Lee Kirksey, MD  
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Five Reliable (Surefire) ways to avoid Heart Disease in 2009

Jan 14, 2009 - 17 comments

heart disease prevention


Heart Attack


high cholesterol


Congestive Heart Failure


stroke prevention


Chest Pain


heart diseases



Patients always ask how they can avoid getting heart disease. I could give you a million things that might work but in the interest of time, I thought of a list of five things that if everyone could do them-the incidence of heart disease would be much less. These are the goals that you should try to achieve. For a detailed program of ideas about how to go about accomplishing these goals, visit www.personalwellnesswheel.com or buy Your Guide to Optimal Health: Creating Your Personal Wellness Wheel on Amazon

1. Don't smoke or use tobacco products
When it comes to heart disease prevention, no amount of smoking is safe. Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.

Tobacco smoke contains more than 4,800 chemicals. Many of these can damage your heart and blood vessels, making them more vulnerable to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

In addition, the nicotine in cigarette smoke makes your heart work harder by constricting blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — only smoking while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.

Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't do either. Worse, this risk increases with age, especially over 35.

The good news, though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

Smokeless tobacco and low-tar and low-nicotine cigarettes also are risky, as is exposure to secondhand smoke.

Tobacco smoke contains more than 4,800 chemicals. Many of these can damage your heart and blood vessels, making them more vulnerable to narrowing of the arteries (atherosclerosis). Atherosclerosis can ultimately lead to a heart attack.

In addition, the nicotine in cigarette smoke makes your heart work harder by constricting blood vessels and increasing your heart rate and blood pressure. Carbon monoxide in cigarette smoke replaces some of the oxygen in your blood. This increases your blood pressure by forcing your heart to work harder to supply enough oxygen. Even so-called "social smoking" — only smoking while at a bar or restaurant with friends — is dangerous and increases the risk of heart disease.

Women who smoke and take birth control pills are at greater risk of having a heart attack or stroke than are those who don't do either. Worse, this risk increases with age, especially over 35.

The good news, though, is that when you quit smoking, your risk of heart disease drops dramatically within just one year. And no matter how long or how much you smoked, you'll start reaping rewards as soon as you quit.

2. Get active
You already know that physical activity is good for you. But you may not realize just how good it is for you.

Regularly participating in moderately vigorous physical activity can reduce your risk of fatal heart disease by nearly a quarter. And when you combine physical activity with other lifestyle measures, such as maintaining a healthy weight, the payoff is even greater.

Regular physical activity helps prevent heart disease by increasing blood flow to your heart and strengthening your heart's contractions so that your heart pumps more blood with less effort. Physical activity also helps you control your weight and can reduce your chances of developing other conditions that may put a strain on your heart, such as high blood pressure, high cholesterol and diabetes. It also reduces stress, which may also be a factor in heart disease.

Federal guidelines recommend that you get at least 30 to 60 minutes of moderately intense physical activity most days of the week. However, even shorter amounts offer heart benefits, so if you can't meet those guidelines, don't give up. And remember that things like gardening, housekeeping, taking the stairs and walking the dog all count toward your total. You don't have to exercise strenuously to achieve benefits, but you can see bigger benefits by increasing the intensity, duration and frequency of your workouts.

3. Eat a heart-healthy diet
Consistently eating a diet rich in fruits, vegetables, whole grains and low-fat dairy products can help protect your heart. Legumes, low-fat sources of protein and certain types of fish also can reduce your risk of heart disease.

Limiting your intake of certain fats also is important. Of the types of fat — saturated, polyunsaturated, monounsaturated and trans fat — saturated fat and trans fat increase the risk of coronary artery disease by raising blood cholesterol levels. Major sources of saturated fat include beef, butter, cheese, milk, and coconut and palm oils. There's growing evidence that trans fat may be worse than saturated fat because unlike saturated fat, it both raises your LDL (bad) cholesterol and lowers your HDL (good) cholesterol. Sources of trans fat include deep-fried fast foods, bakery products, packaged snack foods, margarines and crackers.

Heart-healthy eating isn't all about cutting back, though. Most people, for instance, need to add more fruits and vegetables to their diet — with a goal of five to 10 servings a day.

"There's a huge amount of data to suggest that fruits and vegetables are highly effective in preventing not just cardiovascular disease, but cancer and other diseases as well," Dr. Hayes says.

Omega-3 fatty acids, a type of polyunsaturated fat, may decrease your risk of heart attack, protect against irregular heartbeats and lower blood pressure. Some fish are a good natural source of omega-3s. However, pregnant women and women of childbearing age should avoid shark, swordfish, king mackerel and tilefish because they contain levels of mercury high enough to pose a danger to a developing fetus. But for most others, the health benefits of fish outweigh any risks associated with mercury. Omega-3s are present in smaller amounts in flaxseed oil, walnut oil, soybean oil and canola oil, and they can also be found in supplements.

Following a heart-healthy diet also means drinking alcohol only in moderation — no more than two drinks a day for men, one a day for women. At that moderate level, alcohol can have a protective effect on your heart. Above that, it becomes a health hazard.

4. Maintain a healthy weight
As you put on weight in adulthood, you gain mostly fatty tissue. This excess weight can lead to conditions that increase your chances of heart disease — high blood pressure, high cholesterol and diabetes.

How do you know if your weight is healthy? One way is to calculate your body mass index (BMI), which considers your height and weight in determining whether you have a healthy or unhealthy percentage of body fat.

BMI numbers 25 and higher are associated with higher blood fats, higher blood pressure, and an increased risk of heart disease and stroke.

The BMI is a good but imperfect guide. Muscle weighs more than fat, for instance, and women and men who are very muscular and physically fit can have high BMIs without added health risks. Because of that, waist circumference is also a useful tool to assess abdominal fat. In general, men are considered overweight if their waist measurement is greater than 40 inches. And women, in general, are overweight if their waist measurement is greater than 35 inches.

Even small reductions in weight can be beneficial. Reducing your weight by just 10 percent can decrease your blood pressure, lower your blood cholesterol level and reduce your risk of diabetes.

5. Get regular health screenings
High blood pressure and high cholesterol can damage your cardiovascular system, including your heart. But without testing for them, you probably won't know whether you have these conditions. Regular screening can tell you what your numbers are and whether you need to take action.

Blood pressure. Regular blood pressure screenings start in childhood. Adults should have their blood pressure checked at least every two years. You may need more frequent checks if your numbers aren't optimal or if you have other risk factors for cardiovascular disease. Optimal blood pressure is less than 120/80 millimeters of mercury.
Cholesterol levels. Adults should have their cholesterol measured at least once every five years. You may need more frequent testing if your numbers aren't optimal or if you have other risk factors for cardiovascular disease. Some children may need their blood cholesterol tested if they have a strong family history of heart disease.

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Avatar universal
by Jesse1188, Jan 21, 2009
I bought your book and started to follow the advice a couple of months ago and it is working! I went for a Comprehensive Health Assessment last week and was pleasantly surprised to find that moderate changes to my diet (less meat, old-fashioned oatmeal every morning and more vegetables) have already lowered my total cholesterol (from 5.2 - 4.48), bumped up the HDL and lowered my blood sugar. The assessment showed me that I should improve my cardiovascular fitness (I exercise a lot, but not in the right target heart rate zone, so I burn fat, but don't get fit) and I should lose more weight. My goal is to control my hypertension with lifestyle changes only, but 3 specialists have now told me that this is unrealistic due to a very strong family history of hypertension. Last reading (without meds) was still 132/91. At 47, I may have to accept that I may have to go on meds indefinitely. I hope the hypertension vaccine will soon be on the market! Maybe if I lose a few more pounds and get really fit, I can put meds off a little longer. Dr. Kirksey, thanks for the book. It is my lifestyle workbook!

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by momtofourboys, Jan 24, 2009
I want to thank you for all of your input that has been on the board.  
I have a question, all I hear is that high BP  can be of danger to your heart, well can someone with an extremely low BP cause an issue since the blood isn't flowing as normal as it should for instance for the past year or too my bp has been 85/54 it has come down some for the 20 years prior to that it was 96/63.  I just wonder if it can mess up my heart and blood flow being too low
I just bout books on healthy lifestyles so I can help out the rest of my family, which high BP runs in that side o f the family and yes they did smoke until Nov of this past year

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by StratRebel, Jan 25, 2009
#6 Keep up good oral health.
Here is a link to some recent research from the American Heart Association.  The link between dental and heart health is becoming a major research topic.


Avatar universal
by rdr123, Jan 28, 2009
How do I eat a "heart-healthy diet" when I
1) already have three stents and a triple bypass;
2) have diabetes; and
3) am confused by the many different and conflicting studies and claims regarding heart disease and diabetes diets, cholesterol levels, and fat consumption -- from the government's constantly discredited food pyramid, to doctors' and nutritionists' web pages and books with advice about fat consumption (and everyting else!) all over the map, and claims (by Atkins proponents) that cholesterol levels are over-emphasized. Seems they all cite studties and statistics, but their conclusions are often diametrically opposed.  So, are the studies skewed (purposefully or otherwise), are these professional and governmental advisors charlatans or just limited, and does any of this [email protected]#$% stuff really matter?

Avatar universal
by willjm, Jan 28, 2009
Barry Groves' book "Trick and treat" cites much evidence for the benefits of a low-carbohydrate high-fat diet. He cites for example research that shows that the lower the cholesterol level in blood the more likely you are to die earlier! That's just one example of the reports in this amazing book.

Avatar universal
by indy1955, Jan 28, 2009
I sure hear what you are saying rdr123.    I had my triple by-pass in July 2008 ,  and of course now I have tried to find out what I should be doing.    The medications I'm given are statins for the cholesterol and I've always been told that sodium levels need to be as low as possible and to lower fat intake.   But then various articles support just the opposite.  Saying we need sodium,  fats,  even cholesterol.   I have been sticking to my low sodium,  low fats,  and low cholesterol diets ..... but I'd sure like to eat things that taste good again !!  ha

Avatar universal
by Buddy1972, Jan 28, 2009
I have had to minor heart attacks and have 2 stents as a result of that, I now take my health very seriously. I walk 2-3 mile a day at least 3 times a week and workout at least 3 times a week for a hour or more. I really watch what I eat and after doing this for as long as I have, I no longer even crave the old foods that I once ate. I am still having a few problems with my heart but they are getting better and I'm also not sure if it isn't just getting old that is cause the pains that I'm having now. LOL.

Avatar universal
by CONSTANTIN, Jan 28, 2009
As a man 59 yrs old, I have read literally hundreds of articles like this one which said "raising blood cholestrol numbers increases risk of coronary artery disease." We believed in this for decades, and have taken statin drugs given to us "to reduce cholestrol levels." But then what is meant by "cholestrol"? Is it "total cholestrol" number?  I realise that "total cholestrol" is a number that is not found in the lab by doing test on the blood, but it is only a calculated number, calculated by a formula :
LDL cholestrol + HDL cholestrol + 1/5 of triglyceride.  These three are all supposed to be found by lab tests on blood. Then they say LDL is bad cholestrol so the lower the better, HDL is good cholestrol, the higher the better.  With LDL 110 + HDL 30 + trig 100 you would get total cholestrol of 160. With LDL 80 + HDL 60 +trig 100 you get total cholestrol of 160.. Isn't this stupid, and badly misleading? How can these two persons be decribed at the exact same total chol. or "cholestrol" number when the good chol. of the second one is exceptionally high and that of first one is dangerously low? And the second one is also better off with lower bad chol. What is the validity and use of a total chol. number at all? To sell people statin drugs??? What about the frequently reported gross fact that 50% of people with heart disease /attack have low cholestrol numbers? Doesn't that show that low chol. does not save from heart disease? Your articles always say "lowering chol. is good, you should strive to lower it." Whatever that is supposed to mean.. Lowering LDL is recommended. Then, lowering LDL to what low levels? Why dont you mention the medical fact that too low LDL is found to be directly associated with rising cancer incidence?? Isn't it also worth mentioning that using "cholestrol lowering" statin drugs causes muscles weakness, including heart muscle?   I, as one who is suffering from serious muscle damage /weakness and exercise inability from 15 years of statins using, am now desperately trying to reverse that loss, to no avail probably, while I am totally confused on what benefit, if any, I have gained from my efforts to "lower my cholestrol"..

Avatar universal
by swtest1, Jan 28, 2009
I appreciate your article and value all of the replies I have read. I am a Type II (insulin dependent) diabetic, along with 3 catheter ablations since 2004 for SVT (rapid, irregular heart beats). I smoke (31 years) and do not exercise. I am the perfect setup for a heart attack and have been told so by my cardiologist and electrophysiologist. My problem is my smoking, being 80 pounds overweight and have no energy to exercise. I have smoked most of my life and have been overweight all of my life. I find now that I am stuck in this terrible addiction to smoking cigarettes. The addiction is horrible and I have tried MANY times to give it up. It amazes me that I could smoke knowing that I could lose my life. I am writing to ask if anyone has been through any part of my experience and if you all could share your comments and ideas with me. In my mind, I know what I have to do but somehow I cannot do it.

Thank you all.

Avatar universal
by tinch, Jan 28, 2009
I have been reading  ALL the original research that was cited for the "low fat" advice that has been handed out for more than 3 decades now. It is very clear that the assumptions and advice dished out for a very long time were not based on good science - the experiments may have had merit in cases, but very often the conclusions drawn were tangential. Conclusions like "a low fat diet is clearly beneficial" when the study was a) (control) mice fed a low cal diet, versus b) mice fed same diet plus corn starch to make it calorie rich. Since an "assumption" was made that calorie was a calorie (i.e. equal) they jumped to the conclusion that, as fat has more calories per gram, it is faster to cut that. All research points to insulin's role in the fatty acid balance with triglicerides (and other mechanisms, fat metabolism is dynamic as heck) ... Since VLDL and LDL creation depends also upon glucose availability - and insulin is the enzyme responsible for fat storage and is as involved in regulating fat levels as it is in sugar levels - it is naive and dangerous to come back to people with the "low fat, lots of grains" argument. It is true that foods with fat content don't store as easily for transport and international trade as those low-fat packaged products (typically corn starch, corn syrop and other fructose-sucrose and other sugar and/or starch compounds make the product 'taste good' and can replace the more natural fat content for "low fat foods"). I'm aghast that 30 years of being told by "nutrition experts" that trans-fat laden alternatives to saturated fat were good for you - yes, 30 years of being told to eat margarine and shortening - a lot of people died from that advice. Now  the same type of silly "fluffy" conclusions are being bandied about as sage medical advice. It is clear that the current "wisdom" - and the food marketing and distribution that it has spawned - has created the obesity, heart disease, diabetes and possibly even cancers that it sought to eradicate .. and in huge numbers. It is going to be tough for the experts involved to swallow hard and confess up to their role in this, which sadly is why we haven't heard anything truly courageous. We only hear the same old rehashed (and false) advice that helps no-one and perpetuates seriously outdated and dangerous myths. The "low fat" fad is clearly going to die .. it is very sad to see learned men and women cling to it instead of truly opening their minds and thinking clearly.

Avatar universal
by isoptera, Jan 28, 2009
     Insufficient potassium and vitamin B-1 (thiamin) can not damage the heart significantly when both are deficient. This has important safety implications when supplementing each during heart disease, rheumatoid arthritis, high blood pressure, beri-beri, or diabetes caused or influenced by the deficiency of one of them.  You may see this discussed in detail in  http://charles_w.tripod.com/kandthiamin.html  

       Sincerely,   Charles Weber

Avatar universal
by Goutfree, Jan 28, 2009
#6 Make sure that you don't have sleep apnea. You may have to be persistent to get your doctor to screen you for sleep apnea.

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by BionicBabe, Jan 28, 2009
I am curious to read the doctor's response to all these assertions claiming that eating a low fat diet and having good cholesterol is not beneficial. I find this argument perplexing. How do you respond to this?

Avatar universal
by Hypert809, Jan 28, 2009
SWTEST1: I was pre-diabetic, bloodsugar 6.6. I went to my Dr and he said: ' Take at least 10 gram of Vitamin C, a standard Magnesium tablet, and, most important of all: give up ALL dairy products; if you do that I guarantee you that you will never be diabetic. Lose some weight, avoid sugars, buy food with a low GI. Within 4 months my blood sugar level was 4.6, perfect.
Smoking: Do NOT give it up, just don't smoke. I stopped smoking in 1980 and when offered a cigarette I would say 'I don't smoke'. NEVER ' I am trying to give it up '. If you feel like a smoke eat an apple, have a shower, go for a walk.

Avatar universal
by kkunzie, Jan 29, 2009
People dont ever do Atkins diets, they are very unhealthy, and the "food Pyrimid" is BS also. Just keep in mind if God didnt put it on the earth its probubly not good for you. Keep things simple and whole. Like whole grains and fruits and vegies. Organic (with out pesticides, hormones, not messed with) is best, but you'll pay more for them for good reason. And eat meat very sparingly. We can get the good stuff you think you have to eat meat in order to get from other food sorces, like nuts, soy, dark green leafy. Remember to stay on the perimeter of the grocery store and stay away from the inner isles that are full of processed ****. Good luck. Be well.
Oh and of corse a good ole walk regularly isnt going to hurt! Get out and feel the sun on your skin. It will help in more ways than one. Laughing is healthy too. Why so serious? Hold babies more often. Hug your grandkids. Love.  

Avatar universal
by ally_gator, Feb 14, 2009
Some of you here are spot on and I'm happy people are actively thinking and drawing their own conclusions.
You cannot depend on doctors and Nutritionists, and Scientists to get it right. Be your own experiment. It's better to be yours than theirs, because theirs may cost you your life!

It's time for people to wake up and look at the real statistics- the way our grandparents lived so many years ago.
Their diet consisted of this dreaded 'saturated fat'. There is something to be said about the fact that meat has saturated fat and so does coconut oil and palm oil. There is something about that that the body needs. The poly and mono created by man has proven to create so many problems for so many people.

Why not stick to the original diet God  intended, instead of trying to reinvent the wheel.

He gave us fruits veggies nuts etc and then he later added meat to that diet, and that's exactly what you should eat. He made you and he knows exactly what you need to sustain your body.

Eat a varied diet of fruits, vegetables, nuts, grains, meat and dairy. Get all these foods in their purest form, not modified by anybody and their uncle. You get it organic, and as unprocessed as possible, with out added hormones and additives- the latter 2 are the real culprits to all diseases, and as I mentioned before man made items such as messing with the natural bonds of oils (aka trans fats)

It's really time people got smart, and realize that half the professionals in these professions are confused. I should know, I studied nutrition in school for 6 long years. I do not work in this profession because it is impossible to recommend my brand of a diet to people. I can't tell how many things have changed since I learned them.

Do the math and figure out your own diet. I am 5 8, 130 pounds, and have never had a weight issue, and I'm 39 and female.
I have always eaten meat and it's fat, coconut oil, which is delicious (I grew up on that) cholesterol and all, I eat nuts, grains, tons of fruits, use unprocessed honey, maple syrup. I get nervous when I eat things with sugar (another new generation food) though I don't think a small amount of sugar is harmful, I do believe it is a culprit in the weight gain (especially stomach fat) in so many people.

The difference in my diet and probably some others is that I do not eat too much of anything. Remember, people of ancient times were 10 times more active than we are.  They had to hunt and gather so therefore they were constantly burning calories. We don't do as much.

In as much as I'm not fat, I do try for at the very least 2 times per week walking, plus my lifestyle is pretty active.
That's what I think the problem is. We are too sedentary, and the problem is not eating low fat foods but eating less of whole fat foods.
Our bodies need fat- saturated fat and it needs more than you realize, in fact the less fat you eat at a meal the hungrier you get, this is why diets don't work because people are miserably hungry and dissatisfied. Fat adds satiety in your diet and you need it, and dare I say again., Do not eat altered food. I don't do 'low' anything. I eat it the way it came from nature.

Another thing: the reason why olive oil (cold pressed) is different from other oils is that the chemical bonds are not changed by the heating process of the garbage oils, which means it still maintains it's 'cis' bonds, instead of the rancid oils (which are deodorized for your smelling pleasure) which have hydrogen forced in them to stabilize them which creates 'trans' bonds.

Another huge problem with health, has to do with the type of sugars we eat. Sugar as i mentioned is one thing, but then there's high fructose corn syrup. Wonder why you can't maintain your weight, check your labels. In fact if you eat like I'm telling you to eat, there won't be many labels to check.
Honey, pure and unprocessed is the most natural sweetner available. It is what people used many years ago before the birth of sugar as we know it.

I could go on, but here's food for thought. Do not trust the government (aka FDA) except when something is labeled 100% organic, and organic as there are strict standards for these labels. The exception to this would be cosmetic products that have no such regulation.
If you could trust the government, aspartame would not have been approved and found its poisonous self on the shelf next to other ****, without a skull and bones symbol that used to grace the label of all poisons years ago.
Trust your own instincts, think of how your grandparents lived and people so many years ago, and never, ever eat new age food.
Wishing you great health as God intended it!

Avatar universal
by neicy2, Apr 23, 2009

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