Heart attacks aren't just for older, overweight men with high cholesterol and high blood pressure. Doctors are seeing patients in their 40s come in with heart disease due to self-inflicted risk factors, according to Ilan Wittstein, M.D., an assistant professor at the Johns Hopkins University School of Medicine and its Heart Institute. Middle-aged men need to be on guard. Even if you work out and eat healthy, you could still be at risk.
Beware of risk factors
"In half of the cases of heart attacks, the heart attack is the first time the patient finds out about heart disease," says Richard A. Stein, director of preventive cardiology at Beth Israel Medical Center and spokesperson for the American Heart Association. More than 60 percent of heart attacks have to do with simple lifestyle issues, such as diet, exercise and cigarette smoking, and easy to detect and treat medical issues such as high blood pressure and high cholesterol. "Men need to know about the risk factors that predict the majority of heart disease cases," Stein says.
Research shows that not only do you have to watch your diet, exercise, and avoid smoking and excessive alcohol to prevent a heart attack, it's imperative to be aware of your family history and to manage your stress level. According to the 2004 INTERHEART study in the Lancet, stress is one of three main risk factors for coronary artery disease, and is responsible for a fifth of heart attacks worldwide.
Stress played a very important role in what may have caused the heart attack of Ken Lay, the founder of Enron Corp, says Wittstein. Convicted of conspiracy and fraud, Lay faced 25 to 40 years in prison before his untimely death. "If we look at medical literature over time, we find many good examples of how stress can have a profound affect on the heart," says Wittstein, who co-authored last year's study on "broken heart syndrome" in the New England Journal of Medicine. "We can't prove that heart attacks can be caused by stress, but we know that people who are under higher stress, have a greater risk of developing heart disease," Wittstein adds.
Release the pressure
But it's possible to lessen your risk of heart disease by using calming stress management techniques, say these experts. Duke University Medical researchers conducted a study with 107 patients who had a history of heart problems. To lower the risk of future heart attacks, researchers divided the patients into three treatment groups; a third of the group exercised, another third received standard care, and the last third learned stress management techniques through 4 months of therapy and training. The stress management group fared the best with a 74 percent reduction in cardiac events over the 5-year analysis.
Stress management techniques can include getting therapy, or be as simple as taking up yoga, practicing tai chi or using meditation techniques for five minutes every day. "It's proven that relaxation techniques lower blood pressure and improve bloodflow," Dr. Wittsetin says.
Modify your lifestyle
Below we provide you with risk factors to be aware of and simple modifications you can make to your lifestyle today to lessen the probability of a heart attack down the road.
Starting in your mid-to-late 30's, take measures to prevent heart disease by doing the following:
1. Be aware of major risk factors: Hypertension, high cholesterol, cigarette smoking, having a family history of heart disease, and diabetes are all major risk factors that could increase your probability of having a heart attack.
2. Make a lifestyle change: Think of the things that are in your power to change, like improving your diet, getting exercise, and quitting smoking. Eat seven to nine fruits and vegetables each day, says Dr. Stein, who recommends the Dash Diet, a Mediterranean, fruit-and-vegetable-based diet that can be downloaded online for free. Get at least 2 hours of moderately intensive exercise each week, recommends Dr. Stein.
3. Make an appointment to be evaluated: If you have a family history of heart attacks, or you think you're at risk, spend 45-minutes to an hour with a preventive cardiologist at your local hospital. The evaluation and blood test will reveal your HDL and LDL cholesterol, triglycerides, fasting lipid profile, blood pressure, and family history. "Don't wait until you are in your 50s to get a formal assessment," Dr. Wittstein says. From this checkup, the doctor will be able to determine if you need to have a non-invasive scan of your heart to look for problems, or if you need to be prescribed medication like statins.
4. Don't deny cardiac symptoms: If you're experiencing "shortness of breath or chest pains from exertion, get to the hospital right away," warns Dr. Stein, who had a friend die from a heart attack last year, after experiencing chest pains while riding his bike.
5. Use medication: "If a physician recommends it, get started on medication, like statins, that can help you modify your risk factor," Dr. Wittstein says. If you have a family history or believe you are at risk, also take a 81-160 mg aspirin tablet each day as a precaution. "For a 40-year-old man with a strong family history of heart attacks, a baby aspirin would be reasonable," he says.
Extra: If you're under high stress, take up meditation, yoga, tai chi, or practice any other relaxation technique for five minutes every day. "Exercise can relieve a lot of stress for people," Wittstein says. "People who exercise on a regular basis, are less likely to have heart disease or die from a heart attack later in life."