What You Can Do to Lower the Chances of Heart Attack and Stroke

The diseases that involve the heart, blood vessels or both, are known as Cardiovascular diseases (CVD). Both heart attack and stroke come under the category of cardiovascular diseases, and are one of the leading causes of death for both women and men in the USA and globally.

According to the American Heart Association, almost 92 million US adults have at least 1 type of CVD. And when the stroke is considered separately from other CVDs, it ranks No. 5 among all causes of death, right behind the heart diseases, cancer, chronic lower respiratory disease and unintentional injuries/ accidents.^[1]

Causes of Heart Attack & Stroke

Heart attack and stroke both, are the result of some kind of interruption in the normal blood flow to the heart or the brain.

An interruption in normal blood flow causes a lack of oxygen and nutrient-rich blood, due to which heart or brain cells are not able to function normally, which at times leads to heart attack or stroke.

While a heart attack occurs due to a blockage in blood flow to a part of the heart; a stroke occurs when the blood supply to a part of the brain is interrupted.

Signs and Symptoms of Heart Attack & Stroke

The signs and symptoms of a heart attack include fatigue, unexplained dizziness, chest discomfort, shortness of breath, nausea, altered mental status and/or change in cognition, lightheadedness or breaking out in a cold sweat.

On the other hand, signs and symptoms of a stroke are sudden weakness or numbness on one side of the body, face drooping, difficulty talking and sudden headache.

Risk Factors Associated with Heart Attack & Stroke

Some of the risk factors for heart attacks and strokes are high blood pressure, diabetes, high cholesterol, age, smoking, excessive drinking and prior history of strokes or heart attacks.^[1][2]

Physical inactivity is also one of the risk factors for heart attacks. Additional risk factors for strokes are genetics and use of birth control pills. While men are at a greater risk of having a heart attack, women are more likely to suffer a stroke.^[1]

According to the cardiologist, Dr. Waqar Khan, MD, MPH (author of the book, Be Heart Smart: Understand, Treat, and Prevent Coronary Heart Disease) “there are multiple risk factors which can lead to a heart or stroke. These risk factors lead to the formation of atherosclerotic plaque in the arteries, which grows in size and lead to stoppage of arteries.

Well known risk factors for causing a heart attack or stroke include family history of stroke and heart disease, diabetes, high blood pressure, abnormal cholesterol levels, smoking and obesity. Men over the age of 45 and women over the age of 55 are also at a much higher risk of developing stroke and heart disease, and need to take extra precautions to prevent these conditions.”

Heart attacks and strokes are two life-threatening problems, but you can take the necessary steps to reduce your risk of having either of them.

Tips and Remedies to Keep Heart Attack and Stroke at Bay

Here are some tips to lower your risk of a heart attack or stroke.

1. Stay Informed

The best course of strategy for preventing a heart attack and stroke is by understanding their risk factors, symptoms and treatment options. Ignorance about your health can put you at a higher risk of heart attack and stroke.

There are some risk factors for heart attack and stroke that you can either control or manage, like, blood pressure (hypertension), high cholesterol, diabetes, being overweight, excessive alcohol consumption, physical inactivity, smoking and stress.^[3]

Consult your doctor if you have any health problem and make a note of the instructions given by the doctor. Follow the prescriptions given by the doctor with a strict routine and talk to your doctor if you are unable to take the medicines due to their side effects or for any other reason.

Try to stay informed about the new techniques and insights that are constantly developing in the field of medicine and talk to your doctor about new medicines and procedures.

Furthermore, always brush up your memory regarding the warning signs of either of the life-threatening conditions and be prepared to take the necessary steps (like calling the ambulance right away) in case you notice the warning signs.

“If a person is complaining of chest pain or increasing shortness of breath which are some of the more common signs of a heart attack or having signs suggestive of stroke such as difficulty in speech or complete or partial loss of movement in any part of the body, such patients should immediately call 911.

In the case of possible heart attack, it is advised to take an aspirin immediately. In the event of stroke which can either be due to a clot like in a heart attack or due to a bleed, it is advisable to call 911 immediately. The acute treatment of stroke and heart attack is dependent on quick timing,” says Dr. Waqar Khan.

Learn about the warning signs of a heart attack, here.

Learn about the warning signs of a stroke, here.^[4]

2. Quit Smoking

Smoking or using tobacco in any form considerably increases your risk of developing a cardiovascular disease, and as per the 2009 study published in the Atherosclerosis journal, quitting the habit of smoking can be highly effective for improving your cardiovascular health.^[5]

Tobacco contains harmful chemicals that damage your blood cells which in turn affects the functioning of your heart and blood vessels. This, in turn, increases your risk of atherosclerosis, which can ultimately lead to a heart attack.^[6]

At the same time, smoking or even exposure to secondhand smoke increases your risk of lung disease, peripheral vascular disease and strokes.^[7]

When it comes to heart disease or stroke prevention, no amount of smoking is safe. Hence, if you smoke, quit today.

If you know someone who smokes, encourage him or her to quit. Also, take the necessary steps to avoid exposure to secondhand smoke.

3. Follow a Heart-Healthy Diet

Being careful about what you eat can help lower your risk of a heart attack or stroke. In fact, improving your diet is an important step towards preventing heart diseases. Try to eat nutrient-rich foods that have vitamins, minerals, fiber and other nutrients, but are lower in calories.^[1]

• Eat 5 servings of vegetables and 2 servings of fruits daily.
• Eat a high-fiber breakfast cereal at least 4 times a week.
• Eat more cereals, legumes, whole-grain foods and low-fat dairy products.
• Eat cold-water fish like salmon and tuna at least twice a week.
• Avoid high-fat and high-sugar products and reduce your salt intake.
• Use a healthy cooking oil like olive, canola, sunflower or safflower oil.
• Instead of deep-frying, prepare your foods by grilling, boiling, steaming and baking.

4. Exercise a Little Every day

Regular exercise can help manage heart disease and reduce the risk of a heart attack or stroke. In fact, the more you exercise, the lower is your risk for heart diseases, as physical inactivity is also one of the risk factors for cardiovascular diseases.

People who are physically active have a lesser chance of a heart attack and also in the case, they do get a heart attack, then they have a better chance of recovery than people who lead a sedentary lifestyle, according to the American Heart Association (AHA).^[8]

Regular exercise benefits the heart in many ways, such as reducing body weight, blood pressure, and bad (low-density lipoprotein or LDL) and total cholesterol levels. It also helps increase your good (high-density lipoprotein or HDL) cholesterol and insulin sensitivity.

According to the AHA, 30 minutes of physical exercise, five days a week can help improve your heart health and reduce your risk of heart disease. Some good exercises for your heart are playing sports, walking, jogging, swimming, biking and more.^[9]

5. Maintain Healthy Body Weight

Being overweight, especially having fat around your waist, increases the risk for high cholesterol, high blood pressure and insulin resistance. All these factors, in turn, heighten your risk of cardiovascular disease.^[10]

To know whether you have a healthy percentage of body fat or excess weight, you can calculate your body mass index (BMI) and waist circumference. A BMI between 18.5 and 25 is considered to be healthy. But if your BMI turns out to be 30 or above, then you are overweight.

Furthermore, if the waist measurement in the case of men is greater than 40 inches or greater than 35 inches in the case of women, then also it is a case of being overweight.

If you happen to fall into the category of being overweight, then you would need to lose some pounds to reduce your chances of having a heart attack or stroke. However, strive to lose weight slowly and avoid crash dieting. You can always get help from an expert in weight loss.

6. Control Your Stress Level

According to a 2014 study done at the University of Pittsburgh, stress as well as anger, anxiety and depression not only affect the functioning of the heart but also increase the risk for heart disease.^[11]

Persisting stress increases the risk for atherosclerosis and cardiovascular disease by evoking negative emotions, which in turn raise the levels of pro-inflammatory chemicals in the body called cytokines.

In addition, people who are under stress are more likely to adopt unhealthy habits like smoking, drinking too much and overeating.

If you suffer from stress, identify the triggers and try to avoid them. Also, it would be advisable to try to avoid people or situations that make you anxious or angry.

Some other stress-busting tips include being physically active, relaxing your mind (try meditation or yoga), taking time to laugh, taking vacations at regular intervals and spending time on your favorite hobby.

7. Manage Health Problems

As already mentioned, people suffering from high blood pressure, high cholesterol and diabetes are at a higher risk of heart attacks or strokes.

“Some of the risk factors described above can be altered by each individual but there are some that cannot be changed such as family history.

Maintaining good control of diabetes, high blood pressure and cholesterol, regular exercise, watching your diet and of course, stopping smoking will certainly prevent your chances of heart attack.

Individuals who have two or more than two risk factors described above, must have baseline testing performed by their primary care physician,” says Dr. Waqar Khan.

High blood pressure causes wear and tear of the inner lining of your blood vessels, which increases the risk of a heart attack. To maintain a healthy blood pressure, your blood pressure reading should be around 120/80 mmHg.

To lower high blood pressure, limit your salt intake, exercise regularly and take your medications as recommended by your doctor without fail.

Cholesterol, a fatty substance, tends to accumulate along artery walls and can eventually trigger a heart attack or stroke. Blood cholesterol levels should remain below 200 mg/dL. You need to reduce your intake of saturated fat, get moving, and avoid smoking and drinking to reduce high cholesterol.^[12]

Lastly, as diabetes is a risk factor for developing heart disease, take necessary steps to control your blood sugar level. High glucose levels in the blood cause damage to the arteries and increase the buildup of fatty deposits, thus increasing your risk of a heart attack or stroke.^[3]

Additional Tips

• Get enough quality sleep as sleep deprivation can harm your health in many ways.
• When taken in moderation, red wine can help protect against heart disease. However, excessive intake can raise blood pressure and triglyceride levels as well as damage your heart muscles.
• Get regular health screenings and tests done to detect problems that may increase your risk of a heart attack or stroke like high blood pressure, high cholesterol, diabetes, etc. Consult your doctor to find out which screenings and tests you need based on your age, gender, family history and lifestyle.

Expert Answers (Q&A)

Answered by Dr. Rachana Kulkarni, MD (Cardiology)

What dietary changes can one make to reduce the risk of heart attack and stroke?

Follow a healthy diet plan, which entails:

• consuming foods that are low in saturated fat, trans fat, and cholesterol while having moderate levels of total fat
• limiting your sodium intake
• bringing down your alcohol consumption to no more than one drink a day
• diversifying your food choices to include a variety of whole grains, fruits, and
  vegetables daily
• choosing heart-friendly sources of animal protein such as fish, poultry, and lean cuts of meat
• using non-fat or low-fat milk, cheeses, and yogurt
• maintaining a healthy weight

How can a person tell if he/she is at an increased risk of heart problems?

The following risk factors can predispose a person to potential heart problems:

• family history
• hypertension
• diabetes
• hyperlipidemia
• smoking
• obesity
• sedentary lifestyle
• stress

Do blood thinning medications like aspirin help delay the onset of a heart attack or a stroke?

Since aspirin is a blood-thinner, people with bleeding disorders are advised against its use on a regular basis. However, people with more than 3 risk factors of cardiac disease can benefit from taking one aspirin a day, provided that they don’t suffer from any bleeding issues.

Is there any truth to the claim that drinking water before going to bed helps prevent strokes?

No, medical science does not accord any legitimacy to this claim.

How can one manage high blood pressure efficiently?

To keep your blood pressure within bounds, it is necessary that you refrain from eating salty or high-sodium foods as well as exercise regularly to maintain a healthy weight. Monitor your blood pressure levels by opting for regular checkups. By keeping your doctor in the loop, he/she can alert you to any signs of trouble and prescribe medications if needed.

Can arthritis trigger heart problems?

No, arthritis does not figure among the precipitating factors for heart disease.

Please provide some additional tips or inputs regarding heart attack and stroke.

Whether you are a heart patient or not, everyone must proactively ensure their cardiovascular health by leading a healthy lifestyle. Adopting the following tips can go a long way in that regard:

• Eat lots of fruits and vegetables.
• Quit smoking at once. Seek professional medical assistance if you struggle to let go of this habit.
• Be physically active by indulging in 2 hours and 30 minutes of moderate-intense aerobic activity each week.
• Add strength training to your exercise routine 2 to 3 times a week.

About Dr. Kulkarni: She is the President of American Heart Association New Jersey Chapter and has served as the Chief of Cardiology and Chairman of Medicine at Robert Wood Johnson University Hospital, Somerset. She has been leading the American Heart Association’s “Go Red for Women” initiative for the past decade.

In 2018, she was recognized as a ‘Public Health Hero of New Jersey’ for promoting a culture of Heart Health, and in 2017 she was awarded the ‘Woman of Distinction’ award by the American Heart Association for making ‘sustained and extraordinary contributions to women, health and society.’

Resources:

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3. Wei, Ming, Mitchell, et al. Effects of Cigarette Smoking, Diabetes, High Cholesterol, and Hypertension on All-Cause Mortality and Cardiovascular Disease Mortality in Mexican Americans: The San Antonio Heart Study | American Journal of Epidemiology | Oxford Academic. OUP Academic. https://academic.oup.com/aje/article/144/11/1058/102937. Published December 1, 1996.
4. Jin J. Warning Signs of a Stroke. JAMA Internal Medicine. https://jamanetwork.com/journals/jama/article-abstract/1861804. Published April 23, 2014.
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7. Vandivier RW. Action on Secondhand Tobacco Smoke Exposure. JAMA Internal Medicine. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1930721. Published January 1, 2015.
8. Billinger SA, Arena R, Bernhardt J, et al. Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. https://www.ncbi.nlm.nih.gov/pubmed/24846875. Published August 2014.
9. Oja P, Titze S. Physical activity recommendations for public health: development and policy context. EPMA Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405391/. Published September 2011.
10. Winter Y, Rohrmann S, Linseisen J, et al. Contribution of Obesity and Abdominal Fat Mass to Risk of Stroke and Transient Ischemic Attacks. AHA / ASA Journals. https://www.ahajournals.org/doi/abs/10.1161/STROKEAHA.108.523001. Published December 2008.
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