of fat in your body. They are affected by foods like:

  • Alcohol
  • Butter
  • Red meat
  • Sugars
  • Simple starches, such as potatoes, rice and white flour-based foods

Those foods contain extra calories that end up in your fat cells. A high amount of triglycerides, in combination with low HDL or high LDL cholesterol, is thought to lead to atherosclerosis.

What is a healthy triglyceride level?

As with cholesterol, your doctor can do a simple blood test to check your body’s triglyceride level. It’s represented by a single number. Here’s what your score means:

  • Normal: less than 150 mg/dL
  • Borderline high: 150 to 199 mg/dL
  • High: 200 to 499 mg/dL
  • Very high: 500 mg/dL and above

What is hemoglobin A1c, and how does it relate to heart disease?

Hemoglobin is a type of protein found in your red blood cells. It carries oxygen. Hemoglobin A1c is a protein that’s linked to sugar in your body. Your doctor can do a hemoglobin A1c test to check whether you have healthy levels of sugar in your bloodstream. The results of that test can tell your doctor if you have diabetes or prediabetes.

If you have diabetes, it’s treatable and your doctor can help you manage the condition. Diabetes can damage your blood vessels and is associated with other risk factors for heart disease, including high blood pressure and high cholesterol. People with diabetes are also more likely to develop heart failure.

What is a healthy A1c level?

Your doctor can perform a simple blood test to figure out your A1c level. The number is given as a percentage. Here’s what your score means:

  • Normal: below 5.7%
  • Prediabetes: 5.7% to 6.4%
  • Diabetes: 6.5% and above

Your A1c level tends to rise with age, so Dr. Moore gives her patients a simple rule to follow: “If you’re over 55, your A1c level should be equal to or less than your age [with a decimal in the middle],” she says. “So if you’re 65, it should be 6.5 or less.” She notes that everyone should try to stay under 7.5%, so her rule doesn’t apply to patients older than 75.

Can smoking lead to heart disease?

You’ve been told from a young age that smoking is bad for you. And for good reason. For one thing, it’s a major cause of lung cancer — but it also increases your risk of developing heart disease.

According to the Centers for Disease Control and Prevention (CDC), smoking can raise triglycerides, lower your “good” HDL cholesterol, and make blood sticky and more likely to clot. This can:

  • Block blood flow to the heart and brain
  • Cause thickening and narrowing of blood vessels
  • Damage cells that line the blood vessels
  • Increase the buildup of plaque in blood vessels

Dr. Moore advises her patients to cut back on smoking and eventually to quit. “If you cut back from a whole pack to half a pack, that’s good,” says Dr. Moore. “But you need to stop.”

And if you’re thinking that vaping might be a healthier option, think again. “The chemicals that are in the aerosol of vaping can damage your lungs and heart and make you more likely to start smoking combustible products too,” says Dr. Lloyd-Jones.

Can exercising help me fight heart disease?

Whether you are a personal fitness fanatic, love running or practice yoga, exercise is a great way to lower your risk of developing heart disease. It can help:

  • Improve your mood
  • Lower your blood pressure
  • Lower your blood sugar levels
  • Maintain a healthy weight (although you’ll also have to cut back on the calories you’re eating)
  • Lower your cholesterol

“Exercise and physical activity are some of the most powerful preventive drugs that we have,” says Dr. Lloyd-Jones. “Just as sometimes you have to take a pill every day for your blood pressure, you also need to schedule physical activity for yourself every day to really maximize its benefits.”

Experts recommend getting at least 150 minutes of moderate exercise or 75 minutes of vigorous activity every week. Moderate exercise includes things like:

  • Brisk walking  
  • Light cycling 
  • Dancing (ballroom or social)
  • Recreational swimming 
  • Tennis (doubles)
  • Yard work or gardening

Vigorous exercise includes things like:

  • Running at a fast pace
  • Strenuous, uphill hiking
  • Swimming multiple laps
  • Vigorous aerobic dancing
  • Tennis (singles)
  • Jumping rope

Even in 10-minute chunks, exercise makes a huge difference to your body. In fact, it’s generally better to spread the time spent exercising out over the whole week, rather than cramming it all into the weekend. It’s also a good idea to talk with your doctor before starting a new exercise plan.

Can a healthy diet help me fight heart disease?

You can improve your heart health by avoiding foods that are high in saturated fats, salt or sugar. Those types of foods can increase your risk of developing diabetes and other heart-related conditions. Experts recommend the DASH (Dietary Approaches to Stop Hypertension) eating plan. It advises you to choose foods such as:

  • Beans
  • Fat-free or low-fat dairy products
  • Fish and poultry
  • Fruits and vegetables
  • Nuts
  • Whole grains

It also urges you to limit foods like:

  • Candy and other sweets
  • Fatty meats
  • Full-fat dairy products
  • Oils (the tropical kind, such as coconut)
  • Sugar-sweetened beverages (such as soda and sports drinks)

If you’re not sure where to start, Dr. Moore suggests following this simple rule: “You need to eat 5 servings a day of either fruits or vegetables,” she says.

When can I start fighting heart disease?

The simple answer is right now. If you’re confused about where to start, checking in with your doctor is a good first step. But beyond their advice, you can do a lot of it from the comfort of your own home — or at the gym. And take it easy on yourself; it’s a process.

“If you consistently add 1 apple to your diet every day, exercise for 10 minutes a day, check your blood pressure twice a week, and make the doctor’s appointment to get your cholesterol and diabetes numbers drawn, you’re way ahead of the curve,” says Dr. Moore.

“This is a journey; it’s not a one-time thing,” adds Dr. Lloyd-Jones. “As with all journeys, there are successes and sometimes some setbacks. But the important thing is to be moving forward.”

A heart attack or stroke can be a life-changing event. Explore critical illness insurance now or call a licensed insurance agent at 1-844-211-7730 for more information.

For informational purposes only. This information is compiled by UnitedHealthcare, and/or one of its affiliates, and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.

Sources:

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American Stroke Association. “Atherosclerosis and Stroke.” October 8, 2023. Retrieved from https://www.stroke.org/en/about-stroke/stroke-risk-factors/atherosclerosis-and-stroke

Centers for Disease Control and Prevention. “About cholesterol.” May 15, 2024. Retrieved from https://www.cdc.gov/cholesterol/about/index.html

Centers for Disease Control and Prevention. “About heart attack symptoms, risk, and recovery.” May 15, 2024. Retrieved from https://www.cdc.gov/heart-disease/about/heart-attack.html

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Centers for Disease Control and Prevention. “Benefits of physical activity.” April 24, 2024. Retrieved from https://www.cdc.gov/physical-activity-basics/benefits/index.html

Centers for Disease Control and Prevention. “Health effects of cigarettes: cardiovascular disease.” May 15, 2024. Retrieved from https://www.cdc.gov/tobacco/about/cigarettes-and-cardiovascular-disease.html

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Centers for Disease Control and Prevention. “Heart disease risk factors.” May 15, 2024. Retrieved from https://www.cdc.gov/heart-disease/risk-factors/index.html

Centers for Disease Control and Prevention. “Testing for diabetes and prediabetes: A1C.” May 15, 2024. Retrieved from https://www.cdc.gov/diabetes/diabetes-testing/prediabetes-a1c-test.html

Centers for Disease Control and Prevention. “Your heart and diabetes.” May 15, 2024. Retrieved from https://www.cdc.gov/diabetes/diabetes-complications/diabetes-and-your-heart.html

Harvard Health Publishing. “The many ways exercise helps your heart.” January 1, 2023. Retrieved from https://www.health.harvard.edu/heart-health/the-many-ways-exercise-helps-your-heart

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