In recognition of February as American Heart Month, cardiologist Sherrie Khadanga, M.D., associate professor of medicine at the Robert Larner, M.D. College of Medicine at the University of Vermont, offers some timely reminders about cardiovascular health, including “Life’s Essential 8”—tips from the American Heart Association to reduce cardiovascular risk and improve heart health.

February is American Heart Month, serving as a moment to take time and reflect on your daily habits and lifestyle to improve your cardiovascular health.

Heart disease is the leading cause of death for both men and women in the United States; it is estimated that someone in the U.S. suffers a heart attack every 40 seconds. While high blood pressure, high cholesterol, active smoking, and diabetes are well-known cardiovascular risk factors for women and men, there are some female-specific risk factors—such as breast cancer, pregnancy complications like pre-eclampsia or gestational diabetes, menopause, autoimmune disease, and depression—that increase the risk as well.

“If you are experiencing sudden chest discomfort without improvement, you should seek medical attention regardless of whether or not you have underlying cardiac risk factors.”

Chest pain or discomfort is the number one presenting symptom for a heart attack in both men and women, but additional complaints can include shortness of breath, nausea, dizziness, or arm/jaw pain. A heart attack is most often due to an underlying blockage in the artery, composed of cholesterol plaque. For some people, however, there might be a different cause. Spontaneous coronary artery dissection is a tear in the artery that can mimic the symptoms of a heart attack, more often occurring in women due to pregnancy, hormonal changes, or stress. If you are experiencing sudden chest discomfort without improvement, you should seek medical attention regardless of whether or not you have underlying cardiac risk factors.

For people who have experienced a heart attack or undergone cardiac surgery for valve replacement or coronary artery bypass, cardiac rehabilitation (CR) is recommended to help with recovery of the heart as well as prevent future problems. Studies have shown that participation in cardiac rehab not only improves quality of life, cardiovascular risk factors, and physical function, but also reduces hospitalization and decreases cardiac events. Despite the benefits, only about 30 percent of people who have had a heart attack or cardiac surgery engage in CR—so it is important to encourage people who qualify to participate in the program.

“Lifestyle modification can prevent nearly 80 percent of cardiovascular deaths.”

While cardiovascular disease spans across all ages, it is important to prioritize your health—whether you’re in your early 30s, or your 40s, 50s, or beyond. Research has shown that lifestyle modification can prevent nearly 80 percent of cardiovascular deaths. As such, modifying behavior and controlling health factors can have tremendous benefit for the heart. 

Highlighted below are “LIFE’S ESSENTIAL 8” to improve cardiovascular health, as defined by the American Heart Association:

1. Eat better by including whole foods, fruit, vegetables, lean protein such as poultry and fish, and cooking with olive oil or canola oil.
2. Stay active, aiming to get 150 minutes of moderate exercise or 75 minutes of vigorous activity per week.
3. Quit smoking.
4. Get more sleep; ideally 7–9 hours nightly.
5. Manage your weight—know your body mass index (under 25 is ideal) and waist circumference.
6. Control your cholesterol—LDL is the “bad” cholesterol that contributes to plaque buildup in the arteries; so the lower, the better.
7. Manage your blood sugar—know your glucose level; if elevated, check your A1C (which measures average blood sugar over 3 months) regularly; for healthy individuals, A1C should be below 5.7 percent.
8. Control your blood pressure—levels below 120/80mmHg are ideal

It is important to “know your numbers” and discuss screening and monitoring with your physician. For women in particular, it is important that they share with their primary care provider or cardiologist if they had difficulties with pregnancy or menopausal symptoms, as these increase their cardiovascular risk, and health care providers may not ask about these topics when obtaining medical history. 

“Caring for the heart doesn’t require drastic steps but rather, small well-informed decisions that, over time, will add up to improved overall health.”

Currently, there are various medications to help achieve certain goals when it comes to cholesterol, glucose, and blood pressure; if prescribed by your health care provider, these should be taken as directed.

Start this month and reflect upon your lifestyle:

• Choose the apple instead of potato chips as a side or snack. 
• Take a loop around the house at each commercial break when at home watching TV (or for those streaming shows, after an episode). 
• Skip the takeout and opt to make a simple meal with staples from the fridge or pantry. 

While it may seem daunting—maybe even overwhelming—to tackle these lifestyle recommendations, caring for the heart doesn’t require drastic steps but rather, small well-informed decisions that, over time, will add up to improved overall health.