Heart Health

Three to Thrive: Three Behaviors That Change Everything

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The American Heart Association recommends the "Simple Seven" - seven steps to reduce your risk of heart disease, stroke, and diabetes. 

I'm going to make it even more simple.  There are really only three main things you need to focus on to improve your health and well-being, and if you get these three things right, it follows naturally that you greatly increase your chances of achieving the rest of the Simple Seven.

Three to Thrive

  • Be Physically Active
  • Eat a Healthy Diet
  • Don't Smoke

Sounds simple, right?  Common sense?  Yes and yes.  But not so easy in a sedentary world filled with unhealthy but delicious food choices and seemingly endless binge-worthy shows to watch, along with work that is all to frequently done sitting at a desk. 

Perhaps the easiest habit (if you never take it up) is the third - don't smoke.  But anyone who has ever come under the nicotine spell knows how hard the chains are to break.

But you can take control by making changes in your habits in each of these areas that will lead to lifelong and life-prolonging improvements in your health.  Start small, make one little change, and keep at it until that change becomes a new, healthy habit.  Then make another small change.  Small improvements over time really add up!

National Nutrition Month

Welcome to March which is National Nutrition Month.  This month, I will be sharing tips for healthy eating.  And since we are just coming off of Heart Month in February, the first tip is to eat 10 fruits and vegetables a day for your heart.

Eating 5 servings of vegetables and 5 servings of fruit a day helps to lower your blood pressure.  Look for a variety of colorful fruits and vegetables for a great mix of vitamins and nutrients.


Women and Heart Disease - What Are the Risk Factors for Heart Disease?

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Could you be at risk for heart disease?

Many risk factors play a part in heart disease.  Some of those risk factors are out of our control.  Those risk factors are:

  • Age
  • Gender
  • Family history of heart disease
  • Race
  • Previous stroke or heart attack
80% of heart disease and stroke events can be prevented

But the good news is that a whopping 80% of heart disease and stroke events can be prevented by making changes in the risk factors we can control.

Those risk factors are:

  • High blood pressure
  • Smoking
  • High blood cholesterol
  • Lack of regular activity
  • Obesity or overweight
  • Diabetes

Additional lifestyle factors that can contribute to heart disease, high blood pressure, and stroke include stress and lack of sleep.

Let's talk about each of these areas individually.

High Blood Pressure

In 2017, the American College of Cardiology and the American Heart Association released new blood pressure guidelines. 

Blood pressure categories in the new guideline are:

  • Normal: Less than 120/80 mm Hg;
  • Elevated: Systolic between 120-129 and diastolic less than 80;
  • Stage 1: Systolic between 130-139 or diastolic between 80-89;
  • Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
  • Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage. (Source:  American College of Cardiology)
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If you are in the elevated or Stage 1 category, your goal should be to make lifestyle changes now to control your blood pressure.  If you are in stage 2, you should discuss with your physician if you need medication to help manage your blood pressure, or if you can control your blood pressure through lifestyle changes alone.  In either category, lifestyle changes will be necessary to successfully manage your blood pressure.

Track your blood pressure


Cigarette smoking is one of the major risk factors for heart disease - in fact, smoking increases your risk of cardiovascular disease by 2 to 4 times.  Women who smoke have a 25% higher risk of heart disease than men who smoke (Source:  American Heart Association).

The chemicals in tobacco smoke damage the cells in the body, including the heart and the blood vessels.  Smoking increases the "bad" LDL cholesterol and decreases the "good" HDL cholesterol, and increases triglycerides, leading to more plaque formation in the artery walls.  Smoking raises blood pressure and heart rate.  Smoking also makes blood "sticky" and more likely to clot, blocking blood flow to the heart and brain.  And the carbon monoxide in smoke decreases the amount of oxygen in your blood that can reach your heart, brain, and body.

No wonder smoking can make you feel so out of breath and tired!

Second-hand smoke is also dangerous - even breathing second-hand smoke for a few minutes can damage the lining of your blood vessels and cause your blood to become stickier.  

If you smoke and have other risk factors for heart disease such as high cholesterol, obesity, or diabetes, your risk significantly increases.

The good news is that smoking is the most controllable risk factor of all, and quitting smoking can cut your risk of heart disease in half in just one year!

We can all make small changes in these areas that can really pay off in terms of decreasing our risk for heart disease, high blood pressure, peripheral arterial disease, and stroke.  

High Blood Cholesterol and triglycerides

Cholesterol is a waxy substance that is used to help build cells.  We actually need cholesterol in our bodies.  Cholesterol is made in the liver, and the liver makes all the cholesterol our bodies need.

There are two types of cholesterol.  We talk about these two types of cholesterol as being the "good" cholesterol and the "bad" cholesterol.  

Bad Cholesterol

Low Density Lipoprotein, or LDL for short, is the bad type of cholesterol.  This type of cholesterol builds up in the artery walls as part of plaque, contributing to hardening and thickening of the arteries, and increased risk of cardiovascular disease.  The higher the level of LDL in your bloodstream, the higher your risk of heart disease is.

Good Cholesterol

High Density Lipoprotein, or HDL for short, is the good type of cholesterol.  Think of HDL cholesterol as the cleaner in your blood.  It travels through the bloodstream scooping up LDL cholesterol and carrying it back to the liver to be broken down and eliminated from the body.  Higher levels of HDL in the body protects against cardiovascular disease.  Low levels of HDL in your bloodstream increase your risk of heart disease.


Triglycerides are another type of fat found in your blood.  When you take in more calories than your body can use, your body converts those calories into triglycerides and stores them in your fat cells.  When your body needs energy, your body releases the triglycerides into the bloodstream.  

Some foods that we eat are associated with higher levels of bad LDL cholesterol and triglycerides in our blood, especially diets high in refined carbohydrates, saturated fats, and trans fats.

Women with high cholesterol or high triglycerides do not necessarily experience symptoms so it is important to be tested for your levels.  The American Heart Association recommends that all adults over the age of 20 be tested for cholesterol and triglyceride levels every 4 to 6 years.  This test is called a "lipid profile" or a "lipoprotein profile" and is a simple blood test.

lack of regular activity

It's no secret that our society as a whole has become less active over the past fifty years.  With an increase in jobs that are sedentary and increased usage of computers for daily work, people are more likely to sit.  In fact, we sit on average 12 hours a day, but are bodies evolved to move.  When we sit for long hours, our bodies burn fewer calories, our blood glucose and triglycerides rise, and we are at increased risk for high blood pressure and heart disease, as well as other chronic conditions such as weight gain, stress, and type 2 diabetes. 

Reducing the amount of time you spend sitting and regular physical exercise such as daily walking for 30 minutes is linked to a lower risk of cardiovascular disease and heart attack.

obesity or overweight

According to the American Heart Association, nearly 70% of Americans are either overweight or obese.  Obesity and overweight relate to the amount of body fat you have based on your body mass index (BMI) measurement.  Your BMI is your weight in kilograms divided by the square of your height in meters, and the CDC provides a calculator online if you want to find out your BMI.  The BMI is not without its detractors, but it is a useful screening tool in most cases to determine if you are carrying around more body fat than you should.

If you have over 30 percent body fat, you are considered to be obese, and if your body fat percentage is higher than between 25 and 30 percent, then you are considered to be overweight.  

Obesity and overweight increases the risks for heart disease and stroke because of their association with higher cholesterol, higher blood pressure, and higher risk for type 2 diabetes.  According to the World Health Organization, obesity and overweight are associated with more deaths worldwide than underweight.  Visceral fat, deep in the abdomen, has been associated with inflammation leading to insulin resistance and diabetes.  And obesity and overweight have been linked to an enlarged left ventricle in the heart which can lead to heart failure.


Diabetes is one of the major risk factors for cardiovascular disease.  Adults with diabetes are two to four times more likely to die of heart disease than adults who do not have diabetes.  Diabetes is associated with high blood pressure, high cholesterol, and high triglycerides.  Diabetes can contribute to earlier and more severe heart disease, less successful outcomes, and higher risk of death and disability.  For people who have diabetes, the higher their blood sugar is, the higher risk they have of developing heart disease. 

As you may have gathered as you read through these controllable risk factors, they are all interlinked.  Each risk factor by itself increases your risk of cardiovascular disease; however, they rarely come by themselves.  Most often, people have two or more risk factors, greatly increasing the chance they may be affected by heart disease, stroke, and/or peripheral vascular disease. 

Overweight and obesity, diabetes, high blood pressure, high cholesterol, lack of physical activity, and smoking are all controllable risk factors, meaning we can take action to improve our odds.  In the next series of articles, we will explore what we can do to improve each risk factor.  When you improve one risk factor, you will improve all of them, and give yourself the best chance to increase your heart health.

Learn how you can  Love Your Heart

Learn how you can Love Your Heart

Women and Heart Disease - Some Basic Definitions You Need to Know

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So just what is "heart disease"?  Actually, "heart disease" is a big umbrella term that covers a lot of diseases.  To make it easier to understand, let's start with some definitions.  We will get very basic here, because not everyone has a degree in a medical field, and health class was a long time ago.

Arteries - the blood vessels that carry oxygen-rich blood away from the heart to all the cells in your body.  Your cells depend on the oxygen carried by this blood to function.

Veins - the blood vessels that carry blood back to the heart from all the parts of your body.  

The heart pumps oxygen-rich blood out through the arteries, and it travels throughout every part of your body, delivering oxygen and nutrients to the cells.  The cells take the oxygen and nutrients and exchange waste products like carbon dioxide.  The blood then enters the veins to travel back to the heart.  Once it reaches the heart, the blood is re-oxygenated by the lungs and the cycle starts over.  

As you can imagine, the heart has an easier time pumping all this blood around if the arteries and veins are clear and free of blockages.  

However, blockages do occur in the form of plaque and clots.

What is Plaque?

Plaque is a material made up of fatty substances, cholesterol, cellular waste, calcium, and fibrin (a material in blood that helps it to clot).  Plaque builds up inside the artery walls.  Recall that arteries are the vessels that take oxygen from the heart to the rest of your body.  When plaque builds up, it's kind of like sludge building up inside a plumbing pipe that slows down and could eventually stop the flow.  This narrowing of the arteries can keep vital oxygen from reaching the parts of the body downstream from the narrowing or blockage.

What is Atherosclerosis?

Atherosclerosis is the term for this build up of plaque in the artery walls.  Plaque begins building up in the arteries as early as childhood.  Scientists don't know exactly what causes atherosclerosis, but they do know what makes it worse:

  • High levels of bad cholesterol (LDL) and triglycerides in the bloodstream
  • High blood pressure
  • Cigarette smoking

If plaque breaks off or a blood clot forms at the area of a plaque, a complete blockage can occur in the artery.  Cells downstream that can't receive the oxygenated blood begin to die.

What is Arteriosclerosis?

Arteriosclerosis is sometimes called "hardening of the arteries."  Healthy arteries should be flexible and elastic, but as we age, they become stiff and inflexible.  Some arteriosclerosis is expected with aging, but build up of plaque makes it worse.

Now let's break down the umbrella term of "heart disease" into smaller categories.  To begin with, let's think in terms of three parts of the body:  The heart itself, the blood vessels in the rest of the body, and the brain.

What is Coronary Artery Disease (CAD)?

Coronary Artery Disease (CAD) is the build up of plaque in the arteries in the heart that supply oxygen to the heart muscle itself.  Over time, the arteries become narrow and hardened, and the heart muscle gets less oxygen.  

What Is Angina?

Angina is a condition in which the heart muscle is not getting enough oxygen because of narrowed, hardened coronary arteries, causing pain and discomfort in the chest.  Other symptoms can include pain in the jaw, shoulders, arms, neck, or back.  Angina may feel like pressure, or even indigestion.  Symptoms in women can differ from those in men (and from the classic symptoms you might think of when you think of heart pain), especially in being more vague and less focused to a specific area. 

Over time, the lack of adequate oxygen can damage the heart, leading to more problems.

What Is a Heart Attack?

Heart attack occurs when an artery in the heart becomes completely blocked by plaque or a blood clot.  The heart muscle that is supplied by that artery is starved of oxygen and nutrients and begins to die if blood flow is not quickly restored.  This emergency condition can lead to death or serious disability.

What Is Heart Failure?

Heart failure is not the same thing as a heart attack.  Over time, a combination of high blood pressure and hardening of the arteries causes the heart muscle to have to work harder and harder.  As a result, the muscle can become larger, stiffer, and less efficient at pumping blood through the body.  A healthy heart would be like a beach ball with a valve in it. If you squeezed the beach ball, you could easily squeeze the water out.  But in heart failure, imagine the heart is now more like a basketball filled with water.  You could still squeeze the water out, but you would have to squeeze really hard. 

This condition is often also called "congestive heart failure."  Because blood is being inefficiently pumped through the body, the kidneys try to compensate by retaining fluid in the body.  This extra fluid leads to congestion in the lungs (pulmonary edema) and difficulty breathing, and swelling in other parts of the body, especially the legs, feet, and abdomen.

Now, let's talk about the blood vessels.

The Blood Vessels

When plaque builds up in arteries in the limbs, especially the legs and feet, blood flow is diminished.  This condition is called Peripheral Arterial Disease (PAD).  People with PAD may experience cramping pains during exercises such as walking because the muscles in the legs aren't getting the oxygen they need.  Continued poor blood flow can lead to poor wound healing and gangrene, and it not corrected, amputation.

In the Brain

What does the brain have to do with heart disease?  Well, I'm glad you asked!

Just like the arteries around the heart and in the limbs, the arteries supplying the brain can be narrowed or blocked by arteriosclerosis and plaques and blood clots.  

When a blood vessel supplying the brain becomes blocked, the brain is starved of oxygen and experiences an ischemic stroke.  Just as in the heart, when the brain cells are deprived of oxygen and nutrients, they begin to die, and permanent damage can occur if circulation is not quickly restored.

You may have also heard of a "mini-stroke" or transient ischemic attack or TIA.  This condition is also caused by blocked blood vessels, but the symptoms usually last a very short period of time, without permanent impairment.  However, they are a risk factor for future ischemic strokes.

High blood pressure over time can also damage and weaken these arteries.  If a weakened artery bursts, a hemorrhagic stroke occurs.

Either type of stroke is a medical emergency and can lead to death or disability.

Now that you know the definitions of the major conditions under the "heart disease" umbrella, in the next few articles, we will learn the signs and symptoms for each one.

Thanks for reading this far, and be sure to share this Love Your Heart series with someone you love!



Go Red for Women

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Yes I Can Health is Going Red for Women in February for Heart Health month.  

I will be writing a series of articles this month on women in midlife and heart health called "Love Your Heart."  This group of articles will discuss every aspect of heart disease in women, from definitions to causes, signs and symptoms, and most importantly, what you can do to lower your risk.  

I'll also be adding articles on heart healthy foods and fitness tips, and a series on the DASH diet as I take up a 30-day DASH diet challenge.  I'll share exactly what I'm including in my meal plan, and my results at the end of the month.

Be sure to follow me on Twitter or Facebook to find out when I've posted up a new article.

And pop over to the Go Red for Women website for information on this campaign from the American Heart Association.