Of all the idiot ways to bite the dust, heart disease ranks right up there with BASE jumping into a strong headwind. In both cases, poor choices are almost always to blame. A 2004 study called Interheart found that 90 percent of first heart attacks in men (and 94 percent in women) can be attributed to risk factors that are largely in your control. Here are the key factors cited by Interheart, the American Heart Association, and the CDC.
1. Cigarette smoking. You know this. But did you know that smoking just once a month increases risk of heart disease? Cigarette smoking raises your blood pressure and clogs your arteries. Among men aged 3539, smokers are five times more likely to have a heart attack than nonsmokers. And Bill Clinton notwithstanding, you don't get a free pass for not inhaling. Even cigars raise therisk of death from heart disease, though not as significantly as cigarettes.
Solution: Quit. Even on poker night.
2. High cholesterol. You need to know three things about cholesterol: LDL ("bad") cholesterol causes arterial plaque, the fatty deposits that clog or block blood flow; HDL ("good") cholesterol helps clear arteries; and all adults should have their cholesterol levels checked every three to five years, starting in their twenties. The key numbers: Keep your LDL cholesterol count under 100 mg/dl, your HDL above 40, and the total under 200.
Solution: Maintain healthy cholesterol levels through regular exercise and a smart diet (see "Eat Like a Greek," below). If necessary, statin drugs have proven effective at lowering cholesterol, as have high doses of niacin (vitamin B3).
3. High blood pressure. Like cholesterol levels, your blood pressure can be dangerously high without any outward warning signs. Nearly one in three adults have high blood pressure, but as many as 30 percent of them don't know it. Left unchecked in your twenties and thirties, both problems can lead to clogged arteries later. Your blood pressure should be under 120/80; have it checked at least once a year.
Solution: Consume less salt, exercise, and relax.
4. Diabetes. It's been called an epidemic, and it's hard to argue with 20 million cases of diabetes nationwide.
Solution: Keep your weight in control. Done that? Decrease sugar intake, and lose 5 to 7 percent of your body fat.
5. Obesity. A spare tire around your waist often means fat around your heart.
Solution: Lose the gut. And remember: It's possible to be thin and still have internal fat deposits due to poor diet.
6. Stress. It elevates blood pressure, which increases heart-attack risk. A study published in the May 22 issue of the Journal of the American College of Cardiology concluded that subjects with the highest levels of anxiety had twice the heart-attack risk of those with the lowest.
Solution: Relax, take up yoga, and avoid stressful situations. Yes, you now have a medical excuse to skip that weekend with the in-laws.
7. Poor diet. Specifically, not eating enough deeply colored fruits and vegetables, which are packed with essential vitamins and can help lower your cholesterol and blood pressure.
Solution: Spend big at the farmers' market.
8. Lack of exercise. This one's painfully obvious, like smoking, so don't screw it up. Being young and healthy is no excuse for letting a week go by without raising your heart rate.
Solution: Cardiologists recommend at least 30 minutes of aerobic activity a day. See "Tune Up"(previous page) to make sure you're getting the optimum amount.
9. Heredity. Sorry, this is the hand you're dealt. Researchers recently identified a gene in people of European descent that increases the risk of heart disease 60 percent.
Solution: Until a genetic test is widely available, use this rule: If your father died of a heart attack before age 55 (or mother before 65), ask your doctor if you should get a stress test, which canreveal hidden coronary-artery disease.