YOU May Be Able To Prevent Heart Disease

You may have a say in whether you develop heart disease, because many of the risk factors are controllable, according to a leading cardiologist.

Dr. Richard Stein, director of preventive cardiology at Beth Israel Medical Center in New York, a spokesperson for the American Heart Association and author of the book "Outliving heart Disease" spoke with Harry Smith Thursday in Part One of a two-part Early Show series on heart disease.

He pointed out that the risk of heart attacks in this country was reduced by 25 percent in the last decade because we have made some progress in reducing smoking and identifying and more effectively treating cholesterol and high blood pressure.

How much can we reduce our risk?

"We can do so dramatically, both for people who've never had a heart attack and for people even who've had their first heart attack," Stein told Smith. "When I started doing this 30 years ago, and I thought, 'Gee, if I do everything well, and my patient does everything right, we could add a couple of good years to their life.' At this point, I think, 'If we both do everything right, they could live to die of something else, other than heart disease'(which explains the title of his book)."

Among the most important risk factors, he said, are family history, smoking, high cholesterol, and high blood pressure.

Why is family history so important?

"If you have a father who died of a heart attack under the age of 50, or a mother under the age of 60, you have about one-and-a-half to a two-fold risk yourself," Stein pointed out. "Obviously, it's the genes. Years from now, we'll be able to measure those genes precisely and tell you if you indeed have inherited the family curse or not. But for the moment, we have to sort of ballpark it."

Also, "no question" people should stop smoking if they ant to cut their risk of heart disease, Stein said.

Smith noted, "You have to have control of your cholesterol level and if you are obese, you have to lose weight. Some of these things are, if you really want to not die of heart disease, you have to address these things."

"But the thing to remember," Stein observed, "is it's about global risk. It's the sum of all the risk factors and their influence on you. So, even if you are gonna be 15 or 20 pounds overweight, if you get your cholesterol down with diet and medication if you need it, if you don't smoke, if you exercise 40 minutes a day, four or five times a week, you can bring that risk way down."

One important class of drugs for prevention is known as statins.

"I used to tell my patients," Stein said, "that the rule of bunko is, 'If it sounds too good to be true, it probably is.' Statins, I think, may be the exception. The evidence each years seems to get better that they can reduce, in the appropriate patient, the risk of having a heart attack between a-third and a-half. Big numbers. Big numbers."

What should your cholesterol be?

"Under 130 for most Americans with no risks," Stein responded. "Under 100 if you've had a heart attack or diabetes or have a real high risk of heart disease."

And what about aspirin? Who should be taking it as a preventative measure?

"Well, it's a dramatically effective drug for the right patients," Stein answered. "It drops their heart attack rates almost 25 percent just by taking that one pill. It's men over the age of 35 or 40, with risk factors, over the age of 40 or 50 without risk factors and women with risk factors, over the age of 65."

For information on heart disease prevention from the American Heart Association, click here.

To do a brief American Heart Association assessment of your risk of heart disease, cliclick here. The assessment was prepared in part with information from the famed Framingham Heart Study.