Nine in every ten heart attacks can be prevented by controlling blood pressure, cholesterol and diabetes; eating high fibre-low fat food; staying fit; not smoking; and managing psycho-social factors such as stress.
And it’s never too late to protect your heart from disease. Adopting just four healthy behaviours — eating at least five fruits and vegetables daily, exercising at least 2.5 hours a week, maintaining a healthy weight, and not smoking — in middle age reduces the risk of heart disease by over one-third, reports a study in The American Journal of Medicine. The study found that these changes lowered heart attack risk by 35 per cent and death by heart attack by 40 per cent in people between 45 and 64 years.
Experts say the heart-protective benefits begin the moment a person makes healthy choices. A balanced diet means eating plenty of fresh fruits and vegetables, few fried and processed foods and little refined sugar.
“The nutritional plan for heart health is eating less of saturated fats like butter and more of olive, rice bran and mustard oils, eating five or more helpings of fruits and vegetables a day; six or more of whole grains such as wheat and brown rice, low-fat milk products; legumes and beans; and fish and lean meats,” says Dr Ashok Seth, chairmen, Escorts Heart Institute and Research Centre. One serving is a cupful of uncooked food and half a cup of cooked food.
But making diet changes alone are not enough to keep the heart healthy. People need to have high activity levels, keep weight in check and not smoke. “Smoking is the biggest cause of heart attack in young people with no other risk factors because it raises the risk of clot formation in the blood, which can block arteries and cause a heart attack even in healthy people,” adds Dr Seth. A 21-countries review in the journal Tobacco Control showed that smokers had a five times greater risk of heart attack than non-smokers.
Another major risk factor is obesity as it leads to diabetes, high blood pressure and high cholesterol, each of which individually boosts risk. Keeping the body mass index (BMI) between 22 and 23 — a little lower than the recommended cut off of 25— lowers a person’s heart risk substantially. BMI is calculated by dividing a person’s weight in kilograms by the height in metres squared (BMI = weight in kg/height in m2).
Increasingly, tests such as calcium scoring (detects calcium deposits in the inner walls of the artery, which is normally free of calcium), LDL subfraction test (separates bad cholesterol based on size, density and electrical charge) and the NT-proBNP assay (a blood test to predict heart attacks and failure) can help detect disease at an early stage.
A quick way to calculate your risk of a heart attack in the next 10 years is to go for the Framingham Risk Estimate (http://hp2010.nhlbihin.net/atpiii/calculator.asp). It is based on a summary of major risk factors for heart disease such as age, high blood pressure, cholesterol levels and smoking.