Lifestyle Changes for a Healthier Heart
You cannot change your genetics, but you can make lifestyle choices that will help your heart to be stronger and healthier. The following pages will help you to evaluate your controllable risk factors and to take steps to reduce those risk factors in your life. You also will learn about our Cardiac Rehabilitation program, which is designed to put you back on the path to recovery and wellness.
Risk Factor Assessment
Risk factors are those things that helped create your heart disease. You cannot change risk
factors such as age, sex, heredity and race. There are risk factors that you can change, however.
Making changes to reduce these risk factors can help keep your heart problem from getting
worse. Complete this assessment with your nurse or doctor.
|1. Are you currently a smoker?||NO||YES||_____packs per day x _____years|
|2. Is your LDL greater than 100, HDL less than 40 or triglycerides over 150?||NO||YES||Total______ Triglycerides______
|3. Have you ever been told you had high blood pressure?||NO||YES|
|4. Do you exercise more than 30 minutes a day, three times a week?||NO||YES||Frequency___________
Does it make you sweat?_____
|5. Do you have diabetes or metabolic syndrome?||NO||YES|
|6. Do you have a family history of heart disease, age 55 or younger?||NO||YES||Family member(s)
|7. Are you overweight?||NO||YES||Height_____ Weight_____
Body Mass Index_______
(see BMI Chart below)
|8. How would you rank your daily stress level?||Low High
1 2 3 4 5
|9. Do you drink alcohol?||NO||YES||How many drinks per day?_____|
|10. Do you have chronic depression?||NO||YES|
The more times you answered “yes,” the higher your risk for heart disease.
Reducing Risk Factors
Take charge of controllable risk factors:
- Stop tobacco use.
- Reduce high cholesterol.
- Control high blood pressure.
- Manage diabetes and metabolic syndrome.
- Lose excess weight.
- Manage stress.
- Limit alcohol intake.
Stop Tobacco Use
Tobacco use is the number one preventable risk factor for heart disease. This includes cigarette, cigar and pipe smoking, snuff and chewing tobacco. Quitting is the best thing you can do for the health of your arteries. Smoking can cause the heart to work harder to supply oxygen to your body. It also increases your heart rate and blood pressure. The harmful effects of tobacco use include:
- breaking down the lining of the coronary arteries. Once an artery lining is damaged, cholesterol (LDL) and other substances stick like glue to the artery wall and cause blockage.
- spasms and contractions in the artery, which cut off the blood supply to the heart muscle. Nicotine, a drug found in tobacco, causes blood clots to form.
- inhaling carbon monoxide, a poison created by smoke. This takes the place of oxygen in the blood, which decreases the amount of oxygen reaching the heart muscle.
Tips for Quitting
- Make a firm decision to quit and decide on a date you will quit.
- Consider the different cessation aids available: 1) nicotine replacement therapies such as nicotine patches, lozenges, gum, spray and inhalers. Most can be found over the counter at your drug store. It is important not to use tobacco products when using these aids. 2) non-nicotine medicine (bupropion hydrochloride), which is available by prescription from your doctor. It is an antidepressant that can help reduce withdrawal symptoms and the urge to smoke. 3) alternative therapies such as hypnosis, acupuncture, relaxation techniques and tobacco cessation classes for behavioral change. Contact the TriHealth Fitness & Health Pavilion, (513) 985-0900, or a local chapter of the American Lung Association, American Cancer Society or American Heart Association.
- Make a list of the reasons why you are quitting. Read the list when you feel like smoking.
- Identify daily routines that trigger your desire to light up (drinking coffee, driving to work, stressful situations, being around others who smoke). Be creative and develop new routines. Substitute carrot or celery sticks, gum or hard candies, toothpicks, a popsicle, a bottle of water or brush your teeth when you feel the urge to smoke.
- Try exercise as a great alternative to smoking.
- Reward yourself with the money you save.
- Find a buddy or friend who will quit with you. Tell people you have quit, because the more you say it the more real it will be for you.
You may feel discomfort and withdrawal symptoms as your body rids itself of nicotine. The symptoms will pass in three to five days. Cravings may last longer, so stay active to distract yourself and overcome them. Even if you’ve tried to quit before, don’t give up. Many smokers try quitting four to five times before they succeed.
What happens after you quit smoking?
- Blood pressure drops to normal
- Pulse rate drops to normal
- Body temperature of hands and feet increases to normal
- Carbon monoxide level in blood drops to normal
- Oxygen level in blood increases to normal
- Chance of heart attack decreases
- Nerve endings start regenerating
- Ability to smell and taste improves
2 weeks to 3 months
- Circulation improves
- Walking becomes easier
- Lung function increases up to 30 percent
1 to 9 months
- Coughing, sinus congestion, fatigue and shortness of breath decrease
- Cilia (fine, cleaning hairs) regrow in lungs, increasing their ability to handle mucus, clean the lungs and reduce infection
- Excess risk of coronary heart disease is half that of a smoker
- Lung cancer death rate for the average former smoker (one pack a day) decreases by almost half
- Stroke risk is reduced to that of a nonsmoker five to 15 years after quitting
- Risk of cancer of the mouth, throat and esophagus is half that of a smoker’s
- Lung cancer death rate is similar to that of a non-smoker
- Precancerous cells are replaced
- Risk of cancer of the mouth, throat, esophagus, bladder, kidney, cervix and pancreas decreases
- Risk of coronary heart disease is that of a non-smoker
Sources: American Cancer Society; Centers for Disease Control
All benefits are lost by smoking just one cigarette a day, according to the American Cancer Society.
Reduce High Cholesterol
High blood cholesterol also is a major risk factor that causes heart disease. Cholesterol can build up in the coronary arteries and cause blockages. The best ways to lower your cholesterol levels are to lower the amount of fat in your diet, exercise on a regular basis and take your medicines as prescribed. Reducing your cholesterol is one of the most controllable risk factors.
Cholesterol is a natural, fat-like substance made in the liver. Your body makes 80 percent of the cholesterol it needs, so it doesn’t require much from the food you eat.
There are two types of cholesterol. Good cholesterol, called HDL (high-density lipoprotein), does two things: helps remove bad cholesterol from your blood and helps your body heal when injured or damaged. HDL prevents plaque from building up in the arteries.
Bad cholesterol, called LDL (low-density lipoprotein), is sticky and will build up on damaged heart arteries, slowly blocking off the artery.
|Ideal Blood Levels*
according to the American Heart Association
|HDL||above 40 (men)
above 50 (women)
|LDL||below 100 (high risk)
below 130 (medium
and low risk)
*Recent studies indicate that cholesterol levels may need to be lower than these guidelines suggest. Check with your doctor about the level that is right for you.
Your doctor can calculate your risk of heart disease-low, medium or high. If you already have heart disease or if you’ve had a heart procedure, you are considered high risk.
Methods to increase HDL and lower LDL and triglycerides:
- Stop tobacco use.
- Lose weight.
- Exercise regularly.
- Manage stress.
- Eat a heart-healthy diet.
- Take medicines as ordered by your doctor.
Control High Blood Pressure (Hypertension)
About 50 million Americans have high blood pressure. Many people do not know that they have high blood pressure because there are usually no symptoms. That is why it is called the “silent killer.” Untreated high blood pressure can lead to coronary artery disease, stroke, heart attack, heart failure, kidney failure, blindness and other medical problems.
Blood pressure is the force of blood pushing against the artery walls. Blood pressure is recorded in two numbers. The first number is the systolic pressure, or the pressure in your arteries when blood is pumped into them. The second number is the diastolic pressure, or the pressure in your arteries when your heart rests between beats. Your blood pressure is determined by taking the average of three or more readings at three different times. A normal blood pressure for a healthy adult is less than 120/80.
A blood pressure always greater than 135/85 is called high blood pressure, or hypertension. A person with diabetes should have a blood pressure under 120/80. Many of the steps to help lower your blood pressure also help improve your total health.
Here are some things you can do to help lower your blood pressure.
- Stop tobacco use.
- Exercise 30 minutes a day.
- Eat healthy foods and limit the amount of salt you eat.
- Control your weight – for every pound you gain, you add four pounds of pressure against the heart.
- Limit alcohol to one to two servings per day.
- Limit caffeine to one to two cups per day.
- Take your medicine at the same time every day.
Manage Diabetes and Metabolic Syndrome
When you have diabetes, your body does not do a good job of using the food you eat. This is because it has a problem breaking down carbohydrates. Most of what you eat needs to be broken down into simple sugar, called glucose. Glucose is the body’s main energy source. For glucose to get into your cells, it needs insulin (a hormone made by the pancreas). People with diabetes produce little or no insulin, or the body does not respond to the insulin that is made.
No matter what the cause, glucose builds up in the blood. High blood sugar acts like sand paper and causes the walls of the arteries to become rough. It also causes bad cholesterol (LDL) to build up in the walls of an artery and make it more narrow. This slows blood flow to your body, including your heart. Heart disease may then occur. Controlling your blood sugar can help slow or prevent this damage.
A diagnosis of diabetes is made if you have two fasting blood sugars of 126 mg or more. A random blood sugar of 200 mg or more also is proof of diabetes.
Metabolic syndrome is a collection of health risks that increases your chance of developing heart disease, stroke and diabetes. Your pancreas makes enough insulin but your body may have trouble using it. Treatment includes diet and exercise. You also may need to take medicine. If you have at least three of the five following conditions, you have metabolic syndrome.
Indicators of Metabolic Syndrome
- Central obesity:
- waist circumference over 40 inches for men
- waist circumference over 35 inches for women
Lose Excess Weight
Obesity is linked to many diseases that put you at risk for heart disease, diabetes, high cholesterol and high blood pressure. Your heart must work harder to supply blood to the extra weight. The secret to weight loss is to eat or drink fewer calories than you burn. Diet and exercise can help you do this. If you are overweight, just a 10 percent weight loss will help your heart.
Other good reasons for losing weight:
- Being overweight takes three years from your life.
- Being obese takes away six to seven years of your life.
- Obesity plus smoking takes away 15 years.
Determine if You Have Abdominal Obesity
One way to determine if you have central or abdominal obesity is to measure your waist measurement in inches across your stomach. Women with a waist measurement of 35 inches or bigger, or men with a waist measurement of 40 inches or bigger, have central obesity. A Body Mass Index (BMI) calculation also is used to determine total body fat. See the chart below.
BMI is as accurate as waist circumference in assessing risk of disease. Research shows that as a person’s BMI or waist circumference increases, so does insulin resistance as well as triglycerides and higher blood sugar concentration in the blood. This means you have a higher risk of developing diabetes and an increased risk of developing heart disease.
Body Mass Index (BMI) Chart
Find your height and weight on the chart to determine your body mass index. An ideal range is 19 to 24. A BMI over 25 puts you at risk for high blood pressure, stroke, osteoarthritis, heart disease and certain cancers. A BMI of 25 to 29.9 is considered overweight, and a BMI of 30 or higher is considered obese. For people whose BMI may be higher due to large bone structure or greater muscle mass, the waist circumference measurement described above will help determine whether you are truly at higher risk for serious diseases.
A person who does not exercise has an increased risk of heart disease. Exercising just 30 minutes a day will help you:
- lower your blood pressure
- raise the HDL (“good”) cholesterol, and lower your total cholesterol and triglyceride levels
- lower blood sugar (if you have diabetes and glucose intolerance)
- lose weight
Other benefits of exercise include lowered stress levels, improved sense of well-being, improved quality of sleep and decreased risk of osteoporosis (a disease causing bone to become weaker and more brittle).
Simple ways to increase activity in everyday life include:
- Take the stairs instead of the elevator.
- Park farther away from the entrance to your job or stores.
- When you go shopping at the mall, walk for 10 to 15 minutes before you shop.
- Incorporate exercise into your house work and yard work.
- While watching television, stand up and walk around the room during commercials rather than walking to the refrigerator.
- Start an exercise routine. Join an exercise group.
- Find an exercise you like and gradually increase your activity level.
The goal is to exercise for 30 straight minutes three to five days a week, preferably daily, to improve your cardiovascular health.
Limit Alcohol Intake
Drinking more than one to two servings of alcohol a day relaxes the heart muscle too much and limits the amount of blood the heart feeds itself. When you drink too much alcohol, the heart muscle cannot pump or squeeze as strongly. Extra fluid can build up inside the heart, causing it to stretch or get bigger. The extra pressure on the heart muscle weakens the heart, eventually causing congestive heart failure (build-up of fluid in the heart and lungs).
Drinking large amounts of alcohol increases blood pressure, cholesterol and triglyceride levels. This causes atherosclerosis, or hardening of the arteries.
One serving of alcohol is equal to:
- 1.5 ounces 80-proof distilled spirits (liquor)
- 12 ounces beer or wine cooler
- 5 ounces wine
There is conflicting evidence about the effect of alcohol on increasing HDL cholesterol levels (the protective cholesterol). Some studies have shown that one serving of alcohol per day may increase this level. Other studies have shown that the part of the HDL that is elevated is not the good cholesterol. The action of all heart medicines may be changed with drinking alcohol. If you have questions about using alcohol, please discuss this with your doctor.
Many people try to avoid stress as much as possible; others thrive on it. No matter what you do, stress is unavoidable. Any change, even positive or good change, brings some stress. Stress is the body’s way of dealing with change. Once you begin to view stress as a part of normal life, you can begin to recognize and learn to deal with it better.
Long-term stress that you do not deal with properly may become bad for your health and may lead to heart disease by:
- increasing blood pressure
- increasing heart rate
- increasing cholesterol levels
- increasing blood sugar levels
Some possible symptoms of stress are:
- bowel problems
- tense muscles in the jaw, neck and shoulders
- mood swings
- sleep problems
- stomach problems
People who successfully deal with stress in their lives feel more relaxed. Some effective stress management techniques include:
- use of guided imagery
- muscle relaxation
- listening to music
- deep breathing techniques
- visiting with friends
- taking time to do an activity you enjoy
- reading a book
- stress management class
The best way to manage stress is to practice healthy habits such as eating a nutritious diet, exercising, avoiding alcohol and drugs and getting six to eight hours of sleep a night.
Our Cardiac Rehabilitation program guides you in making lifestyle changes that will help your heart. The purpose of cardiac rehabilitation is to help people return to everyday life. An important goal is to prevent a heart attack and halt or slow disease progression. Cardiac rehab focuses on these main areas:
- exercise to make you stronger
- education about your heart problem
- advice on healthy habits
- assistance with making life changes, such as losing weight or quitting smoking
- counseling to help you cope with depression and learn how to deal with stress
The patients in the program will be a lot like you. Anyone with heart disease, regardless of age, will benefit from cardiac rehab.
People who go to cardiac rehab include those who have had heart disease such as angina or heart event such as a recent heart attack; recent heart surgery; cardiac intervention such as balloon angioplasty or stent placement; or a heart transplant.
The Three Phases of Cardiac Rehabilitation
Phase I – Inpatient
While you are in the hospital, the Phase I nurse (heart educator) may see you and your family. This education starts after you have been treated for a heart problem. The nurse will teach you about your specific heart condition and risk factors that caused your heart disease. You will be given written material.
You may watch a video about your heart problems and treatments. The Phase I nurse also will explain the outpatient Phase II cardiac rehab program, which is designed to help your heart get healthy again and help you reduce your risk factors. You will receive written information regarding entry into a program.
Phase II – Immediate Outpatient
Prior to discharge we will order referral for cardiac rehab. Cardiac rehab is usually scheduled two to six weeks after leaving the hospital, depending on your condition and recovery. The program covers 36 one-hour sessions over 12 weeks (Monday-Wednesday-Friday). Check your insurance policy for coverage before attending a cardiac rehab program. Most insurances will cover hospital-affiliated outpatient programs.
At each session, you will be monitored closely by a cardiac rehab nurse and an exercise physiologist. A personal exercise plan will be developed based on your needs, abilities and goals. These exercise classes are fun, upbeat and slightly challenging.
Along with each exercise session, our staff will review health topics.
- Heart disease
- Blood pressure management
- Lifestyle changes and goal setting
- Nutritional counseling
- Stress management
- Exercise guidelines
- Weight management
Goals for Phase II:
- Improve your energy level by strengthening your heart with exercise
- Provide education about lifestyle changes that will keep your heart healthy
- Reduce the fear and anxiety about increasing your activities and exercise
- Assist you in making social, emotional and psychological adjustments to your heart disease and lifestyle changes
Cardiovascular and Pulmonary Rehabilitation Gym at Penrose-St. Francis – (719) 776-2508
Phase III – Maintenance Program
Phase III of cardiac rehab is a supervised exercise program that is available to those who complete Phase II. This phase teaches independent exercising without a monitor. It is available to you for as long as you choose to participate. It is not typically covered by insurance.
Goals for Phase III:
- Create an ongoing exercise program
- Offer support necessary for lifestyle changes
- Assist you in reaching goals such as independent living and/or returning to work
- Prevent or slow the progression of heart disease
The Cardiac Rehab Team
You are the most important member of the team! Your commitment to take care of yourself is the key to your recovery and ongoing heart health. The cardiac rehab team involves health care providers who are trained to guide your recovery. Your team includes:
- your family
- doctors (your family doctor, cardiologist and/or heart surgeon)
- cardiac nurses
- exercise physiologists
Coming back after a heart attack, heart surgery or a diagnosis of heart disease can be challenging for many reasons. Take advantage of the program classes and work with your health care team to design your own plan to lead a healthier life.