On Valentine’s Day, Love Your Heart

February signals Valentines, chocolates, flowers and perhaps a quick checkup of your heart health. Health organizations across the country honor American Heart Month with an array of events and campaigns to help Americans prevent or address heart disease.

Heart disease is the leading cause of death in the United States, according to the National Heart, Lung and Blood Institute. To adhere to “heart-healthy living,” NHLBI experts urge adults to understand their personal risk of heart disease and make choices to reduce the risk.

A simplified approach to good cardiovascular health can be found in the American Heart Association’s strategy called Life’s Essential 8. These key measures include: embrace healthy eating, move your body, quit tobacco, sleep well, maintain a healthy weight, be a cholesterol control freak, keep blood sugar in check and know the blood pressure basics.

Your primary care physician can help address these factors during annual checkups, says Dr. Anthony R. Magnano, a cardiologist with Ascension St. Vincent's in Jacksonville. Magnano is board certified in cardiovascular disease with a focus in electrophysiology.

“We really try to regroup with each patient on all the different factors,” he says. “I think people lose sight of the value of a good prevention strategy. They sort of feel unempowered. For example, a big factor is body weight. People get accustomed to being heavier than a healthy body weight. I like to bring people back to preventive strategies.”

Lifestyle factors and family history both contribute to the risk of having a heart attack or stroke. But even a worrisome family history can be addressed, Magnano says. About 80% to 85% of cardiovascular risk can be addressed with preventive measures.

“If you have a family history but might think you will follow that pattern. But you don’t have to,” he says. “There are things we can do.”

A healthy body weight and regular exercise can make a big difference in altering risk. He recommends at least 30 minutes of exercise every day. He encourages people to think about four aspects of exercise.

“One is some sort of aerobic endurance. Brisk walking can be great for that,” he says. “Stretching and weight training helps to keep some muscle mass that tends to decline a lot with age. Work on balance and flexibility, for example, with yoga or Pilates.”

There are many tools today to help replace unhealthy foods in the diet. The American Heart Association has simplified the approach to a handful of basics:

• A wide variety of fruits and vegetables
• Whole grains and products made up mostly of whole grains
• Healthy sources of protein (Mostly plants such as legumes and nuts; fish and seafood; low-fat or fat-free dairy; and, if you eat meat and poultry, ensure it is lean and unprocessed.)
• Liquid nontropical vegetable oils such as canola, corn, olive, soybean and sunflower oils.
• Minimally processed foods
• Minimized intake of added sugars
• Foods prepared with little or no salt
• Limited or preferably no alcohol intake

A healthy diet can improve levels of both low-density lipoprotein and high-density lipoprotein cholesterol and triglycerides. But sometimes diet isn’t enough. People with high cholesterol should consider a statin, Magnano says. He says he sees a growing number of people who are resisting statin therapy because of misinformation on the internet. But the medications can be lifesaving.

“For a number of years, people have been reading things in the lay press about the harms of statin therapy,” he says. “I have people who say ‘I’m just not [taking a statin]. Some of these people have had coronary stents placed or have had heart attacks.”

Statins are safe medications, Magnon says. Moreover, side effects can almost always be successfully managed.

Another helpful class of medication is the GLP-1 agonist drugs that have revolutionized diabetes care, such as Ozempic and Wegovy, he says.

“This is a new avenue to get to a healthy body weight,” he says “But it’s too early to say a lot about the medications. For example, do you stay on them forever? It’s really a wide-open question about the long-term use and who should be using them.”

Other tips for good cardiovascular health relate to measures that people often don’t think about quite as much, such as adequate sleep and limiting alcohol intake. Research is accumulating that alcohol carries no health benefit, not even that glass of red wine that has long been touted as heart-healthy.

“There are a lot of mixed messages about alcohol, such as the idea that a couple of drinks every day will improve health. But no alcohol or very little alcohol is the best advice,” he says. “Atrial fibrillation (a serious condition that causes irregular heartbeat) becomes more frequent when people drink more alcohol. Alcohol also negatively impacts sleep.”

Almost every adult can make some changes to improve their heart health. Your primary care provider can offer personalized advice based on your own medical test results showing body weight, glucose levels, cholesterol levels, blood pressure and other objective measures, Magnano says.

“I think having a close relationship with a primary care physician can address most of these things,” he says. “We haven’t been perfect all of our lives, but we can always take an opportunity to regroup to improve our health.”