How to Know Your Heart Is Healthy
Heart disease is the leading cause of death in both men and women in the United States and around the world.
“Identifying people at risk of heart disease, and reducing that risk, is the holy grail of preventative cardiology,” says Stacy Baird, MD, a cardiologist who uses ultrasound to identify problems with the heart’s muscle or valves. When detected early, she says, heart issues can be repaired before they become irreversible.
“The patients I see usually have symptoms concerning for coronary disease. Their doctors are keeping a close eye on their blood pressure, cholesterol, blood sugar levels, so I really want them to focus on lifestyle—and that includes things like exercise, adopting a Mediterranean diet, increasing quality sleep, and decreasing stress.”
We asked Baird to explain the ins and outs of the human heart.
What does your heart do to keep you healthy?
The heart is essentially two simultaneous pumps. The left side of the heart receives oxygenated blood from the lungs and pumps this blood out to the rest of the body, which uses the oxygen. The right side of the heart receives the blood that has moved through the body and pumps the blood back up to the lungs to replenish oxygen.
From the minute we are born, our heart is doing that dual job. And it pumps 60 to 100 times a minute (heart rate) every moment of our entire lives.
How do I know if my heart is healthy?
There are many lifestyle elements associated with heart disease: physical activity, diet, sleep, stress, substance use. If you’re checking off a lot of unhealthy boxes in these categories, it might be time to implement some modifications to maintain a heart healthy lifestyle.
Online risk assessments, such as the American College of Cardiology (ACC) Atherosclerotic Cardiovascular Disease (ASCVD) Risk Calculator, consider age, gender, blood pressure and cholesterol levels, current medications, smoking status, and other factors and conditions such as diabetes to assign a level of risk for cardiovascular disease.
Over the past decade or so, we’ve seen that people in the intermediate category determined by online calculators may benefit from a coronary scan or stress test to confirm risk plus preventative strategies to lower it.
What are signs your heart may not be healthy (and when should you say something to your doctor)?
Not everyone has the typical symptoms of heart problems: chest pressure with exertion, shortness of breath, pain in the neck or jaw.
Keep a close eye on your stamina in your daily activities and/or with exercise. If you notice a change in your ability to keep up, mention it to your doctor.
What is most important to pay attention to in terms of heart health?
Exercise is the single most important factor for a healthy heart. People worry they don’t have the time or energy to fit exercise into their schedule, but a recent study found that even 10 minutes of exercise per day—moving enough to get your heart rate up—can be the difference between a healthy heart and problems.
Every day, you want to get your heart rate during exercise to around 70% of your maximum heart rate, which can be estimated from your age (220 - age in years = maximum predicted heart rate; visit the CDC for more information).
See if you are getting up to that level with your daily activities. If dedicated exercise time is truly unrealistic, add small changes to daily life, such as making your way into work with a power walk instead of a scenic stroll.
Ultimately, the message is: Just get moving!
Stress and heart health
Twenty years ago, when I was in medical school, the interplay between mind and body was not emphasized. Now we know acute stress can dramatically affect hearts—and look indistinguishable from a large heart attack. There is so much more to discover about the links between stress and downstream inflammation on conditions like cardiovascular disease.
I have been convinced of the benefits of incorporating elements of mindfulness—whether through yoga, meditation, breathing techniques, or whatever works—in decreasing inflammation in daily life.
What do your patients most often wish they could do if only their heart were healthy?
Get a good night’s sleep!
Patients with weak hearts are prone to fluid buildup that can be made worse lying flat, making sleeping a challenge. Often, patients resort to propping themselves up high on pillows or sleeping in a recliner to be more comfortable. On top of that, these patients take diuretics to remove excess fluid, which leads to frequent nighttime urination. Quality, uninterrupted sleep can be a luxury.
What’s the one question all patients ask about heart health?
All patients want to know if there is a pill to take to keep their heart healthy. I wish I could bottle exercise in a pill and prescribe it: That is how strongly I feel about incorporating physical activity into heart health. Exercise is incredibly beneficial for the heart, but it also has many other physical and mental benefits that make it so impactful to our health.
Stacy Baird, MD, is assistant professor of medicine in the Division of Cardiology at Columbia University Vagelos College of Physicians and Surgeons and a cardiologist at ColumbiaDoctors and NewYork-Presbyterian.
More from this series: How to know your lungs are healthy