Topic: Heart Attack Prevention

Dr. Lee:
What are proven measures for preventing heart attacks and strokes?

Dr. Gregory Thomas:

The best way to prevent heart attacks and strokes is to prevent the atherosclerosis (cholesterol buildup) of the arteries. The most important measures to prevent atherosclerosis include:

  1. Stopping smoking cigarettes; the day a person quits cigarette smoking that person decreases his/her chance of dying of a heart attack by 50% that same day! In other words the benefit of stopping cigarettes happens immediately.

  2. Lowering blood pressure to below 140 systolic and below 90 diastolic; controlling high blood pressure is especially important to prevent strokes. The brain arteries are more fragile than arteries elsewhere in the body. Untreated high blood pressure significantly increases the risks of stroke.

  3. Lowering total and LDL cholesterol in the blood; cholesterol in proper amounts is needed for making hormones and building cell membranes. But too much cholesterol, especially excess amounts of the bad LDL cholesterol, causes cholesterol to accumulate inside the inner (intimal) layer of the arteries. Cholesterol accumulation in the inner artery can cause narrowing and blockage of the heart arteries causing a heart attack. Whereas blockage of the arteries to the brain can cause stroke. Several studies have convincingly shown that lowering the LDL cholesterol reduces the risks of heart attacks and strokes.

  4. On the other hand, HDL is a good cholesterol that protects against atherosclerosis. Therefore, low HDL is a risk factor for heart attack while high HDL cholesterol is desirable.

  5. Physical activity ; regular exercise has been shown to decrease the chance of heart attacks. Regular exercise is important in maintaining proper body weight and maintaining the proper cholesterol metabolism. Regular exercise also helps to lower the LDL and raise the HDL cholesterol.

  6. The other issue is diabetes mellitus. It has been shown that people without diabetes have less chance of developing arteriosclerosis and artery blockages than people with diabetes. And in patients with diabetes, those patients who have better long term control of their blood sugar have less chances of having heart attacks or strokes than those with poor control of their blood sugar levels.

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Please remember, information can be subject to interpretation and can become obsolete.

For more information, please see Cholesterol Center.

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Last Editorial Review: 8/30/2000