6 heart-health lessons a cardiologist wants you to know

The best time to protect your heart? Before something bad happens. Start here for help staying healthy.

Denise Schipani
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Quit smoking, eat a balanced diet and exercise regularly: You don’t need to be a cardiologist to know that these simple things can help protect your heart. 

But keeping your heart healthy as you age is more complicated than that. Here are six lesser-known things heart doctors wish their patients, particularly older adults, understood about heart health.

Lesson #1: Eat More Plant-Based Foods

In a landmark 2017 study in the Journal of the American College of Cardiology, researchers found that the best diet for heart health is largely plant-based. 

But that doesn’t mean plants plus anything you want. The study also points out that an “unhealthy” plant-based diet is one populated with refined grains (like white bread and rice) or less-healthy forms of fruits and vegetables (like fruit juice or French fries). 

Now, before you think you have to sacrifice BBQs to help your heart, consider this: “A little bit of meat is fine,” says Samir Aziz, M.D., a clinical professor of cardiovascular surgery at Howard University and George Washington University. The best bet is moderation.

What’s most beneficial, he adds, is a nutrition plan light on red meat and saturated fat. A 2017 review of studies in the American Journal of Clinical Nutrition found that eating three ounces of unprocessed red meat (that’s a recommended serving size) three times a week did not worsen blood pressure and total cholesterol levels. 

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Dr. Aziz is a fan of the Mediterranean diet, which relies mainly on fresh vegetables, whole grains, beans, healthy oils, fish and lean meats like poultry. These foods are powered by nutrients that help lower blood pressure and cholesterol and tame inflammation

In the American College of Cardiology study, which tracked participants for two decades, those who followed this style of a plant-based diet had the lowest heart disease risk. Those who ate a typical American diet had a substantially higher risk of heart disease.

Lesson #2: Reducing Stress Is Crucial

It’s long been understood that chronic stress has negative health effects, including those on your heart. However, a 2017 study in the Lancet uncovered a more direct link between emotional stress and heart health. 

Researchers noted that constant stress is connected to increased activity in the part of the brain that processes emotions. As stress levels go up, excess white blood cells are produced. That causes arteries to become inflamed, which increases the risk of heart disease, says Dr. Aziz. 

The way you cope with daily stressors is also key. Angst itself isn’t the real danger, he explains — not managing it is. “It’s how you react to stress that’s important,” says Dr. Aziz, “because it affects how your immune system functions.” 

He recommends exercise, yoga and meditation as ways to unwind. But there are lots of strategies you can try. Find a few that might work for you here

Lesson #3: Cholesterol Isn’t All Bad

Many of us believe that cholesterol is all bad and that’s simply not the case, explains Dr. Aziz. “You need cholesterol to help protect your brain, your eyes and other important functions,” he says.

Yes, your doctor or health care provider should certainly look carefully at your cholesterol numbers. But what’s more important than keeping your LDL (or “bad”) number below the normal range is keeping your HDL (or “good”) number high, “because that’s protective,” says Dr. Aziz. 

Your cholesterol levels should be considered in context with your other risk factors for heart disease, so talk to your doctor about what’s right for you.

Lesson #4: Consider Non-Surgical Alternatives to Stents

A conservative approach to heart disease — one that includes lifestyle changes and potentially medications — may be just as effective as stents or other surgical approaches. That was the conclusion of an important 2020 study funded by the National Institutes of Health, called ISCHEMIA.

“The key here is risk-factor modification,” says Dr. Aziz. “Quit smoking, get your weight down, eat better and take a statin drug if you need it to lower your cholesterol. You can avoid surgery or stents [and continue to live well]. This is new and encouraging information.”

Lesson #5: You Must Know the Signs of a Pending Heart Attack 

“For about 50% of patients, the first recognizable sign of heart disease is a heart attack,” says Dr. Aziz. In other words, there may have been earlier signs of heart disease that were either missed or brushed aside. 

And remember: Even though chest pain or discomfort is the most common heart attack symptom for both men and women, not all heart attacks present with those classic signs, explains the American Heart Association (AHA). Chest discomfort, by the way, could be described as tightness, squeezing, uncomfortable pressure, fullness or pain in the center of your chest. This feeling may last more than a few minutes, or it may go away and come back.

According to the AHA, any of the symptoms below could signal an actual heart attack. Women are somewhat more likely than men to experience these other symptoms, says the AHA. But no matter your gender, if you have any of these signs, seek care right away: 

  • Shortness of breath for no reason (say, you haven’t just climbed a flight of stairs) — with or without chest discomfort.
  • You’re more tired than usual when there’s no cause you can pinpoint.
  • Pain, weakness or numbness in your arms or legs.
  • Swelling in your legs (this could be a sign of heart failure).
  • Pain or discomfort in one or both arms, your jaw, neck or back.
  • Breaking out in a cold sweat.
  • Sudden nausea or lightheadedness.

One simple thing you can do on your own to monitor your heart health is check your blood pressure regularly  — either with a home machine or a pharmacy monitor. 

It’s common to have high blood pressure without knowing it because there are often no symptoms, says Dr. Aziz.

Lesson #6: Personal Risk Factors Play a Key Role

You already know that smoking may increase your risk for heart disease. But each of us has our own set of risk factors — and it’s important to go over them with your doctor. 

For example, “people who are on dialysis for kidney failure or who are diabetic are at a greater risk for heart disease,” says Dr. Aziz. Of course, those likely are things your doctor knows about and is watching. But there are less obvious risks you may not have thought about.

Some questions to ask yourself:
Do you have a family history of early death from heart disease? Heart disease often runs in families. And if you have a primary relative, such as a parent, sibling or grandparent, who died before age 50 of heart disease, you should be extra vigilant, says Dr. Aziz. 

Do you have sleep apnea? This sleep disorder causes brief interruptions in breathing each night. According to research in the Journal of Clinical Sleep Medicine, it is a risk factor for heart disease. 

If you suspect you have it (often, it’s the person lying next to you who can provide a clue, since people with sleep apnea tend to snore loudly), you should share that with your doctor. Find out more about sleep apnea signs here.

Do Your Heart a Favor Heart health is essential for overall health. So becoming even more aware of protective steps may be life-saving. Discover important information and helpful resources with Renew’s heart health learning center. UnitedHealthcare® Medicare Advantage members can learn more by signing in to your plan website and going to Health & Wellness. Then look for the Health Topic Library in the Quick Links section. Not a member? Learn more here.

Do you have other problems sleeping? Poor sleep in general can be a risk factor for heart disease, particularly in older adults, according to a 2020 study in the Journal of the American College of Cardiology.

Having a firm grasp of your risk factors can help you and your doctor land on a plan to help keep your heart in tip-top shape, says Dr. Aziz. To learn about additional ways to care for your heart, check out this video.