Heart health. If you love your heart, how can you best care for it? How can you keep your heart healthy and happy?
As of 2020, heart disease is the leading cause of death (20%) in the US. 1 in 5 of those happen before age 65. Heart disease costs the US over $200 billion each year.
Here’s the latest science to avoid personal heartbreak.
What’s In Your Heart?
Your heart is a muscular organ about the size of a closed fist which is located between your lungs. It pumps blood through your circulatory system to deliver oxygen and nutrients, while also transporting metabolic waste such as carbon dioxide to your lungs.
The heart pumps blood with a rhythm determined by a group of pacemaker cells. These generate a current that causes the heart to contract.
Key Heart Health Risk Factors
High blood pressure (hypertension), high blood cholesterol, and smoking are the top risk factors for heart disease.
Also, you are at a higher risk for heart disease if you have these medical conditions or lifestyle impacts, including:
- Diabetes
- Obesity
- Unhealthy diet and/or microbiome
- Physical inactivity
- Excessive alcohol use
- Loneliness and lack of social interaction
Heart Health Monitoring
How can you set your heart health baseline to determine how healthy your heart is? Beyond what you can get with your annual physical, there are private companies which will provide a full body scan of your heart and circulatory system as part of setting your health baseline. They detect aneurysms and other dangerous conditions.
Cardiovascular diseases do not frequently have symptoms but as they progress may cause chest pain or shortness of breath. Diagnosis of heart disease is often done by taking a medical history, then listening and watching with a stethoscope, ECG, echocardiogram and ultrasound.
There are also options for continuous heart monitoring devices to get feedback on your heart health to make sure it has a proper rhythm.
Optimal Heart Rate Ranges
The normal resting heart rate for adults ranges from 60 to 100 beats per minute. Generally, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness. For example, a well-trained athlete might have a normal resting heart rate closer to 40 beats per minute.
When exercising, according to John Hopkins Medicine, aim for between 50 percent and 85 percent of your maximum safe heart rate. Your maximum rate is based on your age, as subtracted from 220. For example, if you are a 50-year-old, your maximum heart rate is 220 minus 50, or 170 beats per minute. Your exercising range is then 85 to 145 beats per minute.
If at rest, your heart rate exceeds 100 beats per minute (tachycardia), then consult with your primary care physician. If your resting heart rate rises towards your exercising maximum, seek emergency medical attention.
Heart Health Optimal Cholesterol Ranges
During your annual physical, you will receive advanced diagnostic blood testing including tests of your cholesterol levels. Despite what you may think, cholesterol is one of the most important elements in your brain. Without it, you wouldn’t be able to think! Your brain contains about 25% of your total cholesterol, a separate pool than circulates in your blood. Low brain cholesterol leads to mental health issues such as memory problems and/or depression. See this well-researched article for more on the actual importance of cholesterol to your body and the surprising background on the studies which led to the emphasis on cholesterol reduction.
Yes, you’ve likely heard correctly that high cholesterol levels are dangerous. They can lead to atherosclerosis (narrowing of your arteries), heart attack, stroke and peripheral arterial disease.
Lipoproteins are particles that transport fats throughout the body. These particles are essential and carry a combination of proteins, vitamins, cholesterol, triglyceride, and phospholipid molecules. The composition of a lipoprotein particle changes as it circulates in the blood. Some molecules are removed and others are added, resulting in lipoprotein particles with variable amounts of cholesterol. LDL-P is the number of lipoprotein particles. Your LDL-C level is the amount of cholesterol carried by them. HDL (high density lipoprotein) helps carry LDL cholesterol from the arteries to the liver, where the body can use it or excrete it.
The most dangerous situation is when your number of LDL particles (LDL-P) is high. This occurs when they are leftover as bi-products of fat transport and remain in circulation for an extended time. While in circulation, LDL-P can penetrate arterial walls and get stuck, forming fatty plaques. These plaques can build over time and lead to blockages, resulting in heart attacks and strokes. The likelihood of LDL-P getting trapped in an artery wall increases when more LDL-P is in the blood. Increased LDL-P could be one reason that some people have heart attacks even though their total cholesterol and LDL-C levels are not high. Studies have shown that carbohydrate-restriction can reduce LDL-P. Making these lifestyle and dietary changes can help too. If those don’t work enough, statins, potentially combined with Zetia are the typical medical prescription.
Medical standards for optimal health are to keep:
- LDL-C (low-density lipoprotein-cholesterol) level < 100 mg/dl.
- LDC-C mg/dl > 50. We are born with an LDL level of 30–40 mg/dl.
- LDL size > 20.5nm.
- LDL-P < 935 nmol/L. (number of LDL particles)
- Small LDL-P < 435 nmol/L.
- APO-A: for men, 110 to 180 mg/dL; for women, 110 to 205 mg/dL
- APO-B: for men, 66 to 133 mg/dL; for women, 60 to 117 mg/dL
LDL size < 20.5 nm and increased small LDL-P are common in individuals with prediabetes, diabetes, and insulin resistance.
For HDL cholesterol, a minimum of 40 mg/dl for men and 50 mg/dl for women is the standard. The optimal target is a little below 60 mg/dl for efficient transport of cholesterol from the arteries to the liver, where the body can use it or excrete it. Going above 60 mg/dl of HDL may be dangerous in part because it can slow the process of clearing LDL cholesterol from your arteries. HDL levels can be boosted through exercise, quitting smoking or consuming olive oil and other healthy fats. Medications that specifically increase HDL levels have failed to reduce the rate of heart attacks. Drugs containing testosterone and other anabolic steroids can lower your HDL cholesterol levels.
Within your HDL count, is a count of HDL-P, the measurement of HDL particle number concentration. From clinical trial analysis, HDL-P appears to be a better marker for heart attack and stroke risk than HDL or apolipoprotein A-1 (apoA-1, the major protein on HDL). Optimal HDL-P ranges are above 32.8 micromoles/liter.
Cardiac Calcium Heart Risk
A heart computerized tomography (CT) scan creates multiple images to identify plaque deposits in your blood vessels.
Plaque inside the arteries of your heart can grow and restrict blood flow to the muscles of your heart. They can break off and cause blockages. Measuring calcified plaque with a heart scan allows your doctor to identify possible coronary artery disease before you have signs and symptoms.
The result of the test is usually given as a number called an Agatston score. The score reflects the total area of calcium deposits and the density of the calcium. When calcium is present, the higher the score, the higher your risk of heart disease. The Multi-Ethnic Score of Atherosclerosis (MESA) calculator can determine your risk of coronary heart disease within ten years. Unfortunately, your body does not naturally remove coronary calcium so your risk continues to increase through your lifetime.
To gather more detail if your cardiac calcium score is elevated, you can take a Cleerly coronary computed tomography angiography (CCTA) test to evaluate the presence and type of plaque in a patient’s heart arteries, along with stenosis and ischemia. Physicians may then prescribe statins, potentially combined with Zetia, to slow the increase in coronary calcium and to solidify the existing deposits to reduce the chance they break off and clog an artery.
Companies like Shockwave Medical have created treatments to break up and remove high risk cardiac calcium. These treatments do involve surgery and are typically done in combination with stents. A healthy diet low in red meat, processed meat, fried foods, sweets and dairy is even better to avoid this procedure.
The Rhythm of Your Heart
Heart arrhythmia treatment may be needed if an irregular heartbeat is causing you significant symptoms, or if the condition is putting you at risk of more-serious heart problems.
Treatment for heart arrhythmias depends on whether you have a fast heartbeat (tachycardia) or slow heartbeat (bradycardia). Some heart arrhythmias do not need treatment. Your doctor may recommend regular checkups to monitor your condition.
Treatment for heart arrhythmias may include medications, therapies such as vagal maneuvers, cardioversion, catheter procedures or various heart surgeries including installing a pacemaker.
Salt
The 2020–2025 Dietary Guidelines for Americans recommend that Americans consume less than 2,300 milligrams (mg) of sodium each day as part of healthy eating. However, about 90% of Americans consume more than 3,400 mg daily.
If you consume too much sodium, your kidneys cannot process all of it. The remaining sodium elevates your blood pressure, putting you at risk for a heart attack, cardiac arrest, kidney failure or a stroke.
CPR
Cardio-pulmonary resuscitation (CPR) training takes only a couple of hours and you could save someone’s life.
Before discussing CPR, it is important to know the difference between a heart attack and cardiac arrest. A heart attack is when blood flow to the heart is interrupted, usually by a blood clot, whereas sudden cardiac arrest is when an electrical malfunction in the heart causes it to stop beating. A heart attack can lead to cardiac arrest.
If someone is having a heart attack but is alert with a steady heartbeat, CPR is not appropriate.
If someone goes into cardiac arrest, it is recommended that adults start CPR and provide 100-120 chest compressions per minute. That is fast and tiring to deliver. However when CPR is performed in the moments after someone goes into cardiac arrest, the chances of survival are double or triple what they would be if that person waited for paramedics or emergency room treatment.
When performing CPR and the person shows signs of life, such as open eyes and regular breathing, stop CPR immediately. Allow the person to recover, but be prepared if the individual’s heart stops beating again.
Heart Health Key Factors
Beyond the bad things above which damage your heart and circulatory system, what can you do to improve your cardiovascular health? Almost all of the 24 Key Factors to Keep Health in 2024 benefit your heart health. Find it in your heart to follow them. See also our tips for Bloody Good Health.
Heartfelt Conclusion
Thanks for reading and taking care of yourself. In reward for focusing on your health, see this skit from heart attack comic Norm Macdonald to find out why he doesn’t love his heart. After watching, you may want to go buy a defibrillator. It might save your life.
