Are you in the top two percent of heart health? Would you like to be?

I have to admit this is an article I never thought I would have to write. Since my own diagnosis more than 10 years ago, I have spent countless hours, reading, researching, and applying some of the most cutting-edge heart disease prevention, reversal programs and technologies I could find, and then writing about them in blogs or articles like this one.

Then, I recently came across a recent study that proclaimed that there are seven fairly simple practices that lead to “ideal” heart health (all endorsed and promoted by the American Heart Association). But, what was most eye opening and more than just a little troubling, is that the study further claimed that only two percent of Americans currently follow all seven of these practices and that, if they did, it could dramatically lower heart disease risk and mortality.

The study followed nearly 45,000 people for more than 20 years, making the findings practically irrefutable. Let’s examine these seven “low-tech” yet crucial heart health practices, and how you can achieve “ideal heart health” and become a “top two percent-er!”

Step 1: Please, just stop!

The first step is easily among the most powerful, yet often most difficult practices, leading to a healthier heart – stop smoking! The good news is that among the seven steps researchers studied, smoking cessation was the only one where the U.S. population is actually making headway.

Step 2: Find your healthy weight

Unfortunately, the study also found that any gains made through the reduction in smoking were more than offset by increases in other undesirable measurements like this one – Body Mass Index (BMI). Not to be confused with overall weight, your BMI is adjusted for height. It is among the simplest measurements to make at home.

You can use the CDC's BMI calculator or just divide your weight in pounds by your height in inches, then divide it once again by your height in inches, then multiply the result by 703. For example, suppose you are 5'10" inches tall and weigh 200 pounds. Your BMI would be: 200 pounds / 70 inches / 70 inches x 703 = 28.69 BMI.

For those who prefer metric units, BMI can also be calculated using weight in kilograms and height in meters. Since this is the “official” formula, no multiplier is needed so you can drop the “703” multiplication.

Although there are slight variations based on age, nationality, and sex, a healthy BMI for most adults is considered to be between 18.5 and 24.9. Of course, it is hard to grow taller so we all know the only way to reduce your BMI is via weight loss. However, BMI gives you a better idea if your weight is “unhealthy” weight and a contributing factor to heart disease.

There is a lot more to the BMI story and the following Heart Connect discussion along with an excellent article on the subject can be found here.

Step 3: Don’t be so “sweet”

We all love our sweets and our sweethearts. But one "sweet" place we have to be downright stingy is our blood sugar. In fact, combined with overall increases in BMI, increases in fasting blood sugar offset all the gains seen by the reduction in smoking. There is a medical term used when blood sugar is chronically high – diabetes – and most of us understand this is a huge risk factor for heart disease.

The study used a fasting blood sugar cut-off of 100mg/dL but many doctors suggest a fasting blood sugar of 85 mg/dL or less is ideal (below 65 is often considered to be too low).

Here is a dirty little secret I learned from an endocrinologist at my top local research hospital: Exercise (more on this later), more so than any drug, is by far the most powerful tool for reducing blood sugar and actually reversing Type 2 diabetes. And, don’t forget step two. Exercise also is great for weight and BMI reduction, a real two-one punch.

Step 4: How low can you go?

Not surprisingly, the study found that lowering blood pressure is the single most powerful way to reduce heart disease risk (smoking was actually number two). The sinister part of high blood pressure is that it has few immediate symptoms and may go undetected until significant damage is done. Worse, some sufferers stop treatment because they feel fine. There is no constant cue like belly fat or cigarette smoke to remind them of the problem.

I believe most of us understand the risks associated with high blood pressure but many may not realize a new standard has been set. For years ideal blood pressure was considered to be 120/80. More recently it has been discovered that heart disease risk begins rising above when blood pressure rises above 115/75 so a few of us may still have some work to do.

The question in many minds is “how low is too low?” The bottom end of the ideal blood pressure range is about 90/60. Persons with lower blood pressures are considered to have “hypotension” as opposed to hypertension and may experience symptoms such as light headedness or syncope (fainting). However, there are many individuals with even lower blood pressure who have no symptoms at all. The best bet is to have your blood pressure tested regularly and interpreted by your doctor.

The Heart Connect community is absolutely loaded with resources on high blood pressure. Just type in “high blood pressure” in the search box in any area to find useful info. Here are a few that caught my eye:

Alternative Therapies for High Blood Pressure
Inside High Blood Pressure
Get the Most out of Home Blood Pressure Monitoring
Six Effects of High Blood Pressure on Your body

Step 5: Total it up

The next measure the study looked at was total cholesterol and it set the “healthy cut-off” at 200 mg/dL. I am not a fan of using total cholesterol as it treats all cholesterol the same and it definitely is not. But, it is a simple way to look at large groups of people and a quick indicator to determine if further testing may be needed.

Do you know your total cholesterol? If you have regular check-ups with your doctor it is almost certain you have this number in your charts. Ask for the number and talk to your doctor about it as well as the other cholesterol values that are part of the total. Trust me, I neglected this simple heart health tip for years just because my total cholesterol was low. Unfortunately, part of the problem was my good cholesterol was low, a problem I have since corrected.

Enjoy and learn from the rich discussions and information on cholesterol right here at Heart Connect then talk to your doctor about it.

Step 6: You are what you eat

The debate on what is the best heart health diet rages from low-fat to low-carb, from meat to vegetables, Mediterranean Diet, South Beach Diet, Atkins Diet, ApoE Diet, and Wheat-free Diet to name only a few. My best and constant advice is that we are all unique and need to find the best of any treatment and stick with it. For me, a low-carb, wheat-free diet seemed to have the most dramatic effect (and I do mean dramatic – almost unbelievable.)

The study used what has become the American Heart Association diet, which includes the following recommendations.

• Fruits and vegetables: At least 4.5 cups a day
• Fish (preferably oily fish): At least two 3.5-ounce servings a week
• Fiber-rich whole grains: At least three 1-ounce-equivalent servings a day
• Sodium: Less than 1,500 mg a day
• Sugar-sweetened beverages: No more than 450 calories (36 ounces) a week
• Nuts, legumes and seeds: At least 4 servings a week
• Processed meats: No more than 2 servings a week
• Saturated fat: Less than 7% of total energy intake

Honestly, this is not a bad diet. I would take issue with what some consider healthy whole grains but the “fiber-rich” part is right on the money in my opinion. Fruits are also problematic in that they can substantially raise blood sugar and other researchers opine that saturated fat is not the devil we once thought it to be.

I would highly encourage everyone to discuss and contribute to this often vexing issue right here at Heart Connect. There are some great places to “bone up” and then jump into a few very interesting discussions.

What is the Best Diet for Heart Health and Weight Loss
Prevent and Reverse Heart Disease

Step 7: Work it out

Every doctor I speak to harps on this. There is simply no better all-around prescription for health than exercise. As one medical expert repeatedly remarked to me during a private discussion (to the point where he became increasingly frustrated and started shouting), “Look, you gotta exercise!”

There is much discussion and disagreement on the subject of how much is enough, but my research suggests the absolute minimum is 20 minutes per day, three days per week of activity that raises the heart rate. More is obviously better. For me, I like to get at least 30 minutes per day, five days per week, but I have to admit I don’t always achieve that goal (except for Thursday night where I always get at least 60 minutes of basketball).

The absolute best advice I have ever gotten came from a cardiologist who advises, “Find something you like. It is the best way to make certain you keep doing it.”

Whether it is aerobic exercise, resistance training, yoga, you name it, you can find something that works for you. Try looking at some of these items posted by community members:

23 and 1/2 Hours: What is the Single Best Thing We can do for Our Health?

How do you Stay Motivated to Work Out during Cold Weather?

What's the Best Exercise for Heart Health?

How many steps do you practice?

Yes, there are many high-tech solutions to solve specific heart health problems. But, for the great majority of us, there are seven simple and common practices that can put you in what is currently the 2 percent of heart health. The next paragraph from the report sums it up:

“During a median follow-up of 14.5 years, individuals who had six or more risk factors or health behaviors that met the AHA definition of ideal had a 51% lower risk of all-cause mortality, a 76% lower risk of cardiovascular mortality, and a 70% lower risk of ischemic heart disease mortality. Elevated blood pressure was associated with the largest adjusted population-attributable fractions (PAF) for all-cause and cardiovascular mortality (30.4% and 40.6%, respectively), and smoking was associated with the second-largest PAF for all-cause mortality.”

Here is a link to the report and study if you are interested in learning more.

Start your own check list. How many of the “Simple Seven” do you practice?

Looking out for your heart health,