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12 Months to a Healthier Heart—a program that could save your life by Susan Kammeraad-Campbell Director of Marketing Publications Cardiovascular disease is the number one killer of Americans. What’s more, if you live in South Carolina, your chance of dying of a heart attack or stroke is higher than in almost any other state. The MUSC Heart and Vascular Center is committed to helping you develop your own personal plan to a healthier heart and vascular system, with a very doable, step-by-step program for the next 12 months. The program offers information and assessment tools, plus a calendar of events, classes, talks and screenings devoted to helping you every step of the way. Log on to http://www.MUSChealth.com for a comprehensive view of the program, including interactive assessment tools and exercise and nutrition logs to keep track of your progress. You can also call the Heart and Vascular Center at 792-1616 for more information or to schedule a date to attend a Heart Risk Screening.  Through the 12 Months to a Healthier Heart program, you can learn to: Assess your heart health; Reduce your risk factors; Improve your eating habits; Manage your weight; Reduce stress; Cook healthy meals; and Exercise safely and effectively. The first step is simple—make the commitment. How to Begin Your Heart-Healthy Lifestyle Changing your lifestyle to reduce cardiovascular risk factors is a challenge that is within your grasp.  Thousands of people have avoided heart disease or even reversed its effects by making simple changes in dietary and exercise habits. Even if you've tried and failed to lose weight, exercise regularly, avoid fatty foods or quit smoking, you still have the opportunity to be successful. Following MUSC’s program of 12 Months to a Healthier Heart could make a significant difference in your health and even on those around you. While you can’t control some factors, such as age or family history,  there are significant factors you can influence. Remember: Being at high risk for heart disease is almost always reversible.  Let’s begin with seven essential steps to get you started. 1. Assess your heart health: Not knowing you’re at risk for heart disease can be the biggest danger of all. Do you know your blood pressure and cholesterol levels, including your lipid profile and blood glucose? Have you ever had your blood pressure measured in your legs? Do you know your body mass index? MUSC is hosting a number of screening opportunities during February National Heart Month to help you assess your risk for heart disease.  Such assessment, especially before embarking on a diet and exercise plan, is the first place to start.  A checkup with your primary care provider is important, particularly if you have two or more of the major risk factors for developing heart disease. For more information or to locate a health care provider convenient to you, contact MUSC Health Connection at 792-1414 and ask to speak to one of our health resource nurses. Major Risk Factors Male older than 45  Diabetes Female older than 55  Smoker High blood pressure High cholesterol including high LDL Low HDL Family history of heart disease Secondary Risk Factors Obesity  Inactive lifestyle  Chronic stress 2. Target specific health behaviors to change  After determining your risk factors, list the specific behaviors you must change to reduce your risk. Remember, list behaviors or actions such as “eating less fat” as opposed to conditions such as “lowering cholesterol.” It is important to focus on exactly what you need to do each day to improve your health. Even if one of your risk factors is high cholesterol, the required treatment is behavioral—eating a diet low in fat, exercising three to four times a week, taking cholesterol medication, or eating fish high in omega-3 fatty acids. 3. Establish a detailed plan of action Many people, especially when making New Year’s resolutions, make the mistake of failing to set up a detailed action plan. Make a list of exactly what you must do to ensure success. Even “eating a low-fat diet” is not detailed enough. What exactly will this require you to do? For example, you might read information on low-fat dieting, buy a low-fat, heart-healthy cookbook, keep high fat foods out of the house (especially sweets), learn to order low-fat entrees in restaurants, modify your favorite recipes to lower the fat, and plan a week’s worth of low-fat meals. 4. Set a target date to begin Procrastination is your enemy. The time to begin is now. If you think too  much about the “right” time, you’ll never find one. Set a specific date and time to begin. And then, do it! 5. Tell friends and family about your plans Make a public statement about the changes you are making. In fact, try to enlist the aid of others. If everyone in the family is committed to heart-healthy living, your job will be a lot easier. 6. Sign a written contract Studies have shown that when you write something down, you are more likely to follow through on your promises. Write up a contract with yourself specifying what you are committed to do as well as when and how   you will do it. Then, sign and date it and put it in a conspicuous place where you’ll see it often. 7. Believe in your ability to succeed People who have strong beliefs in their ability to change are more successful than those who have doubts. Forget your past failures. This time will be different. Congratulations on taking the opportunity!   February Heart Healthy Events Saturday, Feb. 9 Chef’s Choice Cooking Class—Heart Healthy Cuisine. 1 - 5 p.m. Johnson and Wales. Fee: $50. Call 727-3036 to register. Monday, Feb. 11 Know Your Risk for Heart Disease. 6:30 - 8 p.m.  MUSC Wellness Center Auditorium. Free talk presented by James C. Thomas, M.D. director, MUSC Cholesterol Clinic. Call 792-1616 to register. Monday, Feb. 18 - 21 Heart Risk Screenings at the following locations: Feb. 18, 1 - 5 p.m. University Cardiology Associaties, East Cooper; Feb. 19, 11 a.m. - 7 p.m., Carolina Family Care (CFC), West Ashley; Feb. 20, 11 a.m. - 7 p.m., CFC, James Island; Feb. 21, 11 a.m. - 7 p.m., East Cooper. Registration required. Call 792-1616. Saturday, Feb. 23 American Heart Association Gala. 7 p.m. Charleston Place Hotel Ball Room. Call 853-1597 for ticket information Monday, Feb. 25 Getting Started: Making Heart-Healthy Habits a Habit. 6 - 7:30 p.m. Free talk. Call 792-1616. Thursday, Feb. 28 American Heart Association Eating Plan. 6 - 7:30 p.m. Free talk. Call 792-1616 to register. MUSChealth.com http://www.MUSChealth.com/events/index.htm   Risk factors, assessments Abdominal obesity  Those who carry excess weight around the waist have a condition known as abdominal obesity. Health risk increases as waist measurement increases. Women with a waist measurement in excess of 35 inches or men with a measurement of 40 inches or more are at greater risk even if your body weight is in a healthy range. Body Mass Index To determine if you are at a healthy weight, use the Body Mass Index Calculator, found at http://www.muschealth.com/risk/bmi.htm. The body mass index is a formula to assess your body weight relative to height. It’s a useful, indirect measure of body composition because it correlates highly with body fat in most people. Those with a body mass index that shows 10 percent higher than recommended are at risk of heart and blood vessel disease. The higher your BMI and waist measurement, and the more risk factors you have, the more likely you are to benefit from weight loss. Metabolic syndrome Metabolic Syndrome—also known as Syndrome X—is a cluster of risk factors, including abdominal obesity, high blood sugar while fasting (110 mg/dl or over), high blood pressure (over 130/85) and high triglyceride level (150 mg/dl or over). Individuals who have this cluster of risk factors have a much greater risk for developing heart disease. This syndrome is linked to a metabolic disorder called insulin resistance—an inability of the body’s cells to use the insulin it needs to convert food into energy. Heart Health Personality Quiz The relationship between heart health and state of mind is an important one. Psychological factors such as impatience, tension, depression, anger and social support influence your risk of heart disease.  Take the online Personality Quiz, developed by MUSC behavioral psychologist Peter Miller, Ph.D., to help you determine if your personality could hurt your heart or call 792-1616 and one will be sent to you.   Cardiac Scoring: it could save your life Are you at risk for a heart attack? Find out with a simple, painless procedure at MUSC’s Heart and Vascular Center. It’s a screening test known as cardiac scoring that can quickly assess calcium levels in your heart. “High levels of calcium consistently indicate at least a single blockage in a major heart artery,” said J. Bayne Selby Jr., M.D., head of the MUSC Department of Radiology. And blockages can cause heart attacks. “The test is especially helpful for those who are at high risk for heart disease but who have no symptoms,” he said. The patient, in street clothes, lies on a table that slides through a large donut-shaped scanning device. The two-minute ride generates detailed cross-section images of the heart that reveal the amount of calcium present. The procedure takes less than a half hour. “What makes this test so effective is its ability to detect calcium deposits long before they are large enough to form an obstruction,” said Selby.  Results from the test are returned within 48 hours. Scoring places patients in one of five risk categories, from normal to extremely high risk. Results might indicate a need for cardiac catheterization or a change in diet, exercise or medication. Though not currently covered by insurance, the procedure at MUSC is $350.