10 Easy Steps to Prevent Coronary Heart Disease: How to Cut Your Risk

How to Cut Your Risk

Even if you follow just the first seven tips below (and don't smoke, of course), you'll reduce the chance of having a heart attack by as much as 90 percent compared to a typical person your age!

1. Walk 30 minutes a day every day, no matter what -- and then call someone. Walking a half-hour a day decreases the risk of having a heart attack by about 30 percent. I've found if you succeed at walking daily, you can also succeed at doing other things to improve health. If you skip, you'll start compromising health in other ways too. Calling someone every day is crucial; that's the real commitment. Find a person who's supportive and will not nag but will call if you haven't called her. And by the way, it usually is a "her." Men tend to be lousy at this!

2. Know your blood pressure and do whatever it takes to get it down to 115/75. Your blood pressure number may be even more important than your cholesterol. And you can lower it yourself. The best way? Getting a little exercise and losing some belly fat. Why belly fat? The omentum is what hangs over the stomach. The fat that's stored there feeds the kidney, liver and other vital organs. Here's the hypothesis: When you gain weight, you add fat inside the relatively rigid "kidney capsule." This fat pushes on the kidney, so it says, "Hey, I need more blood pressure to drive blood through because I'm getting squeezed by the fat." So it releases hormones that cause increased blood pressure. When you lose a little of that fat, even with just a few pounds of weight loss, your blood pressure goes down really fast. Cutting back on salt may help, but for some people reducing sugar and saturated fat in the diet may help even more. Recently I coached a patient (he'll be on the PBS special You on a Diet coming in March) whose blood pressure started at 160/100, but he didn't have any arterial disease. In seven weeks, he had his blood pressure down to 115/75 with just weight loss, walking and decreasing sugar and saturated fat in his diet. But if your blood pressure is over 140/90 and you're not going to do these things reliably, then you should probably go on blood-pressure medication. New drugs can reduce blood pressure without major side effects.

3. Eat an ounce of nuts a day. Nuts raise HDL good cholesterol and decrease inflammation. But they have a heart benefit independent of those too. We're not sure why. Nuts have healthy omega-3 fatty acids, healthy protein and some fiber. And this tip is easy to do! Nuts that are raw, fresh and unsalted have the most benefit. You can develop a taste for them if you give them a chance. But if you want to roast, say, (shelled) walnuts, put them in the oven at 350 degrees for about 9 minutes. If you do it yourself, it won't cause any bad fats or dangerous chemical acrylamides to form.

4. Learn your HDL number and do what you can to raise it to 50. For women, some believe a high HDL is more important than a lower LDL. We have no idea why, but study after study shows that the higher the number, the better (50 is fine). Easy ways you can increase it: exercise; have one drink a day; eat healthy fats, such as olive and canola oil and nuts. Talk to your doctor about niacin, which raises HDL but can have side effects. Ask, too, about pantothenic acid, or vitamin B5, which may also help. While the main function of statin drugs is to lower LDL, some also raise HDL.

5. Eat 10 tablespoons of tomato sauce a week. This is one of my favorite tips. Tomato sauce is loaded with blood-pressure-slashing potassium. We're not talking about salty, fatty sauces, or serving with a huge portion of pasta. Keep it simple and healthy, and get a great benefit.

More Smart Heart Tips

6. Floss your teeth regularly. Avoiding periodontal disease prevents inflammation in the arteries, which helps you head off heart disease. Most people don't know that your oral health affects all your arterial health, and that includes blood flow to the heart and sexual organs, and maybe even wrinkles on your skin.

7. Eat no more than 20 grams of saturated fat a day and as little trans fat as possible. Saturated fat and trans fats lead to inflammation in the arteries. A cinnamon roll may have 7 grams of saturated fat. A 4-ounce slice of roast pork tenderloin has about 4 grams. Trans fats (partially hydrogenated oils), found in many processed and baked foods, are probably at least as bad as saturated fats, and maybe a little worse.

8. Read labels and throw out all food that has sugar in the first five ingredients. Don't be fooled by foods that are low in fat but high in sugar. The sugar causes inflammation. And if you eat more sugar than you need, it gets morphed into omentum fat, that dangerous fat around the belly. For a while in the 1990s, many people used "low fat" salad dressings that turned out to be loaded with calorie-laden sugar. And those dressings didn't contain any good fats like olive oil, which are beneficial. healthy fats are better than empty sugar calories. (Because the sugar in fruit is in a complex carbohydrate, it's usually fine.)

9. Have a glass of wine or beer today. We're not sure why; there may be an anti-inflammatory effect. But it's a consistent finding that teetotalers have a higher risk of heart disease than people who drink a little, and people who drink a lot have little heart disease but tend to die of cancer. Seven drinks on Friday night is not the same as one every night! We know there are serious dangers to drinking, but still, any kind of alcohol in moderation is good for arteries.

10. Eat 9 servings of colorful fruits and vegetables a day. That comes with a lot of fiber, and you shouldn't increase to that amount all at once or people won't stay in the same room with you! But you'll adjust in 2 to 6 weeks. Make sure you wash fresh produce carefully and thoroughly. There are farmers' markets all over the country now. If you try fresh locally grown veggies prepared well, you'll be amazed at how good they taste.

Watch The Hidden Epidemic: Heart Disease in America on PBS, February 14 at 9 p.m. (check local listings).