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Heart disease is the leading cause of death in the United States, where one person dies every 33 seconds from cardiovascular disease. In total, heart disease claims the lives of 1 in 5 people.
February is American Heart Month, so it’s worth the reminder that taking care of your heart can help extend your life span and improve the quality of your life. This week, I spoke with CNN wellness expert Dr. Leana Wen about the steps that everyone can take — no matter their age, current lifestyle habits or preexisting medical conditions. Wen is an emergency physician and adjunct associate professor at George Washington University. She previously was Baltimore’s health commissioner.
CNN: Let’s start with people in their teens and 20s. Cardiovascular disease is extremely rare at this age. Why should young people start thinking about taking care of their hearts?
Dr. Leana Wen: First, it’s important to build healthy habits early. Health is not just about the avoidance of disease; it’s also about overall physical and emotional well-being.
Some things that people in their teens and 20s can start paying attention to include physical activity, nutrition and substance use. While paying attention to these issues can help you feel better in the short term, you also benefit your heart in the long term.
Everyone should aim for at least 150 minutes a week of moderate- to high-intensity exercise. This should not feel like a chore; the more physical activity becomes incorporated as an enjoyable part of daily routine, the more it is likely to be continued throughout the years.
Now is the time to find sports that you enjoy. There’s an added bonus if you can find community through physical activity. Is there a running group, rock climbing club or swim group you could join? What about a volleyball, soccer or frisbee league? Find something you enjoy, and that will increase your odds that you will do it consistently.
This is also the age to start building healthy eating habits. That includes planning nutritious meals and aiming to consume more whole foods like fruits, vegetables, whole grains, milk, fish and meat. Other eating habits to strive for include cutting down consumption of ultraprocessed “junk foods” and not eating just before bed.
Younger people should also be attentive to substance use. Smokers have two to four times the risk of developing heart disease and strokes compared with nonsmokers, according to the US Centers for Disease Control and Prevention.
Excessive alcohol use also has detrimental effects on the heart. People should follow the federal Dietary Guidelines for Americans, which recommend no more than one alcoholic drink a day for women and two for men on days that they are drinking. And beware also of cannabis use. Recent studies point to regular marijuana use being associated with higher rates of heart attack, stroke and heart failure.
In addition to building good habits early, younger people should keep in mind that the damage to their bodies from unhealthy choices could carry over in years to come. That’s another reason it’s good to start early with establishing heart-healthy practices.
CNN: What about people in their 30s and 40s? What cardiovascular health practices should they be most attentive to?
Wen: They should keep up a healthy diet and be aware of the risks associated with smoking and excessive alcohol. With regard to exercise, I want to point out a recent study that found desk-bound workers had a 34% higher risk of mortality from cardiovascular disease compared with people who did not predominantly sit at work. Everyone should follow exercise guidelines; those who are sitting a lot at work should take extra care to get up frequently during the day.
This is also the time to think about two additional factors: stress and sleep. Plenty of research points to high levels of stress increasing blood pressure and increasing the risk of having strokes and heart attacks. While stress is a normal human reaction that everyone experiences, sustained high levels of stress can be problematic. Look out for symptoms of elevated stress and be mindful of what works for you to reduce stress in your life.
Along these lines, studies have also shown that sleep is important to cardiovascular health. In fact, some research indicates that sleep may be as important as diet and physical activity. For instance, people who sleep less than seven hours nightly had a higher prevalence of obesity, diabetes and high blood pressure — all significant risk factors for heart disease. Those with irregular sleep patterns also appear to be at higher risk for cardiovascular disease.
There are several strategies that can help achieve better sleep, including establishing a regular bedtime routine and eliminating blue light before bed. Cutting back on alcohol can help, too.
Finally, many people in this age group may be busy with a variety of responsibilities, including child-rearing, work and caring for older family members. Just don’t skip your annual physical exam. This is how you can identify if you have chronic conditions that can increase your likelihood of heart disease.
CNN: Let’s talk about the 50s and 60s. What are key strategies for this age group?
Wen: The prevalence of chronic conditions, including cardiovascular disease, increases with increasing age. Many people in this age group will have a diagnosis of cardiovascular disease or major risk factors such as hypertension, diabetes, high cholesterol and obesity.
Good control of these conditions will reduce the incidence of strokes and heart attacks. People should take medications as prescribed. Continue regular checkups and make sure that the chronic conditions are managed optimally. It may help to keep a diary. For instance, track your blood pressure or your blood sugars and show the diary to your health care provider so that medication dosages can be adjusted.
Many of these conditions will also improve with changes in lifestyle. It isn’t too late to begin exercise, improve dietary habits and reduce substance use. Those starting from scratch for physical activity should know that there are substantial gains in cardiovascular health for people who go from no exercise to some. And people who quit smoking, even later in life, can reverse some adverse effects. Those who wish to address their smoking, drinking and other use of substances should consult their physicians. A variety of tools exist to help them, including medications and counseling.
CNN: And for people in their 70s, 80s, 90s and beyond?
Wen: There are definitely ways to improve heart health at these ages, too. Everything mentioned above applies, with some modifications. Some people may have physical limitations, for instance, but they can still exercise with adjustments. Some may need to see their physicians more often, depending on the medical conditions they have. And everyone should be attentive to signs of emergencies like heart attack and stroke, and not hesitate to seek medical attention.
I’d like to add one more thing. It applies to people of all ages, but older people may face some challenges in an often-overlooked determinant of heart health: social connection. Loneliness is an epidemic in the United States and globally, and is associated with many negative health effects that include worse cardiovascular health and early mortality.
People of all ages should think of social connections as being important not just to their relationships and emotional health but also to improving physical well-being. Seemingly small changes can make a big difference, especially if they are habits sustained throughout decades.
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