Written by Jenna Brinks, M.S., and Barry Franklin, Ph.D., FACSM
Cardiovascular disease (CVD) is a broad term encompassing diseases of the heart and blood vessels, including heart attack, coronary artery disease, congestive heart failure and stroke. Because CVD is the number-one killer of both men and women worldwide, identifying risk factors and prevention strategies for CVD are important steps toward avoiding health problems.
There are numerous risk factors for CVD, some of which we cannot control. For example, as we age, our blood vessels become less elastic and more likely to develop plaques that can lead to coronary artery disease and heart attacks. Furthermore, having a family history of heart-related problems (before 55 years of age in father or other male in your immediate family, or before 65 years of age in mother or other female first-degree relative) can increase your risk of developing CVD.
Although we cannot change our age or family history, there are many risk factors we can influence by making simple lifestyle modifications. One of these “modifiable” risk factors is high blood pressure. Blood pressure readings consistently above 140/90 indicate high blood pressure, or hypertension, and should be evaluated by your physician. To prevent hypertension, you should participate in regular exercise, decrease dietary salt intake, and maintain a healthy weight. If you have hypertension, your doctor may prescribe medications that can lower your blood pressure.
Dyslipidemia, or abnormal blood fat levels, also increases the risk of CVD. The three basic components of dyslipidemia are LDL (low density lipoprotein), HDL (high density lipoprotein), and triglycerides. LDL particles and triglycerides contribute to the formation of blockages in coronary arteries, increasing your risk of heart disease. Conversely, HDL particles help remove LDL cholesterol from circulation, reducing the risk of CVD. Ideal lipid/lipoprotein levels for healthy adults include a total cholesterol of < 200, LDL < 100, HDL 40, and triglycerides < 150. If you have dyslipidemia, your doctor may recommend decreasing dietary intake of cholesterol, saturated fat, and sugars, weight reduction, and a regular exercise program. You may also be started on medication to favorably modify your cholesterol and its subfractions. According to “The Rule of 40,” for every 40 points you lower your cholesterol, you cut your risk of having a heart attack in half!
Diabetes, characterized by high blood sugar, is another risk factor for CVD. Fasting blood sugar levels normally range from 60-100 mg/dL. Over time, our bodies can become less efficient at allowing sugar from the blood into our muscles to be used for energy, leading to elevated blood sugar. This can cause damage to blood vessels and coronary arteries. To prevent diabetes, your doctor may encourage you to eat a balanced diet, lose weight, and exercise regularly. If you have diabetes, several medications are available to improve blood sugar levels.
Obesity is an escalating national health problem that also predisposes you to CVD. To determine if you are at a healthy weight, calculate your Body Mass Index (BMI) by dividing your weight (in kilograms) by your squared height (in meters): for most people 20-24.9 is ideal, 25-29.9 is overweight, and 30 or more falls into the obese category. Because excess weight has numerous consequences for the heart and body, it is crucial to maintain a healthy weight. Regular exercise and a balanced diet are the most effective ways to lose weight and prevent weight gain.
Another major CVD risk factor is smoking. Smoking is a public health concern that not only increases lung cancer risk, but also increases heart rate and blood pressure, promotes abnormal heart rhythms, negatively alters cholesterol levels, damages blood vessels, and increases the risk of blood clotting. Nonsmokers can reduce their risk of CVD by never starting and avoiding secondhand smoke, and smokers should quit immediately. There are several methods that can help you quit, such as nicotine patches and gums, as well as prescription medications.
Finally, a sedentary lifestyle represents another independent risk factor for CVD, and a regular exercise program should be implemented to increase cardiorespiratory fitness. An effective exercise program should include an aerobic component, such as walking or biking, at least three to five days per week for 30-60 minutes. A structured exercise program should also be complemented by increased lifestyle activities (e.g., walking breaks at work, gardening, household chores). Additionally, a resistance training program to increase muscular strength should be performed two to three times per week and focus on the major muscle groups of the arms, legs and trunk.
There are several risk factors for CVD, many of which can be improved through simple lifestyle modifications. High blood pressure, cholesterol levels, obesity, diabetes, and lack of physical activity can all be positively affected by a regular exercise program. Furthermore, a balanced diet rich in fruits, vegetables, lean protein (i.e. chicken, fish), and fiber (the whiter the bread, the sooner you’re dead!) will reduce your CVD risk. Quitting smoking will also drastically improve your cardiovascular health. And finally, regular visits with your physician to discuss your CVD risk factors can help identify problems at an early stage. Being aware of your risk factors and effectively treating them can be the first step toward staying heart healthy!
View the full summer 2008 issue of the ACSM Fit Society® Page online.