Lower Your Risk for Heart Disease: Small Steps You Can Start Taking Today Health Plus

Dr. MacRae Linton, Director of the Vanderbilt Lipid Clinic and Laboratory, and Director of the Atherosclerosis Research Unit, discusses the risk factors for heart disease and gives actionable strategies to begin lowering your risk of heart disease today.

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Bridgette Butler: Welcome to this edition of the Vanderbilt Health and Wellness Wellcast. I am Bridgette Butler with Health Plus. Cardiovascular disease is the #1 killer of American men and women, the cause of one out of every three deaths in this country. The good news is there are simple actions we can take, starting today, to help reduce our risk of cardiovascular disease. Here today to help us better understand the steps we can take to reduce our risk for cardiovascular disease is Dr. MacRae Linton, Director of the Vanderbilt Lipid Clinic and Laboratory and Director of the Atherosclerosis Research Unit. Welcome, Dr. Linton.

Dr. MacRae Linton: Thank you. It's good to be here.

Bridgette Butler: We are so happy to have you. Dr. Linton, what are some of the risk factors for heart disease?

Dr. MacRae Linton: First, you can think about them as modifiable and unmodifiable. The ones that are not modifiable are age, so in men, 45, in women, it's really 55, considered risk factors, family history, which you can't do anything about, but it is really a tremendously important thing to know about, and then the modifiable risk factors - LDL cholesterol levels, high LDL cholesterol levels, low HDL cholesterols (or good cholesterol) levels, then high blood pressure, cigarette smoking, elevated blood sugar, diabetes, and with that, I would put metabolic syndrome just in that whole category because it really brings together several of these risk factors and is sort of a pre-diabetic state where people are at increased risk for cardiovascular event long term, and it is very responsive to lifestyle changes.

Bridgette Butler: So, it sounds like there are several modifiable factors that we can actually do something about and potentially change our risk. What are some of your top strategies for reducing our risk for cardiovascular disease?

Dr. MacRae Linton: You know, absolutely. In fact, I think if you could wave a magic wand and have everybody really lead a healthy lifestyle, eat a healthy diet and exercise, you eliminate most coronary heart disease and diabetes. So, I think the top strategies are - know your risk factors and then lifestyle is tremendously important. Eat a balanced Mediterranean-type diet that is high in leafy green vegetables and fruits and fish and lower in saturated fat and sugars, and one of the top strategies is to cut sugar out of your beverages. Then, I think we have become a much more sedentary society. So, people need to be more active. The current recommendations are - we really should be getting 40 minutes or more of physical activity a day. And also, our jobs are much more computer-based and children are playing computer games, so you really, you sort of need to try and limit screen time and get up and move around during the day if you do have a sedentary-type job. Then, know your cholesterol levels and do something about them; if they are elevated, first, diet and exercise, and if that doesn't work, then you need to take medications to lower your cholesterol, and, by far, the best evidence is, in terms of preventing coronary heart disease, statins are the best approach. And then, controlling blood pressure, again, lifestyle changes are the first step, but then medications. I mean, smoking cessation ... you really should not be smoking cigarettes. And diabetes, you really want to do what you can to keep from developing diabetes in the first place., The kind of conventional wisdom is that, by the time you are diagnosed with diabetes, half those people already have coronary artery disease and it is a very powerful risk factor for heart attack and stroke.

Bridgette Butler: Wow, that is very powerful and it sounds like there are a lot of lifestyle changes that can be made to help prevent the risk of both of those. So, you mentioned first, understanding your risk factors, then making sure that you are eating a healthful diet, a Mediterranean-style diet, making sure that you are getting enough physical activity, about 40 minutes a day, or maybe even just work your way up. And then you also mentioned smoking cessation, but then, also, what is important is working with your doctor to identify if you have high cholesterol or triglycerides and making sure that you are getting the appropriate medication, if necessary, in addition to those lifestyle changes.

 So, we have talked a lot about the different strategies that we can do to potentially prevent cardiovascular disease for the modifiable risk factors. What are some resources available at Vanderbilt for more information or to actually begin enacting some of these strategies?

Dr. MacRae Linton: Health Plus has resources for a number of these things, including information on diet and lifestyle. They also have a new program for hypertension, which you can tell us more about.

Bridgette Butler: Ah, that's right. We have a brand new program  called "Control is the Goal," and that's a blood pressure management program, and anybody is welcome to enroll who is interested in learning more about how to control blood pressure, and that can be found at the Health Plus website under "Control is the Goal." Thank you for mentioning that.

Dr. MacRae Linton: You're welcome.

Bridgette Butler: And, yes, absolutely. We also have lifestyle coaches who are able to help with any of these lifestyle changes that we discussed today, including diet and exercise, and then also smoking cessation as well, and we also have some physical activity programs that people can become involved in in order to be moving more and be motivated to track their physical activity.

Dr. MacRae Linton: Now, that's great, and I think an incredible resource on campus is the Vanderbilt Rec Center because you can go there and exercise and do almost any type of exercise.  I swim there. And then they also have other wellness programs associated with the Rec Center.

Bridgette Butler: Well, thank you so much for your time today and for helping us better understand the risk factors for heart disease and how to act on the modifiable risk factors, what strategies that we can take today. I appreciate your time!

Dr. MacRae Linton: Thank you.

Bridgette Butler: Thanks for listening. If you have a story suggestion, please email it to us at health.wellness@vanderbilt.edu or you can use the "Contact Us" page on our website at www.vumc.org/health-wellness.