Ask a Doc: What to know to have a healthy, happy heart
Thousands of songs have been written about the heart. Depending upon your music genre of choice, we know where “The Heart Of Rock and Roll” is, that “My Heart Will Go On,” and hope to never experience an “Achy Breaky Heart.” In keeping with this theme, Boca Grande Health Clinic Medical Director Dr. Raymond A. James D.O. provides advice on ways to avoid a broken heart in February’s Ask a Doc.
February is American Heart Month, a good time to reflect on medical matters of the heart. But first, the statistics. Heart disease remains the leading cause of death in the U.S., according to a new report from the American Heart Association; yet fewer than half of the people in a 2023 Harris Poll survey conducted on behalf of the association knew that fact. Heart disease has been the leading cause of death in the U.S. for 100 years. There are 2,552 deaths from total cardiovascular disease each day, and on average, someone dies of CVD every 34 seconds.
What are the risk factors?
The most common factors that contribute to your risk of developing cardiovascular disease or having a heart attack are smoking, diabetes, obesity, cholesterol, high blood pressure and stress.
How can I monitor my heart health?
There have been great advances in the treatment of cardiovascular disease, but prevention remains key. Knowing your numbers is a goodplace to begin.
The first is controlling blood pressure. Nearly half of U.S. adults – more than 122 million – have high blood pressure, also known as hypertension. This condition damages and weakens arteries, making it easier for them to burst or become blocked, which can lead to heart attacks, strokes and other problems. It’s the silent killer because contrary to common belief, the reality is that most people don’t have any symptoms of high blood pressure. So, they don’t check their blood pressure or see a doctor for their annual visit. Oftentimes, then, it goes unnoticed, untreated and over time, leads to irreversible damage to their organs, most specifically of concern, the brain, the heart and the kidneys.
Over the last 10 years, the target blood pressure guidance has been lowered twice. High blood pressure is now defined as readings of 130 and higher for your top number or readings of 80 and higher for your bottom number. That is a change from the old definition of 140/90 and higher. By lowering the definition of high blood pressure, the guidelines recommend earlier intervention to prevent further increases in blood pressure and the complications of hypertension. Reaching the lowered numbers can reduce your chances of stroke, heart attack and kidney injury.
Another set of numbers to watch relates to cholesterol – LDL and HDL. Too much LDL, what we call “bad” cholesterol, builds up on the walls of your blood vessels and it’s this plaque buildup that leads to heart attack, stroke and heart failure. High levels of HDL, or “good” cholesterol, can lower your risk for heart disease and stroke.
Basically, you want your LDL number to be as low as possible and your HDL to be as high as possible. Unfortunately, the average LDL in the U.S. is close to 130. When you’re born, your LDL is 30! So, how low should you go? Experts say, “the lower, the better.”
Experts now recommend an LDL cholesterol level under 55 to 50 for high-risk individuals, much below the previous 70. There are many good pharmaceutical therapies available to lower LDL. Some of the studies suggest that when you get under 50, there actually can be some reversal of soft plaque in you, which is fascinating because we weren’t talking about this 10, 15 years ago. As far as HDL goes, 60 or higher is optimal.
How can I make sure my heart stays healthy?
To lower blood pressure, we recommend eating a well-balanced diet that’s low in salt, limiting alcohol consumption, staying physically active, maintaining a healthy weight, not smoking, managing stress and taking medication as prescribed.
Obesity is contributing to heart disease and premature death of many Americans, so we need to get our weight down. Increasing exercise will help us lose weight and lower our blood pressure. According to the AHA, only one in four adults meet the guidelines of 150 minutes of moderate or 75 minutes of vigorous physical activity per week, along with muscle-strengthening activities two or more days per week. It can be walking, swimming, biking, playing tennis or any activity that gets your heart rate up for a consistent 30 minutes or more.
This is a point I continually make with my patients: Exercise remains the most potent prescription and advice that I can provide you to achieve a long and healthy life. It’s not a drug. It’s not the Mediterranean diet. It’s exercise! In addition to all ofthe heart benefits of exercise, it lowers the risk of stroke and the incidence of dementia. Some of the studies out there show a delay of two to five years in the onset of measurable cognitive decline.
That’s how powerful exercise is.
Other modifiable risks include stopping alcohol use or limiting it to one drink when you do drink, stopping smoking, getting adequate sleep with a goal of eight hours of good sleep a night, and decreasing stress. Another is leading a lifestyle that incorporates positive relationships, with the goal of having at least eight people in your life that you routinely interact with and who are supportive.
What advancements in heart health can we expect at the Clinic?
The Clinic of the Future will include the newest CT scanning technology, which when combined with artificial intelligence, will give us more detailed images of the heart not previously available and allow us to perform 3D mapping of the coronary arteries to more precisely direct appropriate treatment. The new CT technology promises to transform the way we approach the treatment of heart disease. It’s really cool, and I can’t wait to get it here because it will allow us to better treat and prevent heart disease on the island.
Get in touch: Do you have a question for the Boca Grande Health Clinic? If so, please send questions to the Clinic at or email the Boca Beacon at and we can forward them for an upcoming column.
