Heart attack - Prevention

Heart disease is considered to be highly preventable. In fact, it is believed that over half the number of deaths that are caused by heart disease and stroke could be prevented if people made simple lifestyle changes relating mainly to diet and exercise.[1]

Healthy lifestyle habits, which need lifelong attention, include:[1,2]

Taking certain medication such as a statinOne of a class of drugs that inhibit cholesterol formation in the liver. or aspirin, may also help high-risk people to avoid coronaryRelating to the arteries supplying the heart itself. arteryA blood vessel that carries blood away from the heart. Apart from the pulmonary artery and umbilical artery, all arteries carry oxygenated blood. disease.[2-4]

If you are a smoker, the single most effective thing you can do to lower your risk of having a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. is to stop smoking.

If you have diabetes mellitusDisordered energy metabolism and high levels of glucose in the blood owing to a lack of insulin, or poor response of the body to insulin., it is important to keep your glucoseA simple sugar that is an important source of energy in the body. levels as well controlled as possible. This is because diabetes increases the risk of heart disease. Plus, people who have diabetes tend to get heart disease at a younger age than others.[5]

Even in people with diabetes, though, heart disease and heart attacks are preventable - keeping a tight control of your bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. glucoseA simple sugar that is an important source of energy in the body., and following the measures described here, will go a long way.[5]

Eating a healthy diet

Adopting a heart-healthy diet includes limiting your fatOne of the three main food constituents (with carbohydrate and protein), and the main form in which energy is stored in the body. intake and eating more unsaturated fats instead of saturated fats. The elimination of trans fatty acids is also important, as is eating more omega-3 fatty acids, which are present in oily fish, for example.[1]

Other dietary measures include eating more fruits, vegetables and nuts, and reducing your salt and sugar intake.[1]

One of the healthiest diets is thought to be the Mediterranean diet: it is rich in fresh fruits and vegetables, fish, nuts and olive oil, with wine often taken with meals, while the intake of red meat is limited. Such a diet seems to reduce the risk of a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction., as well as reducing specific risk factors such as insulin resistanceA reduced response of the body to the hormone insulin, resulting in raised blood glucose levels..[6]

Learn more about the benefits of a Mediterranean diet.

Getting regular exercise

Exercising regularly does not necessarily have to involve going to the gym; adopting a more active lifestyle can be very effective. For example, consider walking or cycling to, or partway to, your destination rather than taking the bus or car every day. At least 20 to 30 minutes of physical activity every day is advised to lower your heart disease risk.

Avoiding or stopping smoking

If you are a smoker, the single most effective thing you can do to lower your risk of having a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. is to stop smoking. Nicotine replacement therapies have also been shown to increase the odds of successfully giving up smoking. If you find this difficult to do on your own, your doctor will be able to advise you, and local support groups may help.

Learn more about stopping smoking.

Studies suggest that lowering blood pressure by a small amount, just 5mmHg, reduces the risk of ischaemic heart disease (heart disease caused by poor bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. supply) by around a fifth.

Maintaining a healthy weight

Maintaining a healthy weight can best be achieved by eating a healthy, balanced diet combined with leading an active lifestyle. Some people use very low-calorie diets to lose weight quickly, but this is inadvisable; such accelerated weight loss can be difficult to maintain, and these extreme diets are unlikely to provide all the nutrients that your body needs. A slow, steady weight-loss regime is preferable. Many people find support groups to be a great help.

Medication

Some medicines have been shown to lower the risk of heart disease, especially in people who are at high risk. These medicines will not be suitable for everyone, though - for example, because of side effects. It is important to speak to your doctor if you feel you may benefit from any of these therapies.

Examples of medicines that may help to lower the risk of heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. include:

  • Statin therapy
  • Aspirin
  • Blood pressure-lowering medication.

High cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy. levels (specifically, LDL-cholesterolSubstance that carries cholesterol around the bloodstream, a form of so-called 'bad cholesterol'.) are an important factor in the development of atherosclerosisDisease leading to fatty deposits in the inner walls of the arteries, which reduce and may eventually obstruct blood flow., a progressive disease that leads to the build-up of plaques and increases the risk of a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction.. Measures such as diet and exercise are thought to lower the level of LDL-cholesterolSubstance that carries cholesterol around the bloodstream, a form of so-called 'bad cholesterol'. in the bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid..

However, diet and exercise are not enough to lower cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy. levels in some people. In these cases, the person may be given a type of medication called a statinOne of a class of drugs that inhibit cholesterol formation in the liver. to lower his or her cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy. levels further. Statin therapy has been shown to reduce the progression of atherosclerosisDisease leading to fatty deposits in the inner walls of the arteries, which reduce and may eventually obstruct blood flow..[2]

It is widely accepted that taking aspirin reduces the risk of a heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. among people at risk, although it has been suggested that aspirin is more beneficial in men than in women.[4]

Studies suggest that lowering blood pressure by a small amount, just 5mmHg, reduces the risk of ischaemic heart disease (heart disease caused by poor bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. supply) by around a fifth. This seems to be true even for people who do not have high blood pressure to start with.[3]

If you think that you might benefit from taking any of these medicines, speak to your doctor to see if the benefits outweigh any risks for you as an individual.

References: 
  1. World Health Organization http://www.who.int/dietphysicalactivity/publications/facts/cvd/en/ [Last accessed May 7th 2009.]
  2. Subclinical atherosclerosisDisease leading to fatty deposits in the inner walls of the arteries, which reduce and may eventually obstruct blood flow.: what it is, what it means and what we can do about it. Toth PP. Int J Clin Pract 2008;62(8):1246-54.
  3. Lowering blood pressure to prevent myocardial infarctionDeath of an area of heart muscle due to poor blood supply. and stroke: a new preventive strategy. Law M, Wald N and Morris J. Health Technology Assessment 2003;7:31. [Accessed from: http://www.ncchta.org/execsumm/summ731.htm.]
  4. The influence of gender on the effects of aspirin in preventing myocardial infarctionDeath of an area of heart muscle due to poor blood supply.. Yerman T, Gan WQ and Sin DD. BMC Med 2007;5:29.
  5. Association of glycaemia with macrovascularRelating to large blood vessels. and microvascularRelating to small blood vessels. complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000; 321: 405-12.
  6. Effectiveness of the Mediterranean diet in the elderly. B Roman, Carta L, Ángel M et al. Clinical Interventions in Aging 2008;3(1):97-109.