By Joyce Reingold
It may be a mouthful, but the pooled cohort risk assessment equation is a helpful phrase to add to your lexicon in February, American Heart Month.
And with this being a leap year, we have 24 extra hours this month to spend understanding heart disease risks and engaging in heart-healthy pursuits.
“I think it’s important that everybody over the age of 40 know what their cardiovascular risk factors are. They should be aware of their own family history and they need to speak with their physician about assessing their long-term risks for heart disease and stroke in the future,” says Dr. Carlos Victorica, a family physician with Boca Raton Regional Hospital’s BocaCare network.
Victorica cites the assessment tool, for individuals over the age of 40, as one of the most important diagnostic advances in recent years. It uses factors such as gender, age, race, cholesterol level and blood pressure to calculate cardiovascular risks.
“We now really try and give you a risk score so we know within a certain probability what the chances would be of a heart attack or stroke within 10 years. And we use that to help dictate what level of testing we do,” he says. “There are all sorts of new tests that we can now do by doing this risk stratification.”
Since President Lyndon B. Johnson established American Heart Month in a December 1963 proclamation, the body of research and recommendations has changed and grown exponentially. Today, doctors regularly emphasize the importance of lifestyle changes — particularly a healthy diet and regular exercise — to stave off heart disease. The recommendations are familiar, but a heart-themed month offers a good opportunity for a refresher.
The American Heart Association recommends:
• “Aim for at least 150 minutes of moderate physical activity each week, or 75 minutes of vigorous activity (or an equal combination of both) each week,” the AMA says on its website.
Victorica says: “I try and tell people that it should be something that is pushing your fitness. It depends on your risk factors and co-morbidities, but if you have the capability to do more vigorous exercise, I encourage it.”
A study published in the Journal of the American Medical Association showed that people who could “do more” on a treadmill during an exercise stress test — regardless of whether they were smokers or had diabetes or high blood pressure — tended to outlive their counterparts, Victorica says.
“I want it to be something where you’re trying to get more physically fit than where you’re at now,” he says. “The main thing I try to do is to make an agreement with the patient where we can have a reasonable goal.”
• “Eat a variety of nutritious foods from all the food groups,” the AMA recommends.
Victorica says to think plant-based foods. He suggests that parents with children at home start inching up a meal’s vegetable quotient to half of the plate. That advice goes for the grown-up set, too.
“I say a plant-based diet, but it’s not that they should become vegetarian. It’s more that the bulk of what they put on their plates should be plant- or legume-based. I do still want them to have meats and, to some degree, animal products because protein is very filling — especially animal protein — and it allows them to consume less carbohydrates,” he says.
“And that’s my bigger issue. We’ve really vilified and demonized fats and cholesterol and meat so much that people … just consume a lot of carbohydrates. And that becomes a bigger problem,” he says.
“I’d rather that we still focus on the main thing that we know is good for you, which is really just fruits, vegetables, legumes and nuts … just a healthy, balanced diet.”
Victorica says he also tells patients, “Life is a marathon and the goal is to try and make small bite-size changes that lead to something greater over time.”
That’s good advice for matters of the heart — heck, life in general — in this leap year and beyond.
Joyce Reingold writes about health and healthy living. Send column ideas to firstname.lastname@example.org.