A stethoscope artistically wrapped around a toy heart.

“Be still my heart” should be the last thing you want. But you could be headed that way if you don’t break bad habits threatening your heart and brain. Here’s how to help extend your life and enhance your cardiovascular health.

1. Failing to Brush or Floss Your Teeth

Why? Inflammation is a general risk for cardiovascular disease. If you don’t brush and floss, your gums can become inflamed – increasing hiking vessel-narrowing C - reactive protein. Germs also can enter the bloodstream, where they cling to fatty deposits in blood vessels.

How Fast Does Your Health Deteriorate? It can takes months to years. Untreated periodontal disease may require surgery to repair.

Can Damage Be Undone? See a dentist every six months for thorough cleanings and exams, says Dr. Giridhar Vedala, a cardiologist at Memorial Hermann Medical Group. Also, brush and floss daily.

Action Items: Take two minutes to brush your teeth thoroughly. Floss at least once daily.

2. Avoiding Checkups

Why? Ignoring health problems doesn’t mean they’ll go away. By addressing the warning signs of heart disease – including elevated blood pressure, cholesterol and hemoglobin A1C (a sign of diabetes) – you can help prevent devastating heart attacks or strokes.

How Fast Does Your Health Deteriorate? Cardiovascular disease can strike as early as in your 40s (and sometimes earlier), Dr. Vedala says.

Can Damage Be Undone? Make your mantra #KnowYourNumbers. “That’s a collective pitch I give my patients,” Dr. Vedala says. “It means knowing your blood pressure, your cholesterol and your hemoglobin A1C. If you develop issues, you know you can go back to what you were doing at an earlier age for better results.”

Action Items: You should get a checkup with blood work at least once in your 20s, then every four to six years before age 40–and annually after that. Recommendations change as you age, but your physician is likely to prescribe lifestyle changes or blood pressure-cutting medications if your blood pressure falls within 130-139 mm Hg for the upper number (systolic) or 80-89 mm Hg for the lower number (diastolic). Half of adults have hypertension, according to the latest American Heart Association data. If diabetes runs in your family but your blood sugar levels are steady, your doctor may suggest having A1C checked just twice yearly. Most physicians urge maintaining A1C levels between 5.7% to 8% and a LDL (or bad) cholesterol below 100. Your HDL (good) cholesterol and triglyceride goals are dependent on your other heart risks. Guidelines relax after 70, to blood pressures of 150/90 mm Hg, and for blood sugar levels, the ideal Hemoglobin A1C of 8.0.

3. Skipping Your Meds

Why? Skipping or suddenly stopping medications that treat heart disease-related ailments can have a significant impact, says Dr. Vedala. When your body is used to having a medication in your system, the body’s reaction can make things like high blood pressure rebound even higher than they were before. When water pills (to treat excess salt) are skipped or stopped, you can have fluid retention, higher blood pressure and shortness of breath.

How Fast Does Your Health Deteriorate? If you’re a sugar-sensitive diabetic, even just one to two missed doses of medications can lead to: confusion, nausea, vomiting and very high sugar levels that in turn may shut down the brain, kidneys and other organs. Over time, amputations, blindness, kidney failure and neuropathy, or pain from nerve damage to the hands or feet, also spike without blood sugar medications. If you stop blood-thinning meds after a heart procedure, that can cause clots to begin forming in blood vessels promptly. “We see that pretty commonly,” Dr. Vedala says.

Can Damage Be Undone? No. Prevention is vital.

What Level is Safe? Missing just one dose of a needed medicine can be harmful. Missing two doses can lead to a heart attack for those patients who had recent heart procedures. “Doctors tell patients this, yet somehow it still happens,” says Dr. Vedala says. “Invariably they forget, or they run out of a dose.”

4. Drinking Excessively

Why? Drinking four to six alcoholic beverages daily weakens the heart muscle and makes function erratic, says Dr. Vedala. The calories consumed feed heart-harming obesity, blood pressure and triglycerides. They also may inflame the stomach lining and liver, which boosts the probability of liver cancer. While antioxidants in red wine, such as resveratrol and flavonoids, curb free radical damage, the bad outweighs the good.

How Fast Does Your Health Deteriorate? Heart distress takes months to years to show.

Can Damage Be Undone? A one- to two- drink daily limit could improve weight, hypertension and stroke-hiking fatty acids (triglycerides). However, damage to heart, stomach and liver may be unsalvageable, Dr. Vedala says.

What Level is Safe? One to two drinks max. However, individuals’ ability to metabolize alcohol differs, so some should just say no. Keep in mind: Single servings of beer are 12 ounces, wine 4 oz. and tequila or other hard liquors 1 oz. (or jigger). Plus, a typical wine glass can hold three servings.

5. Not Eating Enough Fruits and Vegetables

Why? Fruits and veggies are rich in stomach-filling fiber yet low in calories, so your weight and detrimental cholesterol levels are likely to drop. Antioxidants curb free radicals that harden arteries and accelerate aging, Dr. Vedala says.

How Fast Does Your Health Deteriorate? It may take years to see harm–yet only months to see perks.

Can Damage Be Undone? Chances of cancer, heart-injuring inflammation, heart attack and stroke recede with a 10- to 20-pound drop.

What Level is Safe? Most of us cannot overdo these health-boosters. But diabetics should consult their doctor, registered dietitian or health care provider to determine whether they should avoid some sugar-rich fruits that can spike blood sugar.

6. Being Sedentary

Why? Cardiovascular activity improves heart function and burns calories, leading to weight loss. Being overweight exposes you to diabetes, high blood pressure and inflammation, all of which accelerate hardening of the arteries. Together those hazards lead to heart attacks and stroke.

How Fast Does Your Health Deteriorate? The damage may not be visible for years.

Can Damage Be Undone? Within a week after becoming active, your blood sugar, hypertension and other blood markers may improve. “I’ve seen patients on heart medications who were able to get off all medications when they lost weight,” says Dr. Sanjay Maniar, cardiologist affiliated with Memorial Hermann Heart & Vascular Institute – Southwest. “Once their weight was under control, they no longer needed them.”

What Level of Exercise is Safe? The American Heart Association recommends walking, running and otherwise working out 30-45 minutes per day, five times a week. But perfection isn’t required. Even if you walk just three miles a week, you get a 10% reduction in cardiovascular disease. Walking 30 minutes a day brings a 20% reduction. If you run just one hour per week, you cut the chance of heart disease by 40%. And even if you don’t start exercising until after age 40, you still can improve your chances of a healthy cardiovascular system 55%. “It’s never too late,” says Dr. Vedala. “Any exercise is better than no exercise – always. Any increased activity will be good for you. And trying to make it regular will make it even more beneficial.” Best of all, things you might do anyway count, such as yard work and gardening. And try golfing without a cart.

7. Eating Too Much Salt

Why? Excess sodium causes you to hold more water, which hikes blood pressure. The average American consumes 3,400 mg of salt per day, about 50% more than the recommended amount of 2,300 mg. Excess salt is in processed, prepackaged and restaurant food, says Dr. Vedala. To cut heart risks, decrease salt from your diet, or take medications that excrete salt through the urine. If your ring feels a little tight on your finger, you could be holding onto more fluids.

How Fast Does Your Health Deteriorate? The harm to your heart from too much salt is a lifelong process, not an overnight phenomenon. Within a few years you can see effects directly related to high blood pressure. But if you slash salt intake, improvements can be quick.

Can Damage Be Undone? Yes, blood pressure responds within six weeks to lowering salt intake. Start checking for salt in ingredients labels for food. Be wary of salty foods that are processed or served at restaurants. Fast foods, fatty foods, fried foods and meats can have lots of salt, as can soups, frozen dinners, bread and pizza, as well as tomato sauce for pasta. Trim these — and improve your chances of living a longer, healthier life. Also, monitor your blood pressure. It’s not hard to do.

What Level is Safe? The American Heart Association says we should have only 1,500 to 2,300 mg of salt per day. Need to visualize? One teaspoon of granulated salt is 2,325 mg, which should be your daily limit.

8. Smoking

Why? “Smoking is one of the most harmful things people can do to themselves,” Dr. Maniar says. Blood flow drops, slashing oxygen that fuels the heart, which compensates by spiking blood pressure, heart rate and rhythm, and can lead to hardened and narrowed arteries and blood clots causing cardiovascular disease. At the same time, our internal police – inflammatory markers such as C-reactive protein — attack dangerous intruders tar, nicotine and other carcinogens.

How Fast Does Your Health Deteriorate? Within 30 minutes, just one cigarette reduces blood flow to the heart, forcing it to work harder. Even second-hand smoke harms the heart.

Can Damage Be Undone? Two years after quitting, the threat of heart attacks and stroke starts to recede, and after a decade, the threat of lung cancer is halved. After 15 years, heart function improves, “but there’s no way to recover damaged lung tissue,” Dr. Maniar says.

What Level is Safe? None – including second-hand smoke.

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