The road to reducing a man's risk of heart attack is straightforward. If only he would ask for directions.
An influential population-based study of Swedish men found that adhering to five basic rules can prevent four of every five heart attacks. The rules include drinking alcohol in moderation, if at all, refraining from smoking, following a healthy diet, exercising regularly, and maintaining a healthy weight.
Yet, the researchers also found that only 1 percent of men in the study met those goals.
“It is not surprising that healthy lifestyle choices would lead to a reduction in heart attacks. What is surprising is how drastically the risk dropped due to these factors,” says Agneta Åkesson, lead author of the study.
“While mortality from heart disease has declined in recent decades, with much of the reduction attributed to medical therapies, prevention through a healthy lifestyle avoids potential side effects of medication.”
The authors wrote that the reduction in risk can be broken down to its parts as well. “This reduction in risk corresponded to 18 percent for the healthy diet, 11 percent for moderate alcohol consumption, 36 percent for no smoking, 3 percent for being physically active, and 12 percent for having a (smaller waist),” they said.
Alan Taylor, MD, a cardiologist at Methodist Mansfield Medical Center in Texas, agrees with the research, adding that he recommends walking at least 30 minutes a day, in adherence with American Heart Association advice.
Taylor notes there also has been research at Harvard University and other universities across the U.S. showing that yoga lowers blood pressure, cholesterol, heart rate, and cardiovascular risk factors as well.
“It is the relaxation and behavior modifications that benefit individuals,” he says. In other words, don’t get stressed out all the time, and if you find yourself under pressure from work or another situation, blow off some steam.
Other factors that can help prevent a heart attack in men and women alike include knowing family medical history, inherited genetic factors, and having screenings as part of your annual check up for early detection of heart disease.
There is no substitute for routine physical exams. “Screening for heart disease includes routine blood pressure checks,” Taylor says. “Similar to heart disease, blood pressure can also go unnoticed and untreated for years until it’s discovered during an exam or when it causes another problem with your health.”
In the Swedish study, researchers followed more than 20,000 healthy men for 11 years. Their lifestyle choices were assessed through questionnaires. Even in men with higher cardiovascular risk, such as those with hypertension and high cholesterol levels, a reduction in risk was observed with increased healthy behavior.
An editorial that accompanied publication of the study by Dariush Mozaffarian, MD, of Tufts University, said that “substantially lower (heart attack) risk was seen with adherence to very basic lifestyle behaviors. For example, eating a diet richer in minimally processed, healthful foods –such as fruits, vegetables, legumes, nuts, reduced-fat dairy, whole grains, and fish – was associated with a nearly 20 percent lower risk.”
“These healthful diets were neither extreme nor exceptional, but consistent with dietary guidelines. Of note, the observed benefits were related to higher intakes of more healthful foods, not lower intakes of unhealthy foods.” He’s saying you can’t cheat; just giving up your crunchy junk foods and fried chicken isn’t enough.
Moffzarian also wrote the study results should spur you to use doctor visits more effectively. Talk with your doctor about your dietary habits, physical activity, and other risk factors, rather than just leaving the visit with the results of tests for blood pressure, cholesterol, and glucose levels.
An ongoing dialogue with your doctor is important. It can help you learn how to minimize your risk of heart attack, give you motivation – and keep you honest with yourself. It can also prompt your doctor, conversely, to ask you questions about what you eat and how much you move.
March 03, 2015
Christopher Nystuen, MD, MBA