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ALTHOUGH heart disease causes one in four deaths among men in the United States, you don’t have to be one of them - if you have been diagnosed with heart disease, there are things you can do today to lower your risk, says the July 2013 issue of the Harvard Medical School Harvard Men’s Health Watch.

Dr. Deepak L. Bhatt, chief of cardiology at VA Boston Healthcare System and director of the Integrated Interventional Cardiovascular Program at Harvard-affiliated Brigham and Women’s Hospital, offers a heart attack prevention checklist:

• Take your medications - A surprisingly large number of men prescribed cardiac medications do not take them consistently, or do not take them at all; thus, missing out on a powerful prevention strategy - this includes:

1) Statins - they lower the risk of heart attacks by lowering cholesterol, improving artery function and stabilizing the fatty deposits in arteries that can lead to a heart attack if they suddenly rupture;

2) A daily baby (low-dose) aspirin - helps by making platelets less “sticky” and therefore less likely to form clots; and

3) Blood pressure medications - it’s one of the single most effective ways to prevent heart attacks and strokes. Two-thirds of men over age 60 have hypertension, yet many men don’t take blood pressure medications consistently - you need to take them every day for life, unless weight loss, a change in diet, or other lifestyle measures eventually allow you to taper off your blood pressure medication under your doctor’s supervision, says the health letter.

• Be as physically active as you can be - For men with heart concerns, any amount of exercise is preferred over none or very little - “The benefit is linear,” Dr. Bhatt says.

“Some is better than none and more in general is better than some.”

You do not necessarily need to engage in daily sweat-producing cardiac workouts either - “If a man is a couch potato, then going from a couch potato to a regular walk every day would yield substantial benefit,” Dr. Bhatt says.

“If he goes from a daily walk to additional exercise, like workouts in a gym, it benefits him even more.”

• Sign up for cardiac rehabilitation - After a heart attack, angioplasty, or bypass surgery, a cardiac rehabilitation program that offers supervised exercise, nutrition counseling, training in stress reduction, and positive social support - all crucial to regaining health after a cardiovascular crisis - is extremely helpful to the patient.

“If somebody just had a heart attack or cardiac procedure, I don’t think he should just wing it, Dr. Bhatt says.

“He should go to cardiac rehab.”

Many insurance programs, including Medicare, pay for cardiac rehab after a recent heart attack (within the past 12 months), coronary artery bypass surgery, heart valve replacements, a coronary-artery-opening angioplasty or stent procedure, as well as for current chest pain from clogged coronary arteries.

• Get a flu shot - For men with heart disease, besides preventing the misery of influenza, vaccination may also prevent a heart attack or chest pain - a flu infection may increase the risk of chest pain or a heart attack.

Also, a bad bout of the flu can land anyone in the hospital, especially individuals with heart failure, diabetes, kidney disease or asthma.

“If someone had a history of heart disease, that might be another reason to get the vaccination,” adds Dr. Bhatt.

• Drink alcohol in moderation - For men with heart concerns, a standard drink or two of alcohol per day - a standard drink  is 1.5 ounces (one shot glass) of 80 proof spirits, a 5 ounce serving of table wine, or a 12 ounce serving of beer - is not likely to cause harm.

“If you want to drink and you’ve had a heart attack, and if you drink moderately, I think it’s safe,” Dr. Bhatt says.

While some research has hinted that moderate drinking may be slightly cardioprotective, it’s important to understand that such studies are merely observational: moderate drinkers tend to have less heart disease, but is it because of the drinking? - no one can say for certain - at least without doing a major clinical trial, the health letter says.

“There’s no evidence of cardiovascular harm, but I’m skeptical that there’s truly any benefit,” says Dr. Bhatt.

• Lose some weight - If you’ve got a spare tire, losing some of that excess weight can further reduce your cardiac risk, in addition to the effects of medications, exercise and good nutrition, says the health letter.

As with exercise, some weight loss is better than none, and more is better than some - the two work together to improve your cardiovascular fitness.

Some get-started options to get more heart-healthy exercise is offered by Dr. Bhatt to heart patients who aren’t physically active:

• Walking - For previously inactive men, the best way to start is daily walking - “Brisk walking is certainly good for the heart and the vascular system, but it’s also good for everything else - the joints, the muscles, the bones,” says Dr. Bhatt.

You should feel the benefits of daily walking fairly soon, with more energy, a lighter mood and less joint pain - to name just a few benefits identified in research.

• Cardio workout - Before you decide to step it up a bit to more strenuous “cardio” workout at a health club, check in with your doctor to make sure it’s safe to do so, says the health letter.

• Home gym - While health clubs offer a social environment that some exercisers enjoy, others may opt for a home treadmill or exercise bike.

• Smaller amounts count - In contrast to extended sessions on treadmills and elliptical trainers, you can benefit from the collective effect of physical activity in smaller amounts throughout the day -

“Some research says you can get your exercise in smaller increments, say several 10 minute periods,” Dr. Bhatt says.

• Increase physical activity - Although there are a lot of ways to be physically active, the bottom line is to increase your level of activity whatever form it may take - “The greatest benefit is had by going from nothing to something,” says Dr. Bhatt.

Some easy ways to increase daily physical activity include:

1) Walk instead of taking the bus;

2) Take the stairs instead of the elevator;

3) Park farther away from the store;

4) Walk around the mall; and

5) Enroll in a group exercise class, like water aerobics or light aerobics, concludes the health letter.

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