Healthy Heart

How much difference can diet and exercise really make on the health of my heart and cardiovascular system?

Having a low saturated fat, low cholesterol diet and getting regular exercise are excellent health habits for all women to have. These good health habits will lower blood pressure and keep blood sugar and blood cholesterol levels healthy. Studies have shown that being physically active decreases the risk of cardiovascular disease, high blood pressure, and diabetes.

Women, along with most Americans, are becoming more and more inactive. About 60% of American women do not engage in the recommended amount of physical activity needed to maintain health. The Surgeon General recommends getting 30 minutes of moderate activity on most, and preferably all, days of the week to protect heart and overall health. This includes activities such as brisk walking, bicycling, and gardening. You do not have to do the activity for 30 minutes in a row; you can divide it into shorter periods of at least 10 minutes each. Women who have had heart attacks might worry about exercising after their recovery. Studies have shown that people who include regular physical activity in their lives after a heart attack, improve their chances of survival. If you have had a heart attack, talk with your health care provider about developing an exercise plan.

How does high blood cholesterol affect my risk for heart and cardiovascular disease?

Over 25 percent of American women have blood cholesterol levels high enough to put them at risk for heart disease. Cholesterol is a waxy substance found in all parts of the body. It makes cell membranes, some hormones, and Vitamin D. Cholesterol comes from two sources: your body and the food you eat. Your liver makes all the cholesterol your body needs. Eating too much cholesterol in animal foods like meats, whole milk dairy products, egg yolks, poultry, and fish can make your cholesterol go up. However, saturated fat in your diet is the main culprit that causes your cholesterol to rise.

Cholesterol travels through the blood in packages called lipoproteins. Low density lipoprotein (LDL) and high density lipoprotein (HDL) are two types of lipoproteins. LDL is often called the "bad" type of cholesterol because it can cause buildup and blockage in the arteries that carry blood to your heart. HDL is known as "good" cholesterol because it helps remove cholesterol from the blood, preventing buildup and blockage in the arteries. The higher your cholesterol, the greater your risk for heart disease.

From the time women turn 20 years old, their blood cholesterol levels start to rise. From age 40, they rise sharply and increase until about age 60. Being overweight and physically inactive also can raise your level of bad (LDL) cholesterol and lower your level of good (HDL) cholesterol. Family history (genes) can also affect how your body makes and handles cholesterol. All women age 20 and over need to have their blood cholesterol checked. High blood cholesterol is an important risk factor for heart disease that you can help control with diet, exercise (which will increase HDL and lower LDL), and quitting smoking. In some cases, your health care provider might prescribe cholesterol-lowering medication.

I had my cholesterol checked but I do not understand the results. What do they mean?

Talk to your health care provider about the results of your cholesterol test. The following guidelines come from the National Cholesterol Education Program (NCEP) of the National Heart, Lung, and Blood Institute, National Institutes of Health. Cholesterol levels are measured in milligrams (mg) of cholesterol per deciliter (dL) of blood.

• Total cholesterol level - a level of less than 200 mg/dL is desirable. But even levels of 200-239 mg/dL (borderline high) can increase your risk of heart disease.

  Total Cholesterol Level	Category
  Less than 200 mg/dL	Desirable
  200 - 239 mg/dL	Borderline high
  240 mg/dL and above	High

• LDL (bad) cholesterol - a level of 160 mg/dL or above is high. Work with your health care provider to determine a goal LDL level that's best for you.

  LDL Cholesterol Level	Category
  Less than 100 mg/dL	Optimal
  100-129 mg/dL	Near optimal/above optimal
  130-159 mg/dL	Borderline high
  160-189 mg/dL	High
  190 mg/dL and above	Very high

• HDL (good) cholesterol - a level of 60 mg/dL or more is good and helps to lower your risk for heart disease. Remember that HDL (good) cholesterol protects against heart disease, so for HDL, higher numbers are better. A level less than 40 mg/dL is low and increases your risk for developing heart disease.

• Triglyceride levels - can also raise your risk for heart disease. Levels that are borderline high (150-199 mg/dL) or high (200 mg/dL or more) may need treatment in some people.

You can also talk with your health care provider about what you can do to help control your cholesterol, including:

• getting your cholesterol checked, understanding what the numbers mean;

• controlling your weight;

• following a treatment program your health care provider prescribes (such as medication and cutting back on foods high in saturated fat and cholesterol);

• exercising regularly (for 30 minutes, most days of the week);

• quitting smoking.

How do I know if I have heart or cardiovascular disease? Are there any tests?