Changing the Things We Can


While we can’t control everything about our health, there’s plenty that each of us can do to prevent heart disease and stroke. And Million Hearts — a national initiative to prevent 1 million heart attacks and strokes by 2017 — is on a mission to educate people about those things that are within our power to control.

Their mission is needed: about 1.5 million heart attacks and strokes occur every year in the United States, according to Million Hearts, which is co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services. And one out of every six health care dollars is spent on cardiovascular disease, according to CDC data.

The good news is that with a combination of good habits and good health care, we can all reduce our heart attack risk no matter what our genes say. “This is something that we can absolutely do if we work together,” says Janet Wright, M.D., Million Hearts executive director. Read these ABC’S to help you control your risk factors.

A is for Aspirin (when appropriate)

The American Heart Association and other organizations recommend that heart attack survivors and people at high risk for heart attack take a low-dose aspirin. Aspirin thins the blood and prevents the blood clots that contribute to heart attack and stroke.

Aspirin may reduce the odds of heart attack or stroke for those who smoke or suffer from coronary artery disease, diabetes, high blood pressure or high cholesterol. However, those who haven’t had a heart attack should only take aspirin if a health care professional says it’s safe.

B is for Blood Pressure

When your heart has to work overtime because of high blood pressure, you’re more likely to suffer a heart attack or stroke. The higher those numbers go, the higher the risk. To control blood pressure, first, monitor it regularly. And don’t just rely on a routine doctor visit, Dr. Wright says. Check your blood pressure at home, at your local pharmacy, or some other non-medical venue. A medical setting, despite good equipment and intentions, may not give the most accurate reading.

“Most of us get a little bit stressed when we go into the doctor’s office, even for something routine,” says Dr. Wright. “Blood pressure is a dynamic and sensitive indicator, so a little bit of stress can falsely elevate the numbers.” By monitoring blood pressure in a “no-pressure” environment, people get a comprehensive view of their blood pressure, which they can then pass on to the doctor.

To bring those numbers down, adopt a healthy lifestyle and talk with your doctor about medication. Of the one in three U.S. adults with high blood pressure, only about half have it under control. Lifestyle changes can go a long way toward upping that percentage.

C is for Cholesterol

With cholesterol, one can definitely have too much of a good thing. Our bodies need some amount of cholesterol to make hormones and digest fatty foods. But too much cholesterol can build up in artery walls and cause heart disease.

The lifestyle changes to control blood pressure — such as a healthy diet andexercising — can also help reduce LDL cholesterol and triglyceride levels, and raise “good” (HDL) cholesterol. Studies have shown that healthful dietary changes can cut cholesterol by 20 to 30 percent.

When diet and exercise aren’t enough, doctors often recommend medication. Cholesterol-lowering drugs include statins, niacin, bile-acid resins, fibric acid derivatives and cholesterol-absorption inhibitors. Some drugs provide a combination of treatments.

Statins can quickly reduce LDL cholesterol by 50 percent or more and raise HDL cholesterol by as much as 15 percent. This is great news when it comes to reducing heart attack risk. Despite the benefits, of the 71 million people eligible for statins, only a little over half take them. Many people fear or can’t tolerate the side effects. Others don’t want to take a pill every day or can’t afford to.

Dr. Wright advises individuals to consider medication if their doctor recommends it. (Ask for a generic version, which will cut down the cost.) “[Statins] are extremely effective with few side effects,” says Dr. Wright. “Use of these drugs is associated with fewer heart attacks and strokes.”

S Means Stop Smoking

It’s easy to advise someone to quit smoking. It’s not so easy to do it. But quitting tobacco for good has so many benefits. The American Cancer Society reports that within a year after quitting, heart rate and blood pressure drop; the carbon monoxide level in the blood returns to normal; circulation and lung function improve; coughing and shortness of breath decrease; and, most importantly, the excess risk of coronary heart disease drops to half that of a continuing smoker.

A 2004 Surgeon General’s report showed that smoking impacts nearly every organ in the body. Smoking contributes to a host of diseases, from stroke and dental problems to reproductive health, chronic obstructive pulmonary disease (COPD) and heart disease. helps smokers build a “quit plan” that includes the following:

  • Set a quit date.
  • Consider why you want to quit.
  • Understand your smoking triggers.
  • Understand what causes cravings.
  • Ditch the reminders, such as ashtrays, and clean your car and clothes.
  • Tell friends and family so they can support you.

Although a number of resources exist to help smokers quit, and the number of smokers has dropped since the Surgeon General released the first report that warned of the health hazards of smoking 50 years ago, health care providers can do more.

“We’re seeing progress, but we’d like to see more health care providers go beyond asking about smoking status to actually helping their patients quit,” Dr. Wright says. “Million Hearts is directing its efforts in this ‘assist’ step by providing a standardized protocol that helps smokers get the counseling and medication that can help them quit.”

Dr. Wright says meeting the Million Hearts goal will be a collaborative effort among patients, health care providers and non-profits. And she’s hopeful about realizing the vision of cutting the number of heart attacks and strokes by a million: “We can knock heart disease off as the nation’s number one killer.”

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