If you've been lackadaisical about getting your cholesterol checked because you watch your weight, don't have heart problems, and think you're too young to worry about a heart attack, a panel of 27 heart-disease experts has a harsh message for you and others equally casual. Under tough cholesterol guidelines rolled out last week, many people will find that they are now considered to be at far greater risk of a heart attack than they were under the old version. The new report recommends that they and their doctors take decisive steps to lower the risk.
If everyone heeded the new recommendations, some 65 million people would alter their diet, up from 52 million under the previous guidelines, which date from 1993. Cholesterol-lowering medications, especially the class called statins, get wholehearted approval after years of advice to prescribe them gingerly. The guidelines call for 36 million people to take them, compared with 13 million currently. "We ought to address high cholesterol very aggressively," says James Cleeman, coordinator of the National Cholesterol Education Program, a coalition of public and private groups that developed the guidelines. "So it's not necessary to be reticent about recommending aggressive therapy, meaning drugs."
The urgency behind the report's dry language is unmistakable. Panel members had spent 20 months combing through stacks of studies that collectively showed that oversize waistlines, little exercise, and cholesterol levels that generally are still too high pose an even greater risk than had been thought. If all Americans lived by the guidelines, says Cleeman, the overall death rate would drop by an estimated 30 percent.
Even if you don't need a prescription, the recommendations will certainly change the way you--and your doctor--think about cholesterol, from when and how often it should be checked to ways of treating it if it's high.
You are experiencing chest pain, shortness of breath, rapid pounding heartbeats, sweating, and a feeling of impending doom. You're a mess. You've tried to reason with yourself that you're only having, say, a panic attack—not a heart attack. After all, panic attacks are certainly common; many of us have experienced them at one time or another. You’ve read a few articles and talked with your friends. The body reacts to anxiety by producing stress hormones, and it’s these stress hormones that are causing your symptoms, right?
But your chest continues to burn; dizziness, weakness, nausea, and severe indigestion (along with a heightened sense of anxiety) are flooding over you. Are you having a panic attack or a heart attack?
Both can display similar symptoms, and panic attacks are nothing to scoff at. But symptoms that last for more than two or three minutes, or pain that leaves and then returns, could signal a heart attack. Only by having testing can a correct diagnosis be made. You decide to go see your doctor—or maybe even go to the emergency room—because you can't talk yourself into believing you're having a panic attack. Good for you!
Exercise can improve symptoms of depression and anxiety. Even small amounts of exercise help. These realistic tips and goals can help you get started and stick with it.
If you have depression or anxiety, you might find your doctor prescribing a regular dose of exercise in addition to medication or psychotherapy. Exercise isn't a cure for depression or anxiety. But its psychological and physical benefits can improve your symptoms.
There is a link between heart disease and depression. Depressed postmenopausal women have a 50% greater risk of developing or dying from heart disease than those who are not depressed, raising the possibility that treating the mind could help the body fight cardiovascular ills. This finding came from a four-year government study of 100,000 women across the United States. What is most striking is that depression was found to be an independent risk factor for subsequent cardiovascular death. Obviously, volatile emotions such as anger and hostility are bad for your heart’s health. But studies have also shown that some of the quieter emotions can be just as toxic and damaging. Dr. Dean Ornish said, “Study after study has shown that people who feel lonely, depressed, and isolated are many times more likely to get sick and die prematurely, not only of heart disease but from virtually all causes, than those who have a sense of connection, love, and community.”
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