Beat That: 12 Easy Tips For Maintaining A Healthy Heart

Throw Out the Smokes

OK, we admit: this one is not easy. But if you smoke, know that quitting is the number one thing you can do to help protect your heart. Not only is smoking bad for your heart, it can:

• Lead to lung cancer
• Cause COPD (Chronic Obstructive Pulmonary Disease)
• Boost your stroke risk
• Take a major toll on your wallet.

But you can reverse some of the damage. Boycotting tobacco can add years to your life. Consider these options:

Group support, counseling, and smoking cessation agents such as:

• Bupropion
• Varenicline (Chantix)
• Over-the-counter (OTC) nicotine replacement therapies like Nicorette, Habitrol, Nicotrol inhaler, or Nicoderm CQ

And this is not just idle talk -- the benefits of smoking cessation have been demonstrated in clinical trials in a wide range of patients. Cigar and pipe smoking are also linked with heart disease, and smokeless tobacco is highly addictive and can lead to oral cancers.

What's the Catch? Eat More Fish

Certain types of fatty fish contain omega-3 fatty acids and can be beneficial to your heart. Research has shown that omega-3 fatty acids can reduce your risk of heart disease and stroke. For example, you can get omega-3 fatty acids in 2 weekly servings of oily fish such as salmon, trout, sardines, herring, and tuna. Plus fish is low in unhealthy fats, high in protein, and it tastes great.

But should you take a fish oil supplement instead to keep your heart healthy? The American Heart Association (AHA) recommends:

• Eating 2 servings of fatty fish per week to reduce your risk of some heart problems.
• Shark, swordfish, king Mackerel, or tilefish contain high levels of mercury so avoid eating these fish. Seafood low in mercury includes shrimp, canned light tuna, salmon, pollock, and catfish.
• For people at high risk of heart disease, prescription supplements containing EPA (Vascepa) have been found to be beneficial. Some recent studies have raised questions about the benefits of combined EPA/DHA supplements (these are often found over-the-counter), so check with your doctor for the latest advice. Many experts no longer suggest the use of fish oil supplements that contain both EPA + DHA.
• The AHA does not recommend omega-3 supplements for people who do not have a high risk of cardiovascular disease.
• Pregnant women should follow their doctors order on fish consumption (due to mercury levels) and use of any fish oil supplements.

Know Your Heart Age

Just hit your 50th or 60th birthday? Congrats! But just how old is your heart?

Many Americans have a heart older than their age would suggest. The Centers for Disease Control and Prevention (CDC) provides information on 'Heart Age' to help you understand this number.

US adults typically have a heart age that is 7 years older than normal. In fact, 1 in 2 men have a heart age 5 or more years older than their actual age. For women, 2 in 5 have a heart age 5 or more years older than their actual age. Plus, about 3 in 4 heart attacks and strokes are due to risk factors that increase heart age.

Risk factors that increase your heart age (compared to your actual age) includes:

• smoking
• high blood pressure
• diabetes
• obesity

Having an ideal blood pressure (less than 120/80) lowers your heart age.

Learn More: Heart Age: Is Your Heart Older Than You?

To Drink or Not to Drink: That is the Question

Some (but not all) studies have shown positive benefits of moderate alcohol use on heart health. This means no more than two drinks a day for men 65 years of age and younger; and one drink a day for women and anyone over 65 years of age. Of course, no alcohol should be consumed if you are pregnant.

It's always best to talk to your doctor first to determine the risks and benefits of alcohol use in your specific case. If you don't drink, it's best not to start just because studies say it might be good for your heart. Non-alcoholic "mocktails" can be healthy and delicious too. If you choose to drink, moderation is key.

How is one drink defined? In the US, one alcoholic drink is considered:

• 12 ounces of beer
• 5 ounces of wine (about 150 mL)
• One shot (1.5 ounces) of 80-proof liquor (about 50 mL)

Obviously there are many reasons for people to avoid alcohol all together -- underage drinking, driving or operating machinery, pregnancy or trying to get pregnant, history of alcohol use disorder, certain medical conditions like liver disease and pancreatitis, and some drug interactions.

Moderate to high alcohol consumption (three or more drinks per day) are also linked with elevated risks for breast cancer in women. There is consistent evidence that breast cancer risk is higher for women consuming moderate to high levels of alcohol (three or more drinks per day) compared with abstainers. Compared to women who don't drink at all, even women who have three alcoholic drinks per week have a 15% higher risk of breast cancer, according to Breastcancer.org.

Again, if you don't drink, starting for health benefits is not recommended. If you do drink, don't drink more than recommended.

Destress for Success

Life is stressful. Work, money, kids, household chores and bills can all add up. That's why it's important to make time to destress.

Aim for a few changes in your life to control stress:

• A daily 30 minute walk or run, yoga, meditation, prayer, or even a warm aromatherapy bath can do wonders to ease the tensions of daily life.
• Have a warm cup of tea with a good book.
• Spend extra time with friends or family to discuss the days events, hopes, and future aspirations. Have a meal around the table instead of the TV. Focus on the good.
• Limit caffeine intake, especially later in the day, to boost the chances for a restful sleep (this includes soda).
• Put the electronics away -- at least 30 minutes before bedtime -- and that means the TV positioned right in front of your bed, too.
• Try to avoid the news cycle if it causes you anxiety. The constant barrage of social media, phone alerts and world news can often lead to ongoing and harmful stress.

See what works for you best. Choose at least one change.

Fiber and Fluid-Up

The US diet contains way too little fiber, thanks mainly to processed foods found on the grocery shelves. On average, we should be eating abut 25 to 30 grams of fiber per day. Fiber is great to help you feel full and keep your weight down, which is healthy for your heart. Plus, fiber helps to prevent constipation and straining.

Where to get fiber?

• whole grain breads, oatmeal, brown rice, high-fiber cereals
• beans and other legumes
• green peas
• apples, bananas and pears
• berries like raspberries and boysenberries
• whole wheat pastas

Fiber supplements like Fiberall (polycarbofil) or Benefiber (wheat dextrin) can also be added to a diet to boost fiber grams. Bloating and gas can be side effects, so start slowly with fiber supplements and work your way up.

Look at the nutrition labels at the store to find foods high in fiber (try to aim for 3 grams of fiber or higher per serving), and be sure to drink at least 6-eight ounce glasses of fresh water daily, too.

Watch Your Salt

One teaspoon of salt contains roughly 2,300 milligrams (mg) of sodium.

• The AHA recommends no more than 2,300 mg a day (one teaspoonful!) for an average person, and an ideal limit of no more than 1,500 mg per day for most adults (about two-thirds of a teaspoonful).
• If you have high blood pressure, aim for lower end of this range.
• The average American eats more than 3,400 milligrams of sodium each day, about 50% more than what experts recommend.

How do I cut back on salt?

• If cutting back on sodium is a goal for you, try to buy fresh vegetables, meats, and frozen foods without salt added. Canned soup and frozen meals are notorious for high salt content. Avoud prepackaged food that is notoriously high in salt content.
• Avoid monosodium glutamate (MSG), too. Check labels for other sources of hidden sodium.
• Cut back on salt slowly - but daily. Avoid fast food, and try to substitute with salt-free herbs and spices, vinegars and fresh lemon or lime juice.

Can I use a salt substitute?

• Some salt substitutes can be dangerous to your health and heart, and have drug interactions with certain medicines, like Angiotensin Converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARBs).
• ACEI and ARBs can promote high potassium levels (known as hyperkalemia). Adding extra potassium from salt substitutes can worsen high potassium levels, possibly leading to irregular heart rhythm, muscle weakness, nausea, vomiting, irritability, and diarrhea.
• Be careful with salt substitutes that switch out sodium chloride for potasium chloride. If you take an ACEI, ARB or potassium-sparing diuretic, don't use a salt substitute unless your healthcare provider agrees that you can.

Don't Snooze Over Your Sleep Apnea

Does your significant other complain about your snoring? Are you tired all day, wishing for a nap at 2 PM?

Snoring and daytime sleepiness may be a sign of a more serious problem, known as obstructive sleep apnea.

• If you think you might have sleep apnea, it's important to talk to your doctor and schedule a sleep study, some of which can be done at home in your own bed.
• Sleep apnea can increase your risk of a variety of heart-related problems -- from high blood pressure to heart failure to stroke -- so a diagnosis is key.

Talk to your doctor about the various treatments options, including:

• continuous positive airway pressure (CPAP) - commonly used
• certain sleep apnea oral appliances fitted by a dentist
• upper airway surgery

Keep A Check on Your Blood Sugar

Diabetes is not just hard on your kidneys. Preventing type 2 diabetes can help to lower your risk for heart disease, heart attack, stroke, dialysis, and possible amputation.

A regular adult check-up may include a blood sugar (glucose) test. High blood sugar can be the sign of pre-diabetes. Your doctor might order a random or fasting blood glucose test, an oral glucose tolerance test, or a hemoglobin A1c test to evaluate your blood sugar.

If you have pre-diabetes, it is important to:

• make changes in your food choices
• if you smoke, talk to your doctor about the best way to quit
• take your prescribed medications as directed
• get at least 30 minutes of exercise every day to help ward off full-blown diabetes.

Your doctor may decide to put you on a medication known as metformin (Glumetza, Riomet) too, an effective and commonly used type 2 diabetes medication.

Doctor's Order

Remember, heart disease is often called "the silent killer." High blood pressure and high cholesterol do not usually produce any symptoms - that is - not until you have chest pain, a heart attack, or a stroke.

That's why if you have hypertension (high blood pressure) or hyperlipidemia (high cholesterol, LDL, or triglycerides) -- it's important that you take your medicine as prescribed, even if you feel fine.

If you're over 40, you should have your blood pressure checked at least yearly by your doctor; more often if your doctor determines you need it.

Starting at age 20, the American Heart Association recommends all people be screened for lipids and other heart risk factors every 4 to 6 years. Risk factors might include:

• diabetes
• smoking
• older age
• high blood pressure
• obesity or overweight
• being male
• a strong family history of heart disease.

After age 40 or if you develop heart disease, your risk may increase and your doctor may recommend more frequent checks. Ask you doctor about the need for a heart "stress test", too. If you doctor prescribes medications to lower your blood pressure or cholesterol, it's important to take them.

Aspirin: A Wonder Drug That May Not Be For All

Aspirin is not for everyone. Low dose (81 mg) aspirin may be an option to lower the risk of a potentially fatal heart attack in some patients. The evidence is unclear whether aspirin use reduces the risk of colorectal cancer incidence or mortality, according to the latest USPSTF recommendations.

You and your doctor may decide that the benefits of daily low-dose aspirin for primary prevention (to lower the chance of a first heart attack or death) outweigh the risks if:

• You are 40 to 59 years of age AND have a 10% or greater 10-year cardiovacular disease risk (a number your doctor can determine). Evidence indicates that the net benefit of aspirin use in this group is small.
• You are not at a high risk of bleeding
• For patients initiating aspirin use, it would be reasonable to use a dose of 81 mg/day.

The USPSTF recommends against initiating low-dose aspirin use for the primary prevention of CVD in adults 60 years or older.

Aspirin can cause bleeding, and it's especially dangerous in the stomach. So it's important to take a daily aspirin for your heart ONLY if recommended by your doctor. Your doctor can weigh your risks of aspirin use compared to it's benefits; this decision is always made on a case-by-case basis, looking at health conditions, other medications, and family history.

And don't forget about other prevention measures: healthy blood pressure and cholesterol levels also reduce the risk of heart disease, and regular colonoscopy screening starting at age 45 can help prevent colon cancer.

Antioxidants and Vitamins: Worthwhile or Weak Evidence?

Antioxidants have been touted as having the ability to rid the body or toxic free radicals and lower the risk for heart disease. However, most clinicians do not recommend external high-dose vitamin or antioxidant supplements (beta-carotene, vitamin A, C and D) in healthy adults.

In fact, beta-carotene has been shown to increase the risk of lung cancer in some patients who smoke smoke tobacco or have occupational exposure to asbestos. In addition, the USPSTF recommends against the use of beta-carotene or vitamin E supplements for the prevention of cardiovascular disease or cancer. The evidence is insufficient to recommend for or against the use of other multivitamin supplements to prevent cardiovascular disease or cancer.

Plus, the fat-soluble vitamins -- A, D, E and K -- can be toxic in excessive doses; always ask your doctor before you use a fat-soluble vitamin. A well-balanced diet that includes fresh vegetables and fruits, dairy with vitamin D and limited sun exposure should be adequate for vitamin D and anti-oxidant levels in most people. However, older patients may need vitamin D supplementation. Some people do need vitamin supplements in certain situations, too, such as pregnancy or in severe vitamin deficiencies.

The USPSTF separately recommends that all persons who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400 to 800 μg) of folic acid.