Capital Health Plan

Ask Dr. Nancy

Nancy Van Vessem, M.D.
Chief Medical Officer, Capital Health Plan

Q: I hear so much about "heart health" and disease prevention. I'm not too old. I'm healthy. Does this mean me? If so, what should I do?

A: To your first question: Yes. To your second: Move! Physical activity is not the only prevention against heart disease, but medical research gives compelling reasons, as I'll explain in a moment, for focusing on it.

The Ageless Disease.

First, don't think that heart disease is an older person's illness. Heart attacks and fatal disease may strike men in their 50s and women in later life, but the disease itself is a consequence of a lifetime's behavior. It can begin even in the teen years. Your heart-healthy lifestyle becomes a life-saving example for your children. And even the elderly can begin a healthy regime with great effect.

Risks and Remedies.

Each of us should know the major risk factors for heart disease and what to do about them:

• Inactivity: Moderate exercise like walking, for 30 minutes on most days of the week, yields great results. No marathons or weight rooms are necessary.
• Smoking: Don't do it, and get help to quit if you need it. Smoking escalates the risk of heart attack, stroke, and cancer. Women who smoke are up to six times more likely to suffer a heart attack than nonsmokers.
• High blood pressure, high cholesterol, and high weight: The three often go hand-in-hand. Ask your doctor for tests and discuss their meaning. Whether your counts are high or normal, follow a heart-healthy diet low in saturated fat, transfat, and cholesterol.

Note: For both stop-smoking and diet classes, see page 6.

If You Do Nothing Else...Move!

Any exercise can help a healthy heart: walking, dancing, cleaning house, gardening--anything you enjoy so that you'll do it regularly. And believe it or not, exercise will help you feel better within a few days. Here's what studies show:

• Physical activity mattered more than weight in a study of women's heart disease. Even when they were overweight or obese, the least active women showed most disease. (Journal of the American Medical Association, September 8, 2004)
• Regardless of blood pressure, cholesterol level, body mass index, or smoking, moderate activity reduced risk of heart-disease death by 39% in people with type 2 diabetes. (Diabetes Care, April 2005)

In short, sitting still is a silent killer, a "most unwanted" one. You'll also find that, over time, regular exercise can help regulate weight, high blood pressure, and cholesterol, good and bad.

Inactive? Be Prudent, Not Afraid.

If you're apparently healthy, it should be safe to start moderate activity (such as walking or doing yard work for up to 30 minutes). If you are middle-aged or older and at high risk for heart disease, or have a medical condition, check with your physician before significantly increasing activity. Get advice for a gradual plan.

Besides CHP classes and our Stepping Toward Health program (www.capitalhealth.com/steps), these sites feature great exercise ideas and facts: "The Heart Truth" (www.nhlbi.nih.gov/health/hearttruth), the American Heart Association's "Just Move" (www.aha.org), and About.com.

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