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Heart Failure:
A Patient Guide

Heart Failure Management
1.800.3.ADVOCATE
1.800.323.8622

General Information

Risk Factors

Causes Of HF

Signs & Symptoms

Testing

Treatment

Lifestyle Changes

        Excercise

        Smoking Cessation

Spiritual Strength

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Heart Care/Cardiology

Decreasing Your Risk Factors

How does the heart work?
Your Heart About 80 times a minute, 36.5 million times a year, your heart keeps the beat of life. That thump tells you that your heart is doing its job. The heart’s job is to pump blood rich with oxygen from the lungs to the body, and back again. How does the heart work? Read on.

Your heart is really a pump. It is a powerful muscle the size of your fist. It moves blood through your body. The heart has two sides with different jobs to perform. The right side sends oxygen-poor blood to your lungs. The powerful left side sends oxygen-rich blood to all the cells in your body. Your blood is always moving. It is always carrying energy and oxygen to all the parts of your body. It even pumps blood to itself.

Decreasing your risk factors
What is a risk factor?
A risk factor is anything that makes you more likely to get heart disease. There are two kinds of risk factors. Some of these risk factors can be controlled, and some cannot. If you have many risk factors, your risk of getting heart disease will be high. Cutting down your controllable number of risk factors is the key to a healthier heart.

Major risk factors that cannot be changed Major risk factors that can be controlled or changed Contributing factors
*Family background
*Gender (sex)
*Age
*Smoking
*High blood pressure
*Blood cholesterol levels

*Diabetes
*Overweight
*Lack of exercise
*Stress

Couple

Family background—The health problems that run in our families play an important part in knowing what health problems we may develop. Research tells us that if two close family members have had a heart attack before the age of 55, the risk that other family members will develop heart disease is increased as much as five to ten times.

Age and sex—Both men and women can develop heart and blood vessel disease. Women are protected from heart disease by their hormones until after the “change of life.” About 10 years after menopause (change of life), the risk for women is the same as for men.

Smoking—Smoking is a major cause of heart and blood vessel disease. The American Heart Association says cigarette smoking is the most dangerous of the risk factors that can be controlled. Smokers have a much higher death rate (70 percent) from heart and blood vessel disease than nonsmokers. Heavy smokers (two or more packs per day) have a death rate two to three times greater than nonsmokers. The nicotine in cigarette smoke makes the heart work harder. The chemicals in cigarette smoke narrow the blood vessels in the arms and legs. The bad effects of smoking also occur in non-smokers who breathe smoke from those around them.

No Smoking

Nicotine is not the only harmful chemical in cigarette smoke. Carbon monoxide gets in the blood, too. This decreases the amount of oxygen going to the heart and other parts of the body. Cigarette smoking also causes the clotting factors in the blood to become sticky and clump together. This clumping can harm the heart and blood vessels. No cigarette is safe. Many smokers who have switched to low tar and low nicotine cigarettes smoke more often or inhale more deeply. This is to make up for the lower amount of nicotine in the cigarette. Inhaling more deeply may increase the smoker’s risk of disease.

When you quit smoking, your risk of heart and blood vessel disease starts to go down. This decrease happens no matter how much or how long you have smoked. Ten years after you quit smoking, your risk of death from heart disease is almost the same as if you had never smoked. It is important to stop smoking before the signs of disease start. Do not wait until you have heart and blood vessel disease to quit. Stop smoking now. There are many programs available to help you quit smoking. Ask your doctor or nurse to help you locate one.

Hypertension—The other name for hypertension is high blood pressure. To help understand high blood pressure, you must first understand what blood pressure is.

As your heart beats, it forces blood through large blood vessels in your body called arteries. Arteries take the blood from your heart to all other parts of your body. Blood pushes against the walls of the arteries. Blood pressure is the force of your blood against the walls of your arteries. Normally, arteries are muscular and are able to stretch. They stretch and narrow as blood goes through them.

Your blood pressure has two numbers. The top number is the systolic pressure (when your heart is contracting), the bottom number is the diastolic pressure (when the heart is relaxing). If your blood pressure almost always runs 140/90 or more, you may have high blood pressure.

In many cases, the cause of high blood pressure is not known. However, gender, race, body weight, a diet high in salt, fat and cholesterol, and a family history of high blood pressure seems to increase the risk of having high blood pressure.

Man taking medicine

When your blood pressure is high, your heart has to work extra hard to pump blood. If your blood pressure stays high for a long time, your heart will get bigger because blood backs up in it. Bigger is not always better. The heart muscle actually weakens as it enlarges. You can think of this as a traffic jam.

High blood pressure also causes hardening of the arteries of the heart. Hardened arteries don’t stretch as well as arteries should. This increases your risk for heart disease and heart attack. Other blood vessels in the body are also damaged by high blood pressure. The chance of stroke, kidney damage and heart failure is increased.

High blood pressure usually cannot be cured but it can be controlled. Some treatments that your doctor may recommend to you include:

  1. Decrease your salt (sodium) intake
  2. Lose weight
  3. Decrease your stress
  4. Exercise
  5. Schedule regular doctor visits
  6. Check your blood pressure regularly (at your doctor’s office, fire departments, hospitals, community or public centers, or local church programs)
  7. Take medicines as prescribed by your doctor
  8. Stop smoking

Blood pressure needs to be controlled for your whole life!

Cholesterol levels—Reducing the amount of saturated fat and cholesterol in your food will help to lower the levels of fat and cholesterol in your blood.

Food

Cholesterol is a main part of the fatty build-up in arteries. Any increase in the blood cholesterol level is closely tied to heart disease. Studies show that high cholesterol levels may run in families, but diet can help control this.

The body makes cholesterol. It also is found in certain foods. Egg yolks, organ meats, shrimps, oysters, fatty red meats, lard, butter and whole milk dairy products are high in saturated fats (bad fat) which may raise cholesterol blood levels in most people. Some vegetable oils, like palm kernel oil, coconut oil and cocoa butter, also are high in saturated fat.

Monosaturated fats can lower the level of cholesterol in the blood. By using monosaturated fats instead of saturated fats and by increasing the amount of complex starches in the diet, you can lower the levels of cholesterol and fat in your blood.

The American Heart Association suggests:

* Eat fish, chicken and turkey more than red meat, but not more than 6 ounces a day.
* Trim all the fat you can see from red meat before cooking. Serve small portions and use lean cuts.
* Remove the skin from chicken and turkey before cooking.
* Eat more “white” meat from chicken than “dark” meat.
* Use skim milk and skim milk products instead of whole milk or 2% milk and milk products.
* Eat no more than 3 egg yolks per week.
* Cook with very small amounts of liquid vegetable oils (canola, olive) and use more polyunsaturated margarine (such as safflower, cottonseed, corn and soybean).

Diet changes should never be drastic. You may harm your health by cutting important foods from your diet. Keep changes in your diet moderate with careful use of saturated fats and cholesterol. Learn to read labels for hidden saturated fats.

For more information on losing weight and nutritious meal planning, a dietitian at your hospital can help. You also can contact your local American Heart Association.

Diabetes mellitus—High blood sugar can raise your risk of getting heart disease. High blood sugar increases the thickening of the walls that carry blood to the heart. This can lead to the development of heart disease. Your doctor can perform a blood test to find out if your blood sugar is too high.

Woman on scale

Being overweight is a risk factor for diabetes. People with diabetes often also have high blood cholesterol levels and high blood pressure. It is important to get regular checkups, stick to your diet, take medicines and keep your weight at a healthy level.

Overweight—If you weigh more than one-third over your ideal weight, you may double your risk for getting heart disease. Other risk factors such as high blood pressure, high cholesterol and diabetes mellitus also may be linked to being overweight.

It is very important to keep your weight down. Some tips for weight control are:

* Check with your doctor or dietitian to find out how many calories you need a day.
* Have the dietitian instruct you on a proper diet.
* Avoid crash or fad diets because the weight loss usually will not last.
* Exercise regularly.
* Set goals that you can reach.
* Keep up with your good eating habits once you have reached your goals.

Learn how to eat—not how to diet!

Lack of exercise—Your heart is a muscle and regular exercise may make it stronger.

Barbell

Regular exercise that makes your heart rate and breathing faster can cut down the risk for heart disease. Exercise increases the heart’s ability to pump. It lowers the amount of oxygen the heart and body needs, and it increases circulation. You will get good results by exercising for 15 to 30 minutes at least three times per week. Good exercise activities to try are: fast walking, jogging, running, bicycling and swimming. Ask your doctor which one is best for you.

Exercise cycle

It is good to begin with simple exercises (progressive cardiac exercises also known as PCEs) while you are in the hospital. You may advance to a Cardiac Rehabilitation Phase II program after you are home and have seen your doctor for a referral.

Stress—Stress is part of everyday life. It is different for different people. If you find a problem or person to be “stressful,” the feeling will trigger a response in your body. Research studies have shown that when a situation causes good feelings or feelings of challenge, these changes in the body do not happen. When we talk about stress and how it affects health and illness, we are looking at bad stress.

Your body’s response to stress includes a faster heart rate, higher blood pressure and a faster rate of breathing. Stress hormones released by the body cause these changes. One effect of these stress hormones is to narrow your blood vessels. Narrow vessels cause more work for the heart. High stress levels raise your risk for high blood pressure and other conditions that can damage your heart and blood vessels. Bad stress is a risk factor for the development of heart disease. Decreasing bad stress controls this risk factor.

You can learn to lower stress. First, you need to figure out the cause of your stress. Second, you need to change things that cause bad stress as much as possible. Third, you need to learn new ways to deal with stress in your life. Here are a few ideas for coping with stress:

* Do not waste energy being upset over little things. Remember that stress is our reaction to problems, not the problem itself. Often it helps to talk the problem out with a person we trust and get a different view. It also helps to “get things off your chest.”
* Get away from the stress when you can. Exercise, such as taking a walk to calm down, can help get rid of the feelings of stress.
* Watch out for “super-person” urges. Try to think about the most important things in your life. Set goals you can reach. Stop trying to do too much.
* Take time to relax daily. You can learn relaxation methods or just take time out for a favorite hobby.
* Take it easy with arguments. Stand your ground on what you believe is right, but try to hear what the other person has to say. Search for the ‘good’ in situations, other people and yourself.
* Find a group of people who care about you. Friends and social support can help to decrease stress.

If your stress still seems too high, talk about this with your doctor or health care professional. They may be able to direct you to other sources for help such as support groups or professionals trained in stress management.

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