While heart-disease risk increases as we age, even those who spent their younger years sedentary, smoking and overeating can reverse course by adopting heart-healthy practices.

“The body is a remarkable thing if you manage it well,” says Judith Lichtman, chair of the Yale School of Public Health’s Chronic Disease Epidemiology Department. Researchers know that if people quit smoking, they can reduce their risk of heart disease down to the level of a nonsmoker.

This can be applied to other lifestyle choices such as diet and exercise level. “With management of risk factors and lifestyle, there is evidence you can wind back your risk.”

If people can’t fully meet all the recommendations for healthy eating and movement, that doesn’t mean they shouldn’t try, experts say. Doing something is better than nothing.

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A U.K. National Health Service study showed that people are more apt to exercise and eat healthfully if they enjoy it, says Catherine Yeckel, assistant professor of clinical public health at the Yale School of Public Health. People manage to integrate healthy foods into their daily life by finding foods they like and starting small, she says.

Rather than starting a new diet, it’s more sustainable if people choose one change for one day, Yeckel says. “Even if you’re not really motivated, it’s one thing.”

The same goes for exercise. Sedentary people add movement to their schedule by integrating it into their daily life — walking with a friend, parking farther from the door or taking work breaks for 10-minute walks, Yeckel says.

For those unmotivated to exercise, accountability to another person increases the odds for success. The social aspect makes it more fun. Paying for a class boosts compliance short-term, but to keep it going, exercises needs to be enjoyable or become a habit, she says.

Heart disease and women

Heart disease is the No. 1 killer for both women and men, but young women who report heart-attack symptoms are more likely to have them dismissed by health providers as not heart related, according to a study led by Lichtman. The research, published in the American Heart Association journal Circulation, involved patients 55 years and younger who were hospitalized for a heart attack.

Lichtman and her co-authors analyzed data from 2,009 women and 976 men collected from more than 100 hospitals which showed the majority of men and women reported chest pain, pressure, tightness or discomfort as their main heart-attack symptoms. Yet women were more likely to report other related heart-attack symptoms — indigestion, shortness of breath, palpitations or pain in the jaw, neck or arms. Women were more likely to attribute their symptoms to anxiety or stress and to report that their health care providers did not think their symptoms were heart related, the research shows.

“We do know, if a young woman has a heart attack, her risk for mortality or subsequent heart events is twice that of a similarly aged man,” Lichtman says.

She asked women who had heart attacks to share their stories, and a recurring theme emerged about not wanting to waste anyone’s time. While one or two of the symptoms on the list doesn’t equate to a heart attack, she says, those with a strong family history should err on the side of caution.

“We do know, if a young woman has a heart attack, her risk for mortality or subsequent heart events is twice that of a similarly aged man."

Genetics are a strong component of heart-attack risk for younger women, she says. After menopause, the risk for heart disease for women begins to catch up to the risk for men in the same age range.

Women who have gestational diabetes or pre-eclampsia (high blood pressure) in pregnancy are at higher risk for heart disease later in life, says Dr. Supriya Tigadi, a cardiologist with UConn Health.

New treatment for heart disease

In December the FDA approved Vascepa, a prescription-grade purified fish oil, to prevent heart attacks, stroke and death for those with high cholesterol levels, says Dr. Bruce Liang, cardiologist and dean at the UConn School of Medicine. It’s been approved for use with those with elevated triglycerides and other risk factors such as diabetes.

Researchers know that reducing inflammation in the body decreases the risk for heart disease and cancer. Anti-inflammatory medications have been shown to reduce cancer risk, and an anti-inflammatory treatment for heart disease is under review by the FDA and could be approved for use within a year, says Liang, also director of UConn Health’s Pat and Jim Calhoun Cardiology Center.

While it’s years away, Liang is working on developing a new medication that will help those with advanced heart failure feel better, function better and live longer. Most patients with advanced heart failure die within a couple of years of diagnosis, and the need for heart transplants dwarfs the supply. Animal trials have been encouraging, Liang says, so he and his fellow researchers are seeking FDA approval for clinical trials in people. 

Heart attack symptoms

For women

If a young woman has a heart attack, her risk of dying from it or having subsequent heart events is twice that of men the same age (18-55), according to a study led by Judith Lichtman, associate professor and chair of the Yale School of Public Health’s Department of Chronic Disease Epidemiology. Signs of a heart attack in women differ from those in men. Women experience a combination of symptoms, but all do not have to be present for a woman to be having a heart attack. While crushing pressure in the chest can be a sign, the absence of chest pain does not mean a woman isn’t having a heart attack. Any combination of these symptoms occurring together suddenly suggests a heart attack. Call 911, as time is essential.

  • dizziness, light-headedness, fainting
  • pain in the shoulder, jaw and neck
  • nausea or vomiting
  • indigestion
  • shortness of breath
  • upper-back pressure
  • extreme fatigue
  • pain in the lower chest or upper abdomen
  • chest pain, as if an elephant is sitting on your chest

For men

Men having a heart attack are more likely to feel uncomfortable pressure, squeezing, fullness or pain in the center of their chest. Any combination of these symptoms occurring suddenly suggests a heart attack, so also seek medical help immediately.

  • chest pain that lasts for more than a few minutes or goes away and returns
  • pain or discomfort in one or both arms, the back, neck, jaw or stomach
  • shortness of breath, with or without chest discomfort
  • breaking out in a cold sweat
  • nausea, light-headedness, dizziness

Sources: Supriya Tigadi, M.D., UConn Health cardiologist; Judith Lichtman, chair, Yale School of Public Health’s Chronic Disease Epidemiology Department; American Heart Association

Prevention tips

Heart disease, including coronary heart disease, hypertension and stroke, remains the highest cause of death in the U.S. Cardiologists suggest these tips to reduce the risk of heart disease:

  • Quit smoking. One year after quitting, coronary heart-disease risk drops by 50 percent.
  • Exercise. New research shows heart benefits for just 10 minutes of moderate walking. Walking 10 minutes three times a day helps the heart as much as walking 30 minutes at once.
  • Park farther from your destination to add a few steps.
  • Take the stairs rather than the elevator.
  • Eat more fruits and vegetables.
  • Add seafood and other foods rich in Omega-3 fats.
  • Limit red meat and processed meat such as bacon, sausage and deli meats.
  • Limit sodium and nitrates.
  • Snack on nuts and seeds.
  • Limit sugar-sweetened beverages, including sports drinks and fruit juice.
  • Moderate alcohol and caffeine consumption.
  • Eat whole grains and limit simple carbs — white rice, white potatoes, white bread.

Sources: Supriya Tigadi, M.D., UConn Health cardiologist; American Heart Association; Dariush Mozaffarian, M.D., dean, Tufts University Friedman School of Nutrition Science and Policy

This article appeared in the February 2020 issue of Connecticut Magazine. You can subscribe here, or find the current issue on sale hereSign up for our newsletter to get the latest and greatest content from Connecticut Magazine delivered right to your inbox. Got a question or comment? Email editor@connecticutmag.com, or contact us on Facebook @connecticutmagazine or Twitter @connecticutmag.