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Question:

I’m at high risk for coronary heart disease, what advice can you give me to avoid it?

I just went to the cardiologist and was told that I was at high risk for coronary heart disease (CAD). I have high blood pressure and diabetes. I work out 4 times a week for at least an hour and have been active my whole life. I am fearful of the possibility of a heart attack at an early age because my dad died at age 45 from a heart attack. I have a family and want to be around for a long time. Please provide me with some direction as far as lifestyle changes to prevent this from progressively getting worse. 

submitted by George from College Station, Texas on 11/6/2012

Answer:

by Texas Heart Institute cardiologist, Scott R. Sherron, MD  

Scott R. Sherron, MDYou do carry several important risk factors for CAD and I understand your concern. Certainly, the regular exercise that you describe is a useful life-style factor that lowers your risk. A heart healthy diet, low in saturated fat, high in fiber and with limited simple carbs is also useful. Good advice is available through our Heart Information Center, the American Diabetes Association, and the American Heart Association websites. More extreme dietary measures are described by Dr. Dean Ornish and Dr. Edelstein from the Cleveland Clinic, but are very restrictive & hard for most people to follow. 

A key to lowering your risk and one of the few medical interventions that has been proven to lower the chance of heart attack and death is the aggressive use of statins. Your LDL cholesterol level goal should be less than 70. While all medications carry risks, the benefits of statins in your risk group is well proven. Also, regular follow up with cardiology is warranted, possibly to include screening treadmills periodically. Daily aspirin use is probably warranted if you do not have extra bleeding risks. Hope this is helpful.

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Updated November 2012
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