Three Heart-Healthy Makeovers

Can you really improve your heart health and reduce your risk for cardiac disease?

From the WebMD Archives

Young or old, slim or overweight, male or female: Heart disease does not discriminate. We're all at risk for heart disease, still one of the top health conditions in the United States.

Over time, symptoms leading to heart disease -- such as plaque buildup in arteries, high blood pressure, and high cholesterol -- can cause havoc in your body without your knowledge. But eventually, something has to give -- either a heart attack gets your attention, or you realize the significant role your cardiovascular system plays in your well-being. That's when you turn your lifestyle around by tossing out your cigarettes, exercising, and eating healthy, just for starters.

And if you think heart disease can't happen to you, think again. These three different people from three walks of life all had their health challenged by heart disease. But now they are living well to tell the tale.

A Young Father Is Surprised by Heart Disease

A software engineer from Johnstown, N.Y., Mike Haverly is 30 years old, a husband, and a dad to a 4-year-old son and a 2-year-old daughter, with another baby on the way. At 6 feet 1 inch, he's always been a big guy, even in high school when he peaked at 265 pounds -- a hefty weight he maintained for almost 10 years.

With a diet that wasn't exactly the picture of nutrition and a relatively sedentary lifestyle -- topped off by half a pack of cigarettes a day -- Mike never gave his health a second thought, believing youth was on his side. Or was it?

"About a year ago, my wife and I decided it was time for life insurance policies," says Haverly. "When they came to do the physicals, we were totally surprised -- my blood pressure was through the roof."

Mike's blood pressure measured in at 160/130. Considering that a normal reading is less than 120/80, and high is considered 140/90, his chart-topping numbers made Mike and his wife start to worry -- and for good reason. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure, or kidney failure, according to the American Heart Association.

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Heart disease in young people not unusual

"Heart disease in young people is not unheard of at all," says Tracy L. Stevens, MD, a cardiologist at St. Luke's Mid America Heart Institute in Kansas City, Mo. "It's things like a sedentary lifestyle, obesity, alcohol, and cigarette smoking that start to put them at risk at a younger age."

High blood pressure is a symptomless condition, meaning you only know you have it if you get tested. Until then, your body is running in overdrive as the increased pressure in your arteries puts strain on your entire cardiovascular system.

"I was scared, and so was my wife," says Haverly. "I was kind of in shock, not knowing what having such high blood pressure could lead to. But the day I found out was the day everything started to change."

That very night, he went for a walk, came home, and cleaned out the refrigerator. He threw out all the deli meat. He tossed the red meat and the fried food they had stocked in the freezer. He got rid of the soda and the beer. His next stop was his doctor.

Weight loss for heart health

"The first thing he told me was that we were not going to screw around with this," says Haverly. "He gave me a serious talking-to about my diet, about exercising, about smoking, and then wrote me a prescription for high blood pressure right away."

Haverly took his doctor's intimidating advice to heart, literally. He joined a local gym, and at least three times a week he does aerobic exercise and strength training. When the weather is agreeable, he heads outside for a brisk walk.

Now, more than a year after getting the news that his heart was headed in a dangerous direction, Haverly has turned his cardiovascular system around. He's dropped 50 pounds, and through monthly checkups at his doctor's office, he knows his blood pressure is pretty consistently closer to where it should be at 130/80. And he's finally kicked the cigarette habit -- a major risk factor for heart disease -- with the help of a nicotine patch.

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"One of the things I've talked about with my doctor is my age," says Haverly. "We both think the best thing is that we've caught this at a young age, and I have a lot of time to do something about it. It's a big plus in my corner."

Heart-healthy goals

While Haverly's on the right path to heart health, there's even more he can do. Kathleen Zelman, director of nutrition for WebMD, offers these tips:

Drink moderately. Limiting alcohol to two drinks a day for men (one for women) can help increase his HDL or "good cholesterol."

Halt the salt. Haverly should watch his sodium intake to help control blood pressure. Many people think sodium comes from table salt, but most of us get it from processed foods, canned soups, lunch meat, and more.

Watch your weight. Haverly's on the right track, and he should keep up the good work -- losing as little as 5% to 10% of your body weight can reduce your risk of heart disease.

Control the portions. It's the secret to weight loss success. He should limit high-calorie foods and be liberal with vegetables that fill him up but won't fill him out.

A Graduate Student Takes Action Against Heart Disease

Vernita Morgan, 40, is an aspiring PhD candidate at the University of Iowa, studying for a degree in education measurement and statistics. When she "grows up," she wants to help people better understand the issues around obesity, which can raise LDL, the "bad" cholesterol, and triglyceride levels, lower HDL "good" cholesterol numbers, increase a person's blood pressure levels, and in some cases lead to diabetes. In people who are obese, heart disease is a major threat.

For Morgan, heart disease is something that hits close to home: Three of her four grandparents died of either heart attacks or strokes, and her father has struggled with high blood pressure throughout his lifetime.

Only a few years ago, Morgan herself had a brush with heart disease and struggled with her weight. She knew she had to turn her own health around if she was going to live long enough to help others improve their health.

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"I was going through a pretty tough semester in the fall of 2006," says Morgan. "I had three statistics classes, and at the same time I was coordinating a community health and wellness fair. So between these two major projects, it was a bit much, and over the course of several months I really let my health hit rock bottom."

Risk factors of heart disease

And she paid the price. About a week later, she had a doctor's appointment, where she learned her cholesterol was high, her blood pressure was above normal, and her weight was reaching upwards of 250. At 5 feet 4 inches, she knew she was in trouble.

"I thought to myself, 'Here I am planning a health fair, and I can't even keep my own house in order,'" says Morgan.

Morgan's plan was to start over, and set fair and attainable heart-health goals she could reach. She made it her mission to master every piece of cardio equipment at the fitness center -- the elliptical, the treadmill, the bike, and the dreaded stair climber. After a few months, she could spend an hour on any machine at the gym and feel good about it.

Heart-healthy eating

As a PhD student, she knows the value of education, so she learned more about nutrition and which foods, such as whole grains, fruits, vegetables, and legumes, would help her cause. She drank 80 ounces of water every day, and used 6:30 p.m. as her personal cutoff for eating or snacking to avoid going to bed with a full stomach and to keep her daily calorie intake under control. Since 2006, Morgan has lost almost 50 pounds and continues to work at her weight. For the sake of her heart health, she's working on getting her body mass index (BMI) under 25 and her waist circumference under 35 inches -- both good measurements for women at risk for heart disease.

Indeed, a healthy meal plan is key to Morgan's success. For heart-healthy eating, Zelman recommends brushing your teeth right after dinner to control nighttime munching and eating a vegetarian meal several times a week (for low-cal, nutrient-dense, antioxidant-rich boosts).

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Women and heart disease

"We have to remember that women are not immune to heart disease by any stretch of the imagination," says Jennifer H. Mieres, MD, a cardiologist at New York University. "In fact, today more women than men are dying from cardiovascular disease in the United States."

But Morgan is working hard to avoid becoming a statistic. "Vernita is a true success story," says Mieres, who was part of Morgan's treatment team. "She used small steps to get big gains. Losing weight, reducing her cholesterol, making lifestyle changes -- these factors are critical to Vernita's avoiding following in the path of her relatives who have had heart disease and stroke."

A Cardiac Nurse Nurtures Her Own Heart Health

Carolyn Welsh knows heart disease. In fact, she lives heart disease day in and day out as a cardiac nurse supervisor at St. Vincent Heart Center of Indiana in Indianapolis. Treating thousands of people who have been affected by heart disease over four decades, it never occurred to her that she herself was at risk.

"This all happened when I was 55," says Welsh, now 63. "I was right on target with my blood pressure and cholesterol, and my weight was 163 pounds, but I'm 5 feet 6 inches, and I felt comfortable there."

Estrogen and heart disease

Welsh had three things working against her, though: her age, stress, and a hysterectomy (which often includes removal of estrogen-producing ovaries) she'd had almost 12 years prior, meaning the protective effects of natural estrogen were long gone. Estrogen, which binds to receptors in the blood vessels of the heart and as a result helps them stay elastic, may play a part in keeping the cardiovascular system healthy. Its binding action also releases nitric oxide, which helps maintain smooth muscle relaxation in blood vessels, promotes cell growth and repair, and prevents clot formation.

"After about 10 years, the loss of estrogen can accelerate the process of cardiovascular disease and put a woman at higher risk," says cardiologist Stevens.

Having gone through the hysterectomy more than 10 years ago, Welsh was at the tipping point. What pushed her over the edge was some tragic news: While working one evening at the hospital, she learned that her son's unborn child had died during the eighth month of pregnancy, and she was totally distraught.

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"Two hours later, I had the most profound and excruciating chest pain," says Welsh. "Immediately they hooked me up to an EKG, which showed signs of a heart attack. Twenty minutes later I was in the heart catheter lab, where they found an artery that had dissected from my heart." Her physicians eventually determined that built-up plaque in her artery caused the heart attack, which may have been brought on by stress.

Stress and heart disease

"Stress can play a detrimental role in heart health," says Stevens. "It causes adrenaline to be released from the adrenal glands, which can create an unstable state in your body and is a significant factor in causing plaque to become unstable and crack, which could cause a heart attack."

Welsh has recovered from her heart attack, but she is fully aware of her risk. With long-term heart health in mind, she has a three-pronged approach to taking care of herself: After the heart attack, she spent several weeks in cardio rehab and then joined a gym, focusing on strength training. Her diet is loaded with fruits and veggies and lots of water. And, to lower her stress levels, she walks, reads, and goes to church.

"I've been a cardiac nurse for 42 years, and there's not much I haven't seen," says Welsh. "After having gone through it myself, I bring a little something extra to the patients and their families who are facing a similar situation, and I try to encourage them to understand the impact of heart disease and its consequences."

Of course, Welsh needs to recognize that her heart risk never goes away -- in fact, as she ages, it only increases. Michael W. Smith, MD, WebMD's chief medical editor, and Zelman together offer suggestions for avoiding a second run-in with heart disease:

Be whole. Welsh should take a holistic approach to her heart health and not focus on just one aspect. So that means healthy diet, regular exercise, and lowered stress.

Think 3s. Eating fish at least twice weekly can help her get an adequate supply of heart-healthy omega-3 fatty acids.

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Bye-bye fried. Welsh should kiss fried foods goodbye except for occasional treats.

Stress out. With a job that isn't exactly laid back, minimizing stress is an important piece of the puzzle. She should take more time on the things that help her relax, like reading and seeing friends and family.

WebMD Magazine - Feature Reviewed by Michael W. Smith, MD on August 08, 2008

Sources

SOURCES:

Mike Haverly, Johnstown, N.Y.

Jennifer H. Mieres, MD, cardiologist, New York University.

Vernita Morgan, Iowa City, Iowa.

Carolyn Welsh, Fishers, Ind.

Tracy L. Stevens, MD, cardiologist, St. Luke's Mid America Heart Institute, Kansas City, Mo.

Kathleen Zelman, RD, director of nutrition, WebMD.

Michael W. Smith, MD, chief medical editor, WebMD.

© 2008 WebMD, LLC. All rights reserved.

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