Cardiovascular diseases, including heart disease and stroke, are the leading causes of death in New York, killing more than 67,000 residents each year, according to the state health department. Individuals can reduce their risk of cardiovascular disease by eating sensibly, being physically active and not smoking. Yes, you have heard it all before, but American Heart Month in February provides a good opportunity to take these messages to heart.

The single largest contributor to the risk of having a heart attack is smoking. Smokers are twice as likely to have a heart attack as nonsmokers, and they are between two and four times more likely to die suddenly from heart disease. Exposure to smoke in the home and at the workplace has also been shown to increase risk. The Medical Society of the State of New York has long been a forceful advocate for smoke-free work and public places.


Other cardiovascular disease risk factors include high blood pressure, elevated blood cholesterol levels, physical inactivity, poor diet and being overweight or obese. These factors often have an impact on each other. For instance, eating high-fat foods can cause weight gain and increased cholesterol levels. Being overweight increases the risk of diabetes and high blood pressure.

Although our bodies make all the cholesterol we need, we bring more in when we eat foods such as fatty meat, butter, cheese, egg yolks and shellfish. A soft, waxy substance, cholesterol cannot dissolve in your blood and travels through your body by carriers called lipoproteins. Low-density lipoprotein, often called “the bad” cholesterol, can join with other fats and substances and build up on the walls of your arteries. The buildup can clog arteries and reduce blood flow, leading to blood clots. A clot that blocks blood flow to your heart can cause a heart attack, and a clot that blocks blood flow to your brain can cause a stroke. High-density lipoprotein, the “good” cholesterol, carries the cholesterol away from the arteries and helps protect against heart attack and stroke.

The New York State Department of Health offers these cholesterol guidelines:

• Total blood cholesterol of 200 mg/dL or lower is considered optimal, between 200 and 240 mg/dL is considered borderline high and above 240 mg/dL is high.

• LDL cholesterol level below 100 mg/dL is optimal, 160 to 189 mg/dL is high and above 189 mg/dL is considered very high.

HDL cholesterol should not be below 40 mg/dL.

• High cholesterol can be controlled through healthy nutrition, physical activity and, if necessary, medication.

• High blood pressure increases the workload of the heart, causing it to enlarge and weaken. High blood pressure can be controlled by quitting smoking, making healthy food choices, losing excess weight, engaging in physical activity, restricting salt intake, moderating alcohol use and, when necessary, by taking medications.

• Being physically inactive is a contributing factor for heart disease. The New York State Department of Health and the Medical Society of the State of New York recommend that people of all ages engage in at least 30 minutes of physical activity on most or all days of the week. Even modest levels of low-intensity physical activity, such as walking for pleasure, gardening, housework and dancing, will provide increased cardiovascular fitness and reduce the risk of heart attack or stroke. Remember, the best exercise is the one you do.

• Poor nutrition can lead to many health problems, including high blood cholesterol levels, obesity and diabetes. A daily diet of foods that are low in saturated fat and calories have been shown to reduce the risk of cardiovascular disease. The state health department recommends eating five to nine servings of vegetables and fruits every day.


The following steps for making lifestyle changes were adapted from recommendations from the American Heart Association:

• Ask your physician for advice about nutrition and physical activity.

• Keep a record of your nutrition and activity goals and progress.

• Learn to read food labels to make wise choices.

• If having trouble quitting smoking, ask your physician for help.

• Be active in making decisions about your health and solving problems that can prevent following your physician’s advice.