Heart disease: reduce the risk

Heart disease is rarely caused by just one thing. It most often results from an accumulation of risk factors. It is important that you know these factors and work to avoid or improve on any ones that are relevant to you.

An assessment of your risk of heart disease is best done by your doctor who can advise you on ways to reduce your risk factors.

Ways to reduce your risk of heart disease

• Keep your blood lipid levels low (cholesterol and triglycerides).
• Maintain a healthy weight.
• If you have diabetes, ensure it's controlled.
• Have your blood pressure checked regularly.
• Be physically active.
• Don’t smoke.

Keeping blood cholesterol and triglycerides low

Blood cholesterol and triglycerides are best measured as part of an overall assessment of your risk of heart disease. They can be measured by a simple blood test, which can be arranged by your doctor. Depending on your other risk factors (such as a family history of high cholesterol, or other existing conditions such as diabetes), your doctor may aim to get your total blood cholesterol level to about 4.0 mmol/L. Ask for further advice from your doctor.

To help keep cholesterol low, remember the following key points.

• Eat less fat, especially saturated animal fat.
• Achieve and maintain a healthy body weight.
• Keep active.

How do I eat less saturated fat?

• Use small amounts of margarine and monounsaturated and polyunsaturated oils (e.g. canola, olive, sunflower and safflower) instead of butter and other animal fats (such as dripping).
• Cut fat off meat.
• Remove skin from chicken.
• Grill meat instead of frying.
• Choose lower fat cheeses (such as Edam, mozzarella or cottage cheese).
• Use low-fat milk (less than 2 per cent fat).
• Avoid deep-fried, takeaway foods.
• Minimise your intake of cakes, biscuits, pastries and chocolate. Have them only occasionally.
• While most saturated fats have an animal source, some vegetable oils, such as palm oil and coconut oil (and coconut milk and cream), do contain high levels of saturated fat, and should also be avoided.

How do I maintain a healthy weight?

• Avoid foods high in fat: choose lean meats, cut the skin off chicken, choose low-fat dairy products and eat fish regularly. All fats, saturated or not, contain high levels of energy.
• Eat smaller portions.
• Reduce sugar and alcohol intake.
• Be physically active: choose activities that you enjoy and can keep up.
• If you are already overweight, you need to lose some weight. But it is important to do it slowly and properly. Avoid diets that promise rapid weight loss. Don't starve yourself or miss meals. Seek the advice of your doctor or a dietitian.

General rules of healthy eating

• Make vegetables a major part of at least one meal each day and eat fruit frequently. Recommendations are for 5 serves of vegetables and 2 serves of fruit daily.
• Choose wholegrain breads instead of white varieties more often.
• Eat more cereals (rice, pasta and other grains) and legumes (dried peas and beans).
• Use only small amounts of very lean meats and poultry without skin.
• Choose low-fat dairy products (milk, yoghurt and cheese).
• Try to eat fish at least twice a week (tinned or fresh), but make sure it isn't fried.
• Avoid high fat and/or high sugar bakery products, fast foods, desserts, soft drinks and confectionery.
• Use small amounts of margarine or olive oil instead of butter.
• Use monounsaturated or polyunsaturated oils for cooking (e.g. olive, canola, sunflower and safflower).
• Grill, boil, steam, bake or microwave rather than fry.
• Reduce your salt intake.
• Look for the Heart Foundation Tick for healthy food choices.
• Drink plenty of water.

Why is it important to control diabetes?

People with diabetes have a greater chance of developing heart disease than those who don't have diabetes. Diabetes can affect the vessels that supply blood to the heart. Working with your doctor to develop a plan to control your diabetes is the first step in safeguarding your heart.

Many of the lifestyle changes suggested for keeping your heart healthy, such as a good diet and regular exercise, are also important in controlling diabetes. Sometimes medication is needed. Ask your doctor.

Why should I be physically active?

Active people have fewer heart attacks and have a better chance of recovery than inactive people. They also:

• feel good, are less tired, more relaxed and are better able to cope with stress;
• can do more with less effort;
• have better heart function and possibly lower blood pressure; and
• can control their weight and lower their blood cholesterol levels.

Aim to accumulate 30 minutes of physical activity most days of the week. You don't have to join a gym or pound the pavements all day long. Regular brisk walking for half an hour can do the job just as well. Find a variety of activities you enjoy. Look for opportunities to put activity in your day, such as taking the stairs instead of the lift or parking your car a little further away. Every bit helps. Two or 3 sessions that add up to half an hour are OK if you can't do it all at once.

Why is blood pressure important?

High blood pressure can enlarge and weaken the heart. It also damages the blood vessels. If they become narrow or blocked, it may result in a heart attack or stroke. Have your blood pressure checked regularly.

Your doctor can tell you how often is advisable: your blood pressure needs to be checked more often if you are older, taking any medication (including the contraceptive pill), if you are overweight, or if you have diabetes or a family history of heart disease.

How does smoking affect my heart?

If you smoke, your chances of a heart attack are 2 or 3 times more than a non-smoker, and you have a higher risk of stroke and many other diseases. Lifetime smokers have a one in 2 chance of dying from smoking and shorten their lives by an average of 14 years. Smoking also adversely affects the health of others around you.

Is it worth stopping smoking?

YES. Always. Whatever your age, whatever your health. If you stop smoking, the risks mentioned above soon become much less.

How do I stop?

• Set a quit day and go for it.
• Ring the Quitline for free advice and support (131 848).
• Do something different at times when you usually smoke.
• Get your friends to support you.
• Avoid smokers and places where a lot of people smoke.
• Be more physically active.
• Try chewing gum or nibbling on raw fruits or vegetables.
• Promise yourself a treat with the money you save.
• Don’t be put off by one failure: try again and again if necessary.
• Talk to your doctor or pharmacist about nicotine replacement or other prescription medicines to help with cravings.
• Enrol for a stop smoking programme: talk to your doctor.

Should we be stressed about stress?

The exact relationship between stress and heart disease is unclear. However, for our general health and well-being, it is advisable to understand what things stress us unduly, and to find ways of dealing with them.

Here are some helpful ways of reducing stress.

• Identify the cause.
• Be more physically active.
• Relax physically and mentally.
• Maintain healthy eating habits.
• Establish regular sleep patterns.

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