Today is the last day of Heart Health Month, but there is no less need for greater awareness. Heart disease is the number one cause of death for men and women in the country. Yet according to a recent Heart Health Survey by Cleveland Clinic, 74 percent of Americans do not believe that they will die of heart disease. The survey also found that 32 percent are not doing anything to prevent heart disease, despite 77 percent knowing the key factors to do so.

HOW TO RECOGNIZE HEART DISEASE

Common signs of heart disease include chest pain, tightness with exercise that goes away with rest and shortness of breath that develops when you exercise.

In a recent interview with Richard Krasuski, MD, staff cardiologist in Clinical Cardiology at the Sydell and Arnold Miller Family Heart & Vascular Institute at Cleveland Clinic, he added, “Fatigue is an important one, and certainly anyone who gets more tired with exertion, when they didn’t recognize that before, can be a sign of heart disease, particularly coronary artery disease, or blockage in the arteries.”

MARS AND VENUS WITH HEART DISEASE?

While in the past, most of the textbooks and many of the early studies on heart disease focused on men, attention has turned to women as well in the past decade. “There was a very interesting study that was published within the last year that actually tried to break down presenting symptoms for women with heart disease and try to compare that to men,” said Krasuski. “Interestingly, they didn’t find that many differences.”

A lot of women presented with very similar symptoms to men when they had a heart attack or heart-related event. The cardiologist suggesting that both men and women (and their physicians) should have their radar up when they present with shortness of breath, fatigue and exercise intolerance “because in fact we know now that women are at just as much risk for heart disease, possibly even more in certain age populations.”

Genetics plays a huge role in heart risk. In Cleveland Clinic’s Heart Health Survey, 60 percent of the population thought there was a gene that could determine their heart risk. Unfortunately, there is not. However having a first-degree relative, like a parent or sibling, with premature heart disease puts someone at substantial risk. “It’s probably 60 to 70 percent increased risk,” said Krasuski.

HOW TO PREVENT HEART DISEASE

Krasuski offered his Top Three Lifestyle Changes people can make to prevent heart disease:

1.  Watch your diet
2. Quit smoking
3. Find time in your week to exercise and increase your activity

“If you can do these three things you’re really helping yourself to reduce the risk of heart disease,” he said.

WATCH YOUR DIET

“Diet, what we put into our bodies, is critically important,” said Krasuski. He recommends limiting the amount of calories and saturated fat, eating a lot of fruits and vegetables and as many healthy foods as possible. He suggests staying away from the quick and easy meals that are frequently loaded with fat and salt.

“We find that you can go to a restaurant and you pick out what you think is a ‘heart healthy’ meal,” he said, “and then you recognize that, in fact, what you’re consuming is actually loaded with salt.”

Sugar is becoming more of a problem as well. The obesity epidemic weighs heavily on heart disease. As the percentage of obese people increases, the number of people with diabetes increases. “With diabetes, so increases heart risk,” said Krasuski. “So this is unfortunately one of those cycles that as people get bigger, they develop more complications, we’re going to see another epidemic of heart disease probably in a couple of decades.”

The cardiologist believes sugared beverages, like soda and energy drinks, are likely largely to blame for the increasing obese population, particularly in the case of our youth.  “The scary part is there are actually teenaged kids and kids in grade school that are developing diabetes,” he said. “That is, to me, the most frightening.”

Schools and other places where children spend time can take preventative action by replacing soda machines with water or other healthier food options. Krasuski says studies shown that doing so can reduce the incident of diabetes.

A decade or more ago, doctors were excited about vitamin E and fish oil as supplements that might have a beneficial effect on heart disease. “Studies were done with tens of thousands of patients that actually showed [vitamin E] was not beneficial and in large amounts when it was supplemented, it actually increased the risk of things such as heart failure,” said Krasuski. Fish oil in low doses ha very negligible effects on the heart. “Unfortunately at this moment in time, despite the wish to have a supplement that could make a huge difference, healthy lifestyle really is the way to go.”

FOOD THAT CAN HELP HEART HEALTH

Registered dietitians and personal trainers Tammy Lakatos Shames and Lyssie Lakatos, otherwise known as The Nutrition Twins, also contributed their own tips on foods that can help with heart health. The Twins say eating the right vegetables can help improve heart health by lowering high cholesterol and high blood pressure, as well as the inflammation of the arteries. They recommend a healthy diet with at least 5 servings of veggies per day that include potassium, antioxidants, B vitamins, fiber and garlic.

• “Potassium counterbalances sodium,” say The Twins. Good sources of potassium include beet greens, Swiss Chard, lima beans, yams, spinach and, according to Tammy and Lyssie, crimini mushrooms as well.

• The Nutrition Twins say, “Antioxidants protect the heart and keep implementation at bay.” I especially recommend artichoke, broccoli, spinach and tomato. (For fruit, look for your most brightly colored ones, like wild blueberries, cranberries, blackberries and raspberries)

• According to The Twins, B Vitamins  help lower homocysteine, an amino acid in the blood that may promote fatty deposits in blood cells. Leafy greens are high in vitamin B, as well as asparagus, green peas and sweet potatoes. (I also have to give a big shout-out to the eggs and organs (especially liver) from organic, grass-fed, pasture-raised animals, as well as wild tuna and salmon from the right sources.)

• Fiber helps to lower cholesterol levels.  Broccoli, brussels sprouts, celery, carrots, cucumbers, beans, artichokes, parsnips, sweet potatoes and turnips are all great sources, according to The Nutrition Twins.

And of course, Garlic, which lowers triglycerides and total cholesterol by  5 to 15 percent, according to The Twins. “But garlic’s biggest asset is its unique set of sulfur-containing compounds that protect blood cells and vessels from inflammatory and oxidative stress,” they say.

INCREASE YOUR ACTIVITY LEVEL

While people recognize that exercise is good for their hearts, Krasuski said there are other things in their life they can do to increase their activity levels, thus reducing their heart risk. “Going up and down stairs instead of taking the elevator or walking a distance in a garage rather than circling around half a dozen times trying to look for that parking spot right next to where they’re going. Those are ways that you can increase your activity to help,” he said.

QUIT SMOKING

The Women’s Health Study, which took place over more than a decade, emphasized that three or more cigarettes a day greatly increased the risk of heart disease. “Smoking is one of those things that there’s no healthy amount of,” said Krasuski.

The positive news is that quitting smoking can make a big difference within a short period of time. “As far as the heart goes, it’s a very forgiving organ when it comes to quitting smoking,” he said.

**REDUCE STRESS & GET SOCIAL**

Reducing stress is also critical to managing heart disease. Exercise is one way to do so, while other people benefit from meditation. “Contemplative thought for a period of time, shutting the outside world out for a while—I think that’s probably where meditation plays a real benefit,” said Krasuski.

Social connection is also important. People with a strong support team, made up of people with whom they can share how they think and feel, do better physically than folks who don’t have those connections. “And actually there’s been some suggestion that pet owners do better than non-pet owners,” the physician said. “I think this is a complex issue and I think having someone to share information with or your life with can actually reduce your stress and potentially have a beneficial effect.”

While there are treatments like bypass surgery, angioplasty and stents, Krasuski likens them to caulking a leaking roof. They relieve symptoms, but do not solve the problem. In the end, the treatment with the greatest benefit is lifestyle change. “It’s the lifestyle modifications controlling the risk factors that really alter the disease,” he said.