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Know the 123s and ABCs for a healthy heart

Published:Monday | July 20, 2015 | 12:00 AMDr Wendy Post

How are numbers and letters connected with heart health? Certain numbers can tell you if you are at risk of a heart attack or stroke. These numbers have to do with your blood pressure, cholesterol values and other risk factors. Likewise, the letters refer to approaches for preventing cardiovascular disease. Knowing them may help motivate you to make lifestyle changes that can lead to a healthier heart and life.

So how do you know if you are at risk for heart disease? Your doctor can help you determine this by using a new cardiac risk calculator. This tool, called the Pooled Cohort Equation, can estimate your risk for a heart attack or stroke in the next 10 years by using traditional heart disease risk factors, including age, gender, race, blood pressure, total cholesterol and high-density lipoprotein (HDL, or 'good' cholesterol) levels, diabetes, and smoking status. The tool can help start a conversation about the risks and benefits of treatment options and preventive strategies.

If your numbers say you are at low risk for developing heart disease and stroke, then your doctor will probably recommend a healthy lifestyle - eat a heart-healthy diet, exercise and avoid smoking. However, if you are at moderate or high risk, you might benefit from treatment with cholesterol-lowering medications.

With support from your doctor, you can reduce modifiable risk factors for developing hypertension (high blood pressure), diabetes and high cholesterol. You can also get counseling about effective ways for smoking cessation if you use tobacco products.

Lifestyle modifications, including diet, weight loss and exercise, are the cornerstones of preventing cardiovascular disease.

Learn the ABCs of prevention:




Your doctor may recommend low-dose aspirin therapy if you have any of the following:

- A 7.5 per cent or higher risk for heart attack or stroke over the next 10 years.

- Known heart or blood vessel disease.

- Diabetes.

- At least one other risk factor if you are a man over age 50.

- You are a woman over age 65.




If you have high blood pressure, or hypertension, you may be able to lower it with dietary changes, such as decreasing your salt intake and increasing consumption of fruits and vegetables. Increasing your physical activity and losing weight may also help. As you get older, you may need to take blood pressure medications.




Cholesterol levels are influenced by your lifestyle (diet, exercise, weight) and genetics (inherited from our parents). If you have abnormal cholesterol levels or are at risk for heart disease, statin medications can reduce the risk for heart disease by 25 to 30 per cent.




A diet rich in fruits, vegetables and whole grains, and low in saturated fats and simple carbohydrates may help you maintain a healthy weight. Your exercise routine should include aerobic activity (exercise that increases your heart rate) and strength and flexibility training. Get a pedometer or use a smartphone app to track your steps. Aim for at least 10,000 steps a day.

Do not wait until you have heart disease. Prevention is a smarter way to go!

- Wendy Post, MD, is a professor of medicine at the Johns Hopkins University School of Medicine, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, and associate faculty member at the Welch Center for Prevention, Epidemiology and Clinical Research at the Johns Hopkins University. Email: