Before 2019, we didn’t hear the word “pandemic” very often. But today, it is common in everyday conversation, referring to the COVID-19 outbreak that has radically changed all our lives over the last three years. Much of the world has lived in a state of anxiety, concerned about the possibility of contracting the novel coronavirus or even dying from it. And in fact, many people have died from it…just over a million in the US alone.
Frightening as that is, there’s another disease that has killed nearly twice as many Americans in the same time span…yet receives far less attention—heart disease. February is American Heart Month—a time to put the spotlight on heart disease, the number-one cause of death for all Americans regardless of gender, race or ethnicity. In a recent Wall Street Journal essay, Thomas R. Frieden, MD, MPH, former director of the Centers for Disease Control and Prevention (CDC), said that heart disease has become “a pandemic so common it is invisible…so routinely lethal it seems normal…and so ingrained in the fabric of modern society it seems natural.” Indeed, heart attacks and strokes happen so frequently—every 40 seconds in the US—that we barely raise an eyebrow when we hear of them occurring.
The Overlooked Pandemic
COVID and heart disease have a lot in common. The COVID-19 virus attacks the lining of the arteries just as heart disease does. That’s why people with preexisting heart disease (or risk factors for heart disease, such as high blood pressure and/or cholesterol, obesity or diabetes) were more likely to die from COVID at the beginning of the pandemic—their arteries were already damaged from heart disease, and the virus caused further damage, triggering the body’s blood-clotting mechanism. Clotting is what leads to heart attacks and strokes. People with these risk factors still are more likely to die from COVID today, though vaccinations have reduced the likelihood of severe illness and the risk for death.
The COVID-19 pandemic has also changed our lifestyles in ways that hurt our hearts—unhealthy eating habits while we were isolated at home…lack of exercise…increased alcohol consumption…untold amounts of stress. Also, a fear of catching the virus caused hundreds of thousands of patients to avoid health-screening appointments and doctor visits, leaving their high blood pressure and heart disease undetected or unmanaged.
Good news: This twin pandemic can be beat. The vast majority of risk factors predisposing people to heart disease are preventable. With the right lifestyle habits, you can drastically reduce your risk of dying from a heart attack, stroke or other heart condition. Here are five ways to flatten the curve…
Strategy #1: Lower your blood pressure to below 120/80 mm Hg. One in three adults has high blood pressure, and yet 30% of them don’t even know they have it. That’s why it’s called the “silent killer.” Blood pressure is a measure of the pressure against your arteries when your heart pumps as well as between pumps when your heart is at rest. Too-high numbers mean that your heart or arteries are stiff and can’t relax, forcing your heart to work too hard.
What to do: Getting enough exercise (150 minutes of moderate-intensity a week, such as walking, water aerobics or dancing) and following a low-fat, low-salt diet such as the Mediterranean diet (lots of produce, whole grains, nuts, legumes, fish and extra-virgin olive oil) are ways to help lower blood pressure.
Strategy #2: Know your cholesterol numbers. Cholesterol levels are measured via a few numbers. There’s LDL (“bad”) cholesterol, the main source of cholesterol buildup in the blood vessels and arteries. Then there’s HDL (“good”) cholesterol, which protects you by escorting bad cholesterol out of the arteries. And then there are triglycerides, a type of fat in the blood associated with eating too many carbohydrates and sugars. Most people don’t know their numbers for any of these, but that needs to change.
What to do: Ask your doctor for a blood test, and make sure your numbers fall in line with these guidelines to help reduce your heart disease risk…
HDL: 40 mg/dL or higher (for men) or 50 mg/dL or higher (for women)
LDL: Below 100 mg/dL
Triglycerides: Below 150 mg/dL
The goal is to keep your total cholesterol (calculated as HDL level + LDL level + one-fifth of your triglyceride level) below 200 mg/dL.
If your LDL is above 130 mg/dL, you’re 2.2 times more likely to develop heart disease than someone with normal cholesterol.
If your numbers are unhealthy, commit to a plant-based diet low in saturated fat and building more physical activity into your day. HDL and triglycerides respond well to exercise and diet, respectively, but total and LDL cholesterol don’t always budge significantly with these changes—medications such as statins may be needed to bring numbers down. If you’re looking for a challenge, an HDL level above 60 mg/dL is super-protective, especially for women.
Strategy #3: Prioritize sleep. Just this year, the American Heart Association added “get healthy sleep” to its list of the most critical measures that adults can take to improve cardiovascular health and help lower their risk for heart disease, stroke and other major heart conditions. (The other measures are maintaining healthy blood pressure, blood sugars and cholesterol…not smoking…maintaining a healthy diet and weight…and getting sufficient physical activity.)
Sleep is the body’s chance to restore and recharge. When you skimp on sleep, your body cannot adequately repair the damage that naturally accumulates during daily living—that includes any wear and tear that occurred in the heart. It also makes it harder to regulate stress hormones that can, in turn, drive up blood pressure. Poor sleep also compromises nocturnal dipping, which is a natural, healthy drop in blood pressure that happens during sleep. This dip of about 10% to 20% reduces stress on the cardiovascular system.
What to do: Give yourself the best shot at sound sleep by reframing seven hours a night as a non-negotiable, just like eating, exercising and spending time with family. Set yourself up for success with a cool, dark bedroom free from electronics…power down all screens at least an hour before bed (and put your phone on “Do not Disturb” mode)…and practice some sleep-inducing meditation, deep breathing or mindfulness in the minutes before bed.
Strategy #4: Understand the link between stress and heart health. Depression, anxiety, isolation, anger—toxic emotions damage the heart by increasing blood pressure, causing irregular heart rhythms and damaging arteries. Chronic stress has been linked with a 2.1-fold increase in heart attack risk. If you tend to carry your stress in your chest and heart (i.e., stress gives you chest tightness and pain, shortness of breath and/or palpitations), you’re even more vulnerable.
What to do: There’s no way to avoid all stress, but you can take steps to keep it under control. Try limiting upsetting news by avoiding websites and newspapers that run stressful national and world news stories. Carve out some time every day, even if it’s just 20 minutes, to do something that feels good to you, perhaps talking to a friend, taking a walk in nature or reading a book. Therapy also can help you make progress in dealing with chronic stress.
Strategy #5: If you smoke, quit. We all know the dangers of smoking. It causes about one-third of all heart disease deaths. Every time you inhale, toxic smoke damages the lining of the arteries, creating little cuts and tears that eventually lead to hardened arteries that don’t function as they should. It raises blood pressure…slashes your “good” cholesterol…and increases blood clotting, which can cause a heart attack.
Quitting can be extremely tough, but the benefits are worth it. Within one year of quitting, your heart disease risk is cut in half. The risk for several other smoking-related diseases drops, too.
What to do: Get help to quit smoking. The following organizations offer strategies for creating a quit plan, dealing with cravings and triggers, finding a support system and more…
National Cancer Institute (SmokeFree.gov)
American Lung Association (Lung.org)
National Network of Tobacco Cessation Quitlines (1-800-QUIT-NOW).