Many people fail to take the proven steps to prevent
heart attacks and strokes. The strategies listed
below are ranked by the number of heart attacks and
strokes they could prevent in American adults over
the next 30 years, according to a special report in
the July 29, 2008, issue of Circulation.
Lower your blood pressure
Goal: A systolic (upper)
level under 140 and a diastolic (lower) level
Problems prevented: 6.2
million heart attacks, 7 million strokes.
What you can do: Get your
blood pressure checked at least once a year. If
it's high, cut back on salt, lose excess weight,
and exercise more. If drugs are necessary, our
CR Best Buy Drugs recommendation for most people
is a generic diuretic, especially a thiazide
Improve your cholesterol levels
Goal: An LDL (bad)
cholesterol under 160 for people at low risk of
heart attack, 130 for those at intermediate
risk, and 100 for those at high risk. (To
determine your risk, use our online calculator.)
Problems prevented: 9.6
million heart attacks, 3 million strokes.
What you can do: Men 35 and
older as well as women 45 and older with
coronary risk factors, such as high blood
pressure, should get tested at least every five
years. Other adults might consider testing, too.
If your levels are high, control your weight,
exercise more, quit smoking, and eat a
heart-healthy diet. If medication is necessary,
our CR Best Buy Drugs recommendations for most
people are generic lovastatin, pravastatin, or
Lose excess weight
Goal: A body mass index
(BMI) under 30 (the cutoff for obesity) and
preferably under 25 (the cutoff for being
Problems prevented: 7.1
million heart attacks, 1.1 million strokes.
What you can do: Determine
your BMI by multiplying your weight in pounds by
703, then dividing by your height squared in
inches. (Or use our online calculator.) Even
simpler: Measure your waist. Men with a
waistline over 40 inches and women with a
measurement over 35 inches should lose weight.
Control your blood sugar level
Goal: A fasting blood
glucose level under 110 for people who do not
have diabetes, and preferably under 100; an A1C
level, a measure of long-term blood sugar
control, under 7 percent for people who already
have the condition.
Problems prevented: 4.8
million heart attacks, 0.6 million strokes.
What you can do: Consider
getting your blood sugar level measured,
especially if you're at high risk for type 2
diabetes because of high blood pressure or
cholesterol levels or excess weight. The same
lifestyle changes that lower blood pressure and
cholesterol can lower blood sugar, too. Our CR
Best Buy Drugs recommendation for most people
with type 2 diabetes is generic metformin, alone
or combined with other drugs.
Goal: Quit—for good.
Problems prevented: 3.3
million heart attacks, 1.4 million strokes.
What you can do: Talk with
a doctor about the best smoking-cessation
program for you and be examined for
Consider low-dose aspirin
Goal: Take a low-dose (81
milligrams) aspirin daily if appropriate.
Problems prevented: 3.4
million heart attacks, 0.3 million strokes.
What you can do: Talk to a
doctor about your risk of heart attack, stroke,
and gastrointestinal bleeding starting at age 45
for men and 55 for women. Use our calculator to
see whether the benefits of aspirin outweigh its
risks for you.