Give Your Heart Some Love
February is American Heart Month and it’s time to give your heart some love. The American College of Cardiology and the American Heart Association have introduced new guidelines on reducing the risk of heart disease and stroke. Heart disease and stroke are among the top killers in the world and amount to billions of dollars in health care costs each year. These new recommendations highlight the importance of shifting the focus to prevention and lifelong health.
THE NEW GUIDELINES AND
WHAT YOU NEED TO KNOW
1) The new guidelines are focused on reducing risk of a future cardiovascular event in those at high risk through lifestyle changes, diet, and the administration of a statin, a cholesterol lowering medication.
2) A risk calculator has been developed based on high quality randomized trials, meta-analyses, and observational studies to assist doctors in determining an individual’s risk for a heart attack or stroke in the next 10 years.
Statin therapy is suggested for:
(1) People without cardiovascular disease ages 40-75 with a 7.5% or higher risk of having a heart attack or stroke in the next 10 years based on the CV Risk Calculator.
(2) People with a history of a prior cardiovascular event.
(3) People 21 years or older with LDL, or "bad", cholesterol of 190 mg/dL or higher.
(4) Type 1 or type 2 diabetics ages 40-75.
3) Doctors are encouraged to take a multifactorial approach to primary (preventing a future event in those at high risk) and secondary (preventing a future event in those who have had a heart attack or stroke in the past) prevention by considering not only levels of LDL cholesterol, but also age, comorbidities such as diabetes, gender, race, and lifestyle factors (i.e. smoking). The risk factor calculator should not be the sole deciding factor in prescribing a statin.
4) Those who are already taking a statin no longer have to reduce their LDL cholesterol to less than 190 mg/dL as there are little to no studies showing that this specific number will help reduce the risk of a cardiovascular event.
5) Americans must focus on the long-term effects of following a heart healthy diet low in sodium, saturated fats, and trans fats. It is acceptable to stray from a healthy diet for special events such as birthdays, but when these unhealthy food and drink choices become a habit, heart health can become compromised.
6) Sodium intake should be limited to 2400mg/day and ideally less than 1500mg/day. Avoid processed food and find sodium free seasonings. Limiting saturated fat to 5-6% of total calorie intake can help lower cholesterol. Based on an 1800-calorie diet, this is equivalent to 10-12 grams of saturated fat. Trans fats should also be avoided.
7) A weight loss of 5% can have significant health benefits in those who are obese (BMI > 30) or overweight (BMI 25-29.9) with one cardiovascular risk factor (i.e. hypertension). These benefits include improved blood pressure, blood sugar, and blood lipids. Healthy weight loss of 1lb per week can be achieved by reducing intake by 500 calories per day.
8) People should aim for at least 2 ½ hours of physical activity per week.
9) Communication with your doctor is crucial. They can work closely with you to determine if you would benefit from a statin. Also consult a registered dietitian to assist you in following a heart healthy diet tailored to your specific needs.
Lloyd Jones, a cardiologist and chair of the Department of Preventative Medicine at Northwestern University, stated that these new recommendations regarding prescribing statins could potentially lower the risk of cardiovascular disease by 30-50% in the future. Shifting our mindset to prevention is the key to improving the health of this nation. Contact your doctor for more information. Ask your insurance provider about preventative medical services that are included in your coverage. Many insurance companies are increasing coverage and even providing incentives for participation in weight loss programs, including counseling and even gym memberships.
Access the TOOLS section for printables to help you get started on a heart healthy diet. Click here to access the CV Risk Calculator. This calculator is available as a mobile app and a downloadable spreadsheet.
References
(1) American Heart Association and the American College of Cardiology. Understanding the New Prevention Guidelines. American Heart Association website. Updated November 17, 2014. Accessed February 15, 2015.
(2) American Heart Association and the American College of Cardiology. 2013 Prevention Guidelines Tools CV Risk Factor Calculator. Accessed February 15, 2015.
