A cardiologist’s 10-step guide to preventing heart disease

3. Protect a healthy weight

Being overweight or obese shows excess white fat tissue. This type of tissue can increase the risk of heart disease, because it stores fat cells known as adipocytes that release substances that contribute to inflammation.

In studies, we have seen that glucagon-like peptide (GLP-1) drugs may reduce inflammation with weight loss and high-risk patients treated for obesity may be significantly reduced. Lean body weight also helps to protect against atrial fibrillation, the most common heart rhythm abnormality.

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4. Know and avoid metabolic syndrome and prediyabet

It is partly insulin resistance and metabolic syndrome problem due to obesity. In two out of three people with obesity, it has this syndrome, which has three of five features: high hunger blood sugar, high hunger triglyceride, high blood pressure, low high -density lipoprotein (HDL) and central fat (more than 40 inches of waist circumference [101cm] 35 inch for men [89cm] women).

Metabolic syndrome is available in a high rate of about 50 million Americans who do not have obesity. Prediabet usually overlaps with it. Prediabet is defined as a hemoglobin A1C (a measure of how much glucose adheres to your red blood cells) or as a hunger glucose between 5.7 percent or between 100 to 125 milligrams per decicerea.

Both metabolic syndrome and prediabetes have a risk of heart disease and may be prevented and faced by weight loss, exercise and optimal diet.

As the glucagon -like peptide pharmaceutical family goes to pills and less costs in the future, these drugs may be useful to reduce the risk in metabolic syndrome and prediabetes. For those with type 2 diabetes, the aim is to optimize glucose management and to optimize maximum attention to lifestyle factors.

5. Keep your blood pressure in a healthy range

Hypertension is an important risk factor for heart disease and is extremely common as it gets older. Optimal blood pressure is 120/80 mm Hg or lower. However, there is an increase in systolic blood pressure to approximately 130 mm HG for the hardening of the arteries with aging. Although it is widespread, it is still considered as raised.

Ideally, everyone should monitor blood pressure with a home device to ensure that they do not develop hypertension. A mild blood pressure abnormality typically heals with lifestyle changes, but more important heights will probably require medication.

6. Learn your genetic risk

Now we have tools to determine your risk of genetic coronary artery disease known as a pollenic risk score derived from a gene chip. Polenic term means hundreds of DNA variants associated with the risk of heart disease in the genome. This is very different from a family history, because we are a product of both our mother and our father’s genomes, and the way they come together in each of the DNA variants can change significantly for variant combinations.

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This means that you may have high or low risk for heart disease that is different from your familial pattern. People with high polygenic risk score provide the most benefits from drugs to low cholesterol, such as statins. A polygenic risk score can be obtained from a number of commercial companies, but is usually not covered by insurance.

I do not recommend that you get the calcium score of your coronary arteries through computed tomography (CT) screening. This test is used excessively and usually induce overwhelming anxiety in patients with high calcium score but do not have symptoms or well -intentioned risks. If you have symptoms that make you think of coronary artery disease, such as breast discomfort from exercise, it may be useful for mapping an AV angiogram coronary arteries. It is much more informative than calcium score.

7. Check your blood lipids

The main lipid abnormality that requires attention should be handled for low -density cholesterol (LDL) for people with high risk of heart disease. Although lifestyle improvements help, significant height typically requires drugs such as statin; Ezimibe; Bempedoic acid; or evolocumab (repatha), alirocumab (praluent) or inklisiran (leqvio). The higher the risk, the more aggressive LDL reduction can be considered.

It should be noted that strong statins such as rosuvastatin or atorvastatin are particularly linked to high doses of glucose intolerance and type 2 diabetes. Although this is not a common side effect, it requires attention because it is frequently missed from the lack of awareness.

A low high -density lipoprotein (HDL) cholesterol usually responds to weight loss and exercise. We would think that high HDL was an indication of “good cholesterol, but new evidence suggests that this is not the case and that it can reflect the increasing risk when it is too high.

To get a comprehensive risk assessment through your blood lipids, it is important to take the apolipoprotein B (APOB) test at least once, because about 20 percent of people have normal LDL and a high apobe.

High hunger triglycerides, such as low HDL, may show insulin resistance as part of metabolic syndrome and will often respond to lifestyle factors.

Lipoprotein, known as LP (A), should also be evaluated at least once because it shows the risk when it rises. The good news is that scientists are at the top of having medicines to lower it with five different drugs in late stage clinical studies.

8. Reduce exposure to environmental pollutants

In recent years, We have learned a lot about air pollution, germs and important pro-inflammatory effects of chemicals forever, all of which depends on the risk of higher heart disease. In a study, germs or nanoplastic on the artery wall were found in about 60 percent of more than 300 people. The researchers found four to five -fold heart attacks or strokes during a vicious inflammatory response around the plastics and three years of follow -up.

Although we need policy changes to address these toxic substances in the environment, the risk can be reduced by paying attention to air and water quality by using filtration or purification devices, less use of plastic water bottles and plastic storage and in general to be more conscious and careful than our widespread use.

9. Do not smoke

At this point, it should be well known that smoking is a strong risk factor for coronary artery disease and should be completely prevented.

10. Good sleep

Although we tend to bind sleep health with the brain and cognitive function, there is evidence that sleep regulations and quality are associated with less heart disease risk. Regularity means to be connected to a routine program as much as possible, and its benefit can be caused by the preference of our body to protect the circus rhythm. Sleep quality – Less interruption – and maximum deep sleep can be monitored with smart watches, fitness bands, rings or bed sensors.

Sleep apnea is quite common when breathing stops and starts during sleep, and is usually undoubtedly. So if you have difficulty sleeping or snoring loudly, talk to your doctor about excluding the situation. The test for sleep apnea may include control good oxygen saturation throughout his sleep. This can be done through a sleepwork or at home, using rings or smart watches containing oxygen saturation and disturbing breathing body movement algorithms.

Eric Topol is the Vice President of Scripps Research in San Diego. He is the author of “Super Agers: Long -Life Evidence Based Approach ve and the authors of the ground realities in the causal hide.

Washington Post