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It is the leading cause of death in men and women and all ethnic and racial groups in the United States.

      ✔ About 150,000 deaths from heart disease occur annually in people younger than 65. Preventable deaths in this younger population have not declined significantly in the last 10 years.

      ✔ While deaths from heart disease declined, the numbers of operations and procedures for heart disease increased 28 percent between 2000 and 2010.

      ✔ If money is the most important thing in your life, you might like to know that the yearly estimated cost of cardiovascular disease in the United States is $315.4 billion.

      As a cardiologist, I’ve seen these statistics made all too real in the lives of too many patients. But I’ve also seen what people can do to take charge of heart health at all stages, from working to lower their risk of developing heart disease to learning how to control and live well with advanced coronary heart disease (CHD) and its varied manifestations.

       Seizing the Good News about Preventing Heart Disease

      The bad-news facts about heart disease are real, but they aren’t the only news. Extensive research proves that you can do many things in your daily life and in working with your physician to use the latest medical science in order to preserve and maximize the health of your heart – even if you already have heart disease. Consider these good-news facts:

      ✔ People who are physically active on a regular basis cut their risk of heart disease in half.

      ✔ People who stop smoking cigarettes can return their risk of heart disease and stroke to almost normal levels within five years after stopping.

      ✔ Overweight people who lose as little as 5 to 10 percent of their body weight can substantially lower their risk of heart disease. In Chapter 10, I offer suggestions that can help you maintain or reclaim a healthy body weight, and in Part V, I offer a number of recipes that prove you don’t have to deny yourself enjoyable foods to do so.

      ✔ Simple changes in what you eat can lower total blood cholesterol and LDL-cholesterol, both of which contribute to heart disease.

      ✔ The number of deaths from heart disease declined by millions during the last decade – a decline largely based on lifestyle changes.

       Checking Out Heart Disease as an Equal Opportunity Health Problem

      So who should care about heart disease? As the previous sections suggest, everyone. No matter your present state of heart health, you can do plenty to reduce your risk factors for heart disease. (Find out more about that in Chapter 3.) You need to care about heart disease whether you are young or old, man or woman, totally healthy or coping with heart disease or other health problems, and regardless of your ethnic and racial background. If you belong to certain groups, however, some associated facts and conditions should raise your consciousness about why paying attention to heart disease and heart health should be important to you.

       If you’re an adult younger than 65

      If you think of heart disease as a problem mainly for older adults, that’s understandable. The majority of deaths from heart disease do occur in people older than 65. However, as I discuss in Chapter 2, early signs of fatty streaks and fibrous plaques, the precursors of coronary artery disease, are already present in a majority of young adults between the ages of 21 and 39. Here are some other reasons that younger adults should take steps now to prevent heart disease:

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About half of all sudden cardiac arrests occur in people under age 65, many in people in their 40s and 50s.

      ✔ 34 percent of people hospitalized for stroke are younger than age 65.

      ✔ More than 1 in 5 Americans with heart failure are younger than age 60.

      ✔ An estimated 80 percent of premature heart disease and stroke is preventable.

      ✔ Among U.S. youth and adults aged 12 to 60, almost none meet the seven criteria for ideal heart health established by the American Heart Association. That figure would be none, except that 0.3 percent of young adults ages 20 to 29 meet the seven ideal criteria.

      So if you are younger than 65, there is no time like the present to start taking steps toward better heart health.

       If you’re a woman

      Although heart disease is an equal-opportunity killer, many people, men and women alike, continue to think that heart disease is primarily a man’s problem. Wrong! Consider these facts:

      ✔ Although men suffer heart attacks an average of ten years earlier than women, after menopause, women catch up. Within the year after a heart attack, 42 percent of women will die, compared to 24 percent of men.

      ✔ In spite of extensive public education campaigns, only 54 percent of women know that heart disease is the leading cause of death for women. Heart disease kills more women than all forms of cancer combined.

      ✔ Stress poses a greater risk of heart disease in women than in men.

      ✔ Diabetes in women is a greater risk factor for heart disease than it is in men.

      In the final analysis, heart disease is at least as dangerous for women as it is for men. So, if you’re a woman who bought this book for the man in your life, think again. Keep this copy for yourself and buy another one for him! There is just as much in this book for you as there is for the men in your life.

       If you’re African American

      Heart disease is the leading cause of death for African Americans, just as it is for all Americans. Although every individual is different, African Americans, as a group, experience a higher incidence of certain conditions that contribute to the risk of heart disease. Consider these facts:

      ✔ African Americans develop high blood pressure at earlier ages than white Americans, and at any decade of life, more have high blood pressure, which is a risk factor for heart disease and stroke. Currently, among African Americans, 47 percent of women and 43 percent of men have high blood pressure, compared to 31 percent of women and 33 percent of men among white Americans.

      ✔ Compared to white Americans, African Americans have twice the risk of a first stroke and are more likely to die from the stroke.

      ✔ African Americans are 1.7 times as likely as non-Hispanic whites to have diabetes, a factor that contributes to developing heart disease. They are also more likely to have complications, such as blindness or kidney failure.

      Although much current research seeks to determine the causes of the higher incidence of risk factors, such as high blood pressure, among African Americans, African Americans can prevent and control hypertension and other risk factors by adopting appropriate lifestyle practices and working with their physicians to develop appropriate drug therapies.

       If you’re a parent

      The incidence of heart disease is, of course, very rare among children and youths. But the roots of heart disease are firmly planted in childhood. As people in the United States have spent more and more time in front of the TV or computer screen, commuting in cars, and eating out, children in the U.S. are learning lifestyle behaviors and developing health conditions that may make them more, rather than less, likely to develop heart disease and other health problems. The good (and bad) habits of a lifetime usually begin in childhood. Parents need to set good examples for their children and encourage them to adopt practices that optimize their future health. Consider the following facts about children in the U.S.:

      ✔ An estimated 2.4 million teenagers ages 12 to 17 use tobacco products. Though this figure has declined significantly in the last decade, 23.4 percent of high school students currently use tobacco products. Smoking is a major contributor to heart disease, cancer, and other health problems.

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