• Mayo Clinic Q and A: Top tips for reducing heart attack and stroke risk

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DEAR MAYO CLINIC: My sister just turned 50. She went in for a standard cardiac checkup and learned she has high blood pressure and high cholesterol. The doctor told her that since our mom also had these issues, she must drastically change her diet, increase her exercise, and take medications to lessen her risk for a heart attack or stroke. I'm only 34 and have never had an issue, but I'm wondering if there are things I should be doing now to stay more heart-healthy.

ANSWER: Heart disease remains the No. 1 cause of death in the U.S., with over 655,000 people dying annually, according to the American Heart Association. And heart disease kills more women annually than breast cancer.

Since genetics play a role in the risk for heart disease, being aware of your health history is important. But just because your mom and sister are dealing with issues doesn't mean you will automatically have cardiac problems. You can be proud of yourself for being proactive to reduce your risk long term.

Given your family history, I recommend that you reach out to your health care provider and share an update about your mom and sister. Your health care provider may suggest that you have regular follow-up visits based on your family history.

In the meantime, I always share with my patients my top five recommendations for how to keep their heart — and bodies — in shape:

Know your numbers

Aiming to maintain a healthy weight is important, but it also is important to be aware of other numbers, especially your blood pressure and cholesterol.

The biggest challenge is that there are generally no symptoms associated with high blood pressure, also known as hypertension, which is why it's often called the silent killer. Having high blood pressure long term can cause many serious health problems, such as heart disease and stroke, so it's vital to keep blood pressure numbers down.

High blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.

Ideally, a normal blood pressure is below 120/80 mmHg. You are said to have prehypertension if your top number ranges from 120 to 139 mmHg or your lower number ranges from 80 to 89 mmHg. Prehypertension tends to worsen over time. And anything over 140/90 mmHg is considered hypertensive.

You should check your blood pressure two to three times a week because you don't know if it's high or if it's at goal unless you check it.

Talk with your health care provider about also getting a baseline cholesterol check, especially given your family history. Cholesterol is a waxy substance that's found in the fats in your blood. When you have too much cholesterol, you can develop fatty deposits, or lipids, in your blood vessels that can make it difficult for blood to flow through your arteries. An estimated 29 million adults in the U.S. have high cholesterol.

Feed your heart

Research shows consuming food high in sugar, salt and saturated fat can increase the risk for heart disease. But it's often difficult to change your eating habits. I encourage my patients to embrace a Mediterranean diet.

That means you should:

  • Eat at least five servings of fruits and vegetables per day. Besides being low in calories and rich in dietary fiber, fruits and vegetables are full of important vitamins and minerals.
  • Use olive oil when you cook or in salads instead of mayonnaise or other rich condiments.
  • Eat at least one serving of fish per week.

Mayoclinic.org and the American Heart Association website feature many recipes.

Cut the salt and the sugar

As good as it tastes, too much sodium can cause high blood pressure. Avoid processed foods, and stock up on a variety of herbs and spices to use in your cooking.

A diet that is low sugar is important, too. Monitoring your blood sugar levels is especially important if you have diabetes.

Move more

It's important to keep your heart healthy by getting active. American Heart Association guidelines recommend 150 minutes a week of moderate-intensity aerobic activity or 75 minutes per week of vigorous activity. Ideally, the goal would be five times a week, but it's important to find something — anything — you love to do that gets you moving, even if it's in small increments. For instance, parking farther away from the grocery store entrance or taking the stairs at work instead of the elevator can count toward your fitness goals.

Lighten your load

Stress can be a trigger for many people, which can increase your blood pressure and lead to other unhealthy habits, such as smoking, difficulty sleeping and overeating. I recommend making mindfulness a part of your daily routine, as well as activities to help reduce stress and anxiety. Consider massageyoga or meditation. Make a cup of tea and curl up with a good book. You can get your exercise in by going for a walk. Whatever you choose, your heart will benefit.

Although you may be concerned about your heart health, realize that making lifestyle adjustments takes time. Focus on one thing you can do today and then add in another change the next week. Taking small steps over time will add up, and can help you improve and maintain good heart health into the future. — Dr. Amy Pollak, Cardiovascular Disease, Mayo Clinic, Jacksonville, Florida


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