Long Live You!. Jane Wilkens Michael

this. One in three Americans has some sort of cardiovascular disease, which can include hypertension (high blood pressure), coronary artery disease, heart failure, or arrhythmias (irregular heartbeat). He attributes a new uptick in coronary crises to a sedentary lifestyle, obesity, diabetes, smoking, and diets rich in processed foods.

      Dr. Tomaselli stresses that we must turn our attention from risky to healthy behavior. For a start, that would include what the AHA refers to as Life’s Simple 7:

       1. Get Active

       2. Eat Better

       3. Lose Weight

       4. Stop Smoking (smoking damages your entire circulatory system and increases your risk for coronary heart disease, hardened arteries, aneurysm, and blood clots)

       5. Control Cholesterol

       6. Manage Blood Pressure (normal is less than 120 mm Hg systolic and less than 80 mm Hg diastolic or <120/80)

       7. Reduce Blood Sugar

      When it comes to getting active, there is a preponderance of evidence that shows exercise can strengthen your heart, lungs, and blood vessels. The AHA recommends 150 minutes of moderate-to-vigorous activity a week, which can be broken down into sessions of as little as 20 to 30 minutes of activity five or six days a week.

      Eat better to lose weight, control cholesterol, manage blood pressure, and reduce blood sugar. Fat—especially if a lot of it is around your waist—puts you at higher risk for many health problems and is especially bad for your heart. According to the AHA, if your body mass index (BMI, a measure of body fat based on height and weight) is 25.0 or higher, you will benefit by bringing your number down below 25. If your BMI is 30.0 or higher, you are at significant risk for heart health problems.

      “If a person has had a coronary event in the first place, then clearly life changes need to be made,” says Dr. Suzanne Steinbaum, director of Women and Heart Disease at the Heart and Vascular Institute at Lenox Hill Hospital in New York City and a spokesperson for the American Heart Association. “Eighty percent of the time you can prevent a repeat performance by making healthy lifestyle choices. Start by incorporating fruit, vegetables, whole grains, legumes, beans, olive or canola oil, and fish into your diet, and getting rid of all the saturated fats and simple ‘white’ carbohydrates, such as rice, pasta, bagels, and potatoes. Know that exercise is the best medication, and don’t forget to smile and breathe. Believe it or not, perspective is everything, and being pessimistic and hostile can be damaging to your heart. On the other hand, having a positive outlook and a glass-half-full approach can help your heart’s vitality and spirit.”

      Studies presented at a recent AHA’s Scientific Session confirmed that women who drank more than two sugar-sweetened drinks a day had increasing waist sizes but weren’t necessarily gaining weight, reports Dr. Christina Shay, lead author of the study and assistant professor at the University of Oklahoma Health Sciences Center. “These women also developed high triglycerides, and women with normal blood glucose levels more frequently went from having a low risk to a high risk for developing diabetes over time.” This put them at higher risk for a heart attack.

      Lack of exercise and an unhealthy diet, along with smoking and genetics, are unquestionably the most important risk factors for heart disease. But stress is also a huge factor. So “it is critical to make the connection between your emotional health and the health of your heart,” says Harvard assistant professor of psychiatry Dr. Paul Hammerness. “At its extreme, heart injuries and heart failure can occur during severe emotional stress. This is called stress cardiomyopathy, or ‘broken-heart syndrome.’ Less dramatic but far more common examples,” he claims, “include the well-known impact of anxiety and depression on heart disease and recovery from heart disease.” And as corroborated by a major and well-regarded Danish study, he notes that the relationship between mood/anxiety and heart disease appears to be a “dose-response relationship,” meaning that greater sadness and anxiety lead to greater heart disease and/or worse heart outcomes.

      Therefore, one key step in caring for your heart is caring for your emotional health and working diligently to reduce levels of stress in your life (see Rung 2). When all is said and done, a calm, organized life may actually save your life.

      Of course, along with these lifestyle changes, it’s important to have your blood pressure, cholesterol levels, and blood sugar tested regularly. If you already suffer from hypertension, high cholesterol, or elevated blood sugar, more frequent monitoring is required.

      Bone Up on Your Bones

      Arthritis

      Less fatal, but considerably more common, is the pain and debilitation of arthritis. About 50 million Americans have been diagnosed with one of the seven common forms. Yes, I am one of them. But it would take another book to tell you the stories about my recent hip replacement!

      “Arthritis is a complex family of musculoskeletal disorders consisting of more than 100 different diseases or conditions, divided into three major categories: osteoarthritis, rheumatoid arthritis, and juvenile arthritis,” says Patience White, M.D., professor of medicine and pediatrics at the George Washington University School of Medicine and Health Sciences and vice president of public health for the Arthritis Foundation. “Although common belief is that arthritis is a condition affecting the elderly, two-thirds of people with arthritis are under the age of 65, including 300,000 children. Also, arthritis affects people of all ethnicities.”

      The vast majority of current sufferers, about 27 million Americans, have osteoarthritis (OA), which is characterized by a breakdown of joint cartilage. The rest of arthritis sufferers have the more severe form: rheumatoid arthritis. Per Dr. White, “rheumatoid arthritis (RA) is characterized by inflammation of the membranes lining the joint. Although it can strike at any age, women are typically diagnosed between the ages of 30 and 60, while male patients usually are older. There are about 1.5 million affected individuals in the United States. Finally, juvenile arthritis (JA) is a term used to describe many autoimmune and inflammatory conditions that can affect children ages 16 and younger.”

      The disease takes a heavy toll. “Each year, arthritis accounts for 44 million outpatient visits and more than 900,000 hospitalizations. In fact, it’s the leading cause of disability in the United States and is a more frequent cause of activity limitations than heart disease, cancer, or diabetes. By some estimates, 67 million Americans will have arthritis by 2030.”

      So what can we do? Knee, shoulder, and, of course, hip replacements are the drastic remedies. And they are really the only full cures, since bone spurs and lost cartilage simply will not dissolve or regenerate in our present state of technology. Most arthritis sufferers, though, are not there yet. As even my orthopedic surgeon, Dr. Roy Davidovitch, director of the New York Hip Center, NYU Hospital for Joint Diseases will agree, it’s only when your lifestyle is completely compromised and you can’t take another moment of pain that you have to bite the bullet and get the joint replaced.

      However, there is much to do in between. Says Phyllis Crockett, DPH, in the Express Scripts Rheumatoid Arthritis and Inflammatory Disease Therapeutic Resource Center, “Each patient is different, and a physician can help determine the best treatment plan, including managing the symptoms and pain of arthritis, starting with exercise. It is a valuable tool in the fight against arthritis. Osteoarthritis and RA patients particularly can benefit from both endurance and resistance training.”

      Maintaining a healthy weight and protecting against joint injury can help prevent OA. “Every pound of weight lost reduces the pressure on each knee by four pounds. Even a small weight loss can be a big help in fighting it.”

      For patients who are already on medication to treat the condition, adherence—taking medications as prescribed—is critical to healthier outcomes. But never self-medicate! “Combining over-the-counter medications with prescription medications can be risky and can cause side effects, such as an increase in gastrointestinal (GI) irritation or a GI bleed. And don’t adjust doses or make changes to the medication regimen without checking with your healthcare team.” Watch for drug interactions. “Some common drugs like acetaminophen can have an