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Dr. K’s 10 RULES to Lower Your Heart Disease Risk

Dr. K’s 10 RULES to Lower Your Heart Disease Risk. Peter Klementowicz MD FACC Director, Cholesterol Management Center Catholic Medical Center. # 1: Smoking Keeps Me in Business. No smoking Minimize exposure to second hand smoke. # 2: Do Not Ignore Your Family.

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Dr. K’s 10 RULES to Lower Your Heart Disease Risk

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  1. Dr. K’s 10 RULES to Lower Your Heart Disease Risk Peter Klementowicz MD FACC Director, Cholesterol Management Center Catholic Medical Center

  2. # 1: Smoking Keeps Me in Business • No smoking • Minimize exposure to second hand smoke

  3. # 2: Do Not Ignore Your Family • If your brother or father had a heart attack, required a stent, underwent bypass surgery or had a stroke before the age of 55, then you are at risk. • If your sister or mother had a heart attack, required a stent, underwent bypass surgery or had a stroke before the age of 65, then you are at risk.

  4. # 3: Exercise is a Medicine • 30 minutes of moderate intensity aerobic physical activity five days a week • Walking at 3.0 mph is 3.3 METS • Walking at a brisk pace (4mph) is 5.0 METS • Vigorous intensity aerobic activity for a minimum of 20 minutes three days a week. • Jogging at 5mph is 8.0 METS

  5. # 3: Exercise is a Medicine • Your minimum goal is 450 MET min/wk to 750 MET min/wk. • Comprehensive listing of MET values: http://prevention.sph.sc.edu/tools/compendium.htm

  6. # 3: Exercise is a Medicine

  7. # 3: Exercise is a Medicine Aerobic Interval Training 90% 70% MPHR TIME (Maximum Predicted Heart Rate=220-Age)

  8. # 3: Exercise is a Medicine • If you are older than 50 years old and plan to run a marathon, you should consider having a coronary artery calcium score performed.

  9. # 4: Have a Nutritional Plan • Balance caloric intake and physical activity to achieve or maintain a healthy body weight. A healthy body weight is currently defined as a body mass index of 18.5 to 24.9 kg/m2. • The lowest risk related to BMI, a BMI of 25.3 for men and a BMI of 24.3 for women • Avoid fast food restaurants. • No sugary drinks.

  10. # 4: Have a Nutritional Plan • Consume a diet rich in vegetables and fruits. • Choose whole grain, high fiber foods. • Limit your intake of saturated fat to <7% of energy; eliminate trans fats • Choose lean meats and vegetables • Select fat-free, 1% fat and low fat diary products

  11. # 4: Have a Nutritional Plan • If you need to lose weight, strongly consider adopting a Low Glycemic Index Diet.

  12. # 5: Eat a Fish • Consume fish, especially oily fish, at least twice a week • Avoid frying the fish or using cream sauces.

  13. # 5: Eat a Fish Grams of fatty acid per 3 oz of fish, cooked

  14. # 5: Eat a Fish • If you do not like to eat fish, take fish oil capsules instead. You should consume between 500 mg and 900mg of EPA+DHA. • When buying fish oil capsules, ignore the dose listed on the front label.

  15. # 6: Drink Alcohol Responsibly TOTAL MORTALITY RELATIVE RISK 1 0 1 2 3 4 5 6 DRINKS/DAY

  16. # 7: Do Not Develop Diabetes • Normal Blood Glucose: < 100 mg/dl • Impaired Fasting Glucose: 100-125 mg/dl • Diabetes Mellitus: ≥126 mg/dl • Determine your risk of developing Diabetes Mellitus

  17. # 7: Do Not Develop Diabetes • If you are at risk of developing diabetes Mellitus, you should: • Lose 7% of your weight over a 6 month period of time • Exercise at least 150 minutes/week

  18. # 8: Measure Blood Pressureat Home • Use a fully automated device with an upper arm cuff that has been validated by the Association for the Advancement of Medical Instrumentation

  19. # 8: Measure Blood Pressure at Home • Measure BP • No tobacco or caffeine for 30 minutes preceding measurement • After 5 minutes of rest • With arm at heart level, back supported and feet flat on the floor • On non-dominant arm (or arm with the highest BP)

  20. # 8: Measure Blood Pressure at Home • Base decisions on a 7-day measurement period with 2-3 measurements each morning and 2 to 3 measurements in evening at pre-stipulated times (an average of 12 morning and evening measurements)

  21. Target BP goals Normal blood pressure <125/75 mmHg 130/80 mmHg if you have diabetes, coronary heart disease or chronic kidney disease 135/85mmHg # 8: Measure Blood Pressure at Home

  22. # 9: Use NSAIDs Wisely Cardiovascular Gastrointestinal Risk Risk Rofecoxib Diclofenac Naproxen Celecoxib Ibuprofen

  23. # 9: Use NSAIDs Wisely • If you take immediate release low dose Aspirin( 81mg) and Ibuprofen 400mg, take the Ibuprofen at least 30 minutes after the Aspirin or at least 8 hours before taking the Aspirin.

  24. # 10: You Do Not Need Most Vitamin Supplements • These do not prevent heart disease: • Beta carotene • Folate • Selenium • Vit B6 • Vit B12 • Vit C • Vit E

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