Note: cardiac conditions are inherently unstable.Encyclopedia Entry for Heart Disease :Heart disease - resources. Resources - heart disease.Coronary artery blockage Coronary artery blockage Prevention of heart disease Prevention of heart disease.Encyclopedia Entry for Heart Disease :Heart disease - risk factors. A risk factor is something about you that increases your chance of getting a disease or having a certain health condition. Some risk factors for heart disease you cannot change, but some you can. Changing the risk factors that you have control over may help you live a longer, healthier life.Some of your heart disease risks that you CANNOT change are: Your age. Risk of heart disease increases with age. Your gender. Men have a higher risk of getting heart disease than women who are still menstruating. After menopause, the risk for women gets closer to the risk for men. Your genes or race. If your parents had heart disease, you are at higher risk. African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk for heart problems.Some of the risks for heart disease that you CAN change are: Not smoking. If you do smoke, quit. Controlling your cholesterol through diet, exercise, and medicines. Controlling high blood pressure through diet, exercise, and medicines, if needed. Controlling diabetes through diet, exercise, and medicines, if needed. Exercising at least 30 minutes a day. Keeping to a healthy weight by eating healthy foods, eating less, and joining a weight loss program, if you need to lose weight. Learning healthy ways to cope with stress through special classes or programs, or things like meditation or yoga. Limiting how much alcohol you drink to 1 drink a day for women and 2 a day for men. Good nutrition is important to your heart health and will help control some of your risk factors. Choose a diet rich in fruits, vegetables, and whole grains. Choose lean proteins, such as chicken, fish, beans and legumes. Choose low-fat dairy products, such as 1% milk and other low-fat items. Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods. Eat fewer animal products that contain cheese, cream, or eggs. Read labels, and stay away from 'saturated fat' and anything that contains 'partially-hydrogenated' or 'hydrogenated' fats. These products are usually loaded with unhealthy fats. Follow these guidelines and the advice of your health care provider to lower your chances of developing heart disease.Heart disease - prevention; CVD - risk factors; Cardiovascular disease - risk factors; Coronary artery disease - risk factors; CAD - risk factors.Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC Guidelines on lifestyle management to reduce cardiovascular risk: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922. Hansson GK, Hamsten A. Atherosclerosis, thrombosis, and vascular biology.Encyclopedia Entry for Heart Disease :Heart disease and depression. Heart disease and depression are linked in a number of ways. Some symptoms of depression, such as lack of energy, can make it harder to take care of your health. People who are depressed may be more likely to: Drink alcohol, overeat, or smoke to deal with feelings of depression Not exercise Feel stress, which increases your risk for abnormal heart rhythms and high blood pressure. Not take their medicines correctly All of these factors: Increase your risk of having a heart attack Increase your risk of dying after a heart attack Increases the risk of being readmitted to the hospital Slow down your recovery after a heart attack or heart surgery.It is pretty common to feel down or sad after having a heart attack or heart surgery. However, you should start to feel more positive as you recover. If the sad feelings do not go away or more symptoms develop, do not feel ashamed. Instead, you should call your health care provider. You may have depression that needs to be treated. Other signs of depression include: Feeling irritable Having trouble concentrating or making decisions Feeling tired or not having energy Feeling hopeless or helpless Trouble sleeping, or sleeping too much A big change in appetite, often with weight gain or loss A loss of pleasure in activities you usually enjoy, including sex Feelings of worthlessness, self-hate, and guilt Repeated thoughts of death or suicide.Treatment for depression may depend on how severe it is. There are two main types of treatments for depression: Talk therapy. Cognitive behavioral therapy (CBT) is a type of talk therapy commonly used to treat depression. It helps you change thinking patterns and behaviors that might add to your depression. Other types of therapy may also be helpful. Antidepressant medicines. There are many kinds of antidepressants. Selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) are two of the most common used to treat depression. Your provider or therapist can help you find one that works for you. If your depression is mild, talk therapy may be enough to help. If you have moderate to severe depression, your provider may suggest both talk therapy and medicine.Depression can make it hard to feel like doing anything. But there are ways you can help yourself feel better. Here are a few tips: Move more. Regular exercise can help reduce depression. However, if you are recovering from heart problems, you should get your doctor's OK before starting to exercise. Your doctor may recommend joining a cardiac rehabilitation program. If cardiac rehab is not right for you, ask your doctor to suggest other exercise programs. Take an active role in your health. Studies show that being involved in your recovery and overall health can help you feel more positive. This includes taking your medicines as directed and sticking to your diet plan. Reduce your stress. Spend time each day doing things you find relaxing, such as listening to music. Or consider meditation, tai chi, or other relaxation methods. Seek social support. Sharing your feelings and fears with people you trust can help you feel better. It can help you better handle stress and depression. Some studies show it may even help you live longer. Follow healthy habits. Get enough sleep and eat a healthy diet. Avoid alcohol, marijuana, and other recreational drugs.Call 911, a suicide hotline, or go to a nearby emergency room if you have thoughts of harming yourself or others. Call your health care provider if: You hear voices that are not there. You cry often without cause. Your depression has affected your ability to participate in your recovery, or your work, or family life for longer than 2 weeks. You have 3 or more symptoms of depression. You think one of your medicines may be making you feel depressed. DO NOT change or stop taking any medicines without talking to your provider.Lichtman JH, Froelicher ES, Blumenthal JA, et al. Depression as a risk factor for poor prognosis among patients with acute coronary syndrome: systematic review and recommendations: a scientific statement from the American Heart Association. Circulation. 2014;129(12):1350-1369. PMID: 24566200 www.ncbi.nlm.nih.gov/pubmed/24566200. Vaccarino V, Bremner JD. Psychiatric and behavioral aspects of cardiovascular disease.Encyclopedia Entry for Heart Disease :Heart disease and diet. A healthy diet and lifestyle can reduce your risk for: Heart disease , heart attacks, and stroke Conditions that lead to heart disease, including high cholesterol , high blood pressure, and obesity Other chronic health problems, including type 2 diabetes , osteoporosis , and some forms of cancer This article makes recommendations that can help prevent heart disease and other conditions that can affect the health of your heart. People who currently have a heart condition, such as heart failure, or other health problems, such as diabetes, should talk with their health care provider about what type of diet is best. You may need to make certain changes to your diet that are not included in these recommendations.FRUITS AND VEGETABLES Fruits and vegetables are part of a heart-healthy diet. They are good sources of fiber , vitamins, and minerals. Most are low in fat, calories, sodium, and cholesterol. Eat 5 or more servings of fruits and vegetables per day. Get more fiber by eating whole fruits instead of drinking juice. Fruits and vegetables GRAINS Include whole wheat bread and pasta, brown rice, and starchy vegetables (such as peas, potatoes, corn, winter squash, and lima beans). These foods are high in the B vitamins, iron, and fiber. Choose whole grain foods (such as whole-wheat bread, cereal, crackers, and pasta or brown rice) for at least half of your daily grain intake. Grain products provide fiber, vitamins, minerals, and complex carbohydrates. Eating too many grains, especially refined gain foods (such as white bread, pasta, and baked goods) can cause weight gain. Limit high-fat baked goods such as butter rolls, cheese crackers, and croissants, and cream sauces for pasta. Avoid packaged snacks that contain partially hydrogenated oils or trans fats. EATING HEALTHY PROTEIN Meat, poultry, seafood, dried peas, lentils, nuts, and eggs are good sources of protein, B vitamins, iron, and other vitamins and minerals. Fish in diet You should: Limit high-fat proteins. These include meats such as duck, goose, prime cuts of steak, organ meats such as kidneys and liver, and prepared meats such as sausage, hot dogs, and high-fat lunch meats. Trim off all visible fat before cooking the meat. Eat at least 2 servings of low-mercury fish per week. Cook by baking, broiling, roasting, steaming, boiling, or microwaving instead of deep frying. For the main entree, use less meat or have meatless meals a few times a week. Get protein from plant-based protein foods instead. Use skinless turkey, chicken, fish, or lean red meat to reduce the amount of saturated fat in your diet. Milk and other dairy products are good sources of protein, calcium, the B vitamins niacin and riboflavin, and vitamins A and D. Use skim or 1% milk. Cheese, yogurt, and buttermilk should be low-fat or non-fat. FATS, OILS, AND CHOLESTEROL Some types of fat are healthier than others. A diet high in saturated and trans fats causes cholesterol to build up in your arteries (blood vessels). This puts you at risk for heart attack, stroke, and other major health problems. Avoid or limit foods that are high in these fats. Polyunsaturated and monounsaturated fats that come from vegetable sources have many health benefits. Obesity and health You should: Limit total fat intake to 25% to 35% of your total daily calories. The American Heart Association recommends eating a healthy diet that limits 5% to 6% of calories from saturated fat. Foods with a lot of saturated fats include animal products such as butter, cheese, whole milk, ice cream, sour cream, lard, and fatty meats such as bacon. Some vegetable oils (coconut, palm, and palm kernel oils) also contain saturated fats. These fats are solid at room temperature. Limit trans fats as much as possible by avoiding hydrogenated or partially hydrogenated fats. These are often found in packaged snacks and solid margarine. Eat less than 300 mg of dietary cholesterol each day. (One egg yolk contains an average of 184 mg of cholesterol.) Think about the following when choosing a margarine: Choose soft margarine (tub or liquid) over harder stick forms. Choose margarines with liquid vegetable oil as the first ingredient. Even better, choose 'light' margarines that list water as the first ingredient. These are even lower in saturated fat. Read the package label to choose a margarine that does not have trans fats. Trans fatty acids are unhealthy fats that form when vegetable oil undergoes hydrogenation. Trans fats can raise LDL (bad) cholesterol level in your blood. They can also lower your HDL (good) cholesterol level. To avoid trans fats, limit fried foods, commercial baked goods (donuts, cookies, and crackers), and hard margarines. OTHER TIPS TO KEEP YOUR HEART HEALTHY You may find it helpful to talk to a dietitian about your eating choices. The American Heart Association is a good source of information on diet and heart disease. Balance the number of calories you eat with the number you use each day to maintain a healthy body weight. You can ask your doctor or dietitian to help you figure out a good number of calories for you. Limit your intake of foods high in calories or low in nutrition, including foods like soft drinks and candy that contain a lot of sugar. The American Heart Association recommends that sodium intake be no more than 2,300 milligrams (about 1 teaspoon, or 5 mg) a day with an ideal limit of no more than 1,500 mg per day for most adults. Cut down on salt by reducing the amount of salt you add to food when eating and cooking. Also limit packaged foods that have salt added to them, such as canned soups and vegetables, cured meats, and some frozen meals. Always check the nutrition label for the sodium content per serving and be sure to pay attention to the number of servings per container. Season foods with lemon juice, fresh herbs or spices instead. Foods with more than 300 mg of sodium per serving may not fit into a reduced sodium diet. Exercise regularly. For example, walk for at least 30 minutes a day, in blocks of 10 minutes or longer. Try to move at least 30 minutes most, if not all, days of the week. Limit the amount of alcohol you drink. Women should have no more than 1 alcoholic drink per day. Men should not have more than 2 alcoholic drinks each day. One drink is defined as 12 ounces (355 milliliters, mL) of beer, 5 ounces (148 mL) of wine, or a 1 1/2-ounce (44 mL) shot of liquor.Diet - heart disease; CAD - diet; Coronary artery disease - diet; Coronary heart disease - diet.Cholesterol - drug treatment.Healthy diet Healthy diet Fish in diet Fish in diet Fruits and vegetables Fruits and vegetables Obesity and health Obesity and health.Eckel RH, Jakicic JM, Ard JD, et al. 2013 AHA/ACC guideline on lifestyle management to reduce cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J am Coll Cardiol. 2014;63(25 Pt B):2960-2984. PMID: 24239922 www.ncbi.nlm.nih.gov/pubmed/24239922. Heimburger DC. Nutrition's interface with health and disease.Encyclopedia Entry for Heart Disease :Heart disease and intimacy. Both you and your provider may be concerned that having sex will bring on a heart attack. Your provider can tell you when it is safe to have sex again. After a heart attack or heart procedure: You may have an exercise test, to see how your heart reacts to exercise. Sometimes, at least the first 2 weeks or so after a heart attack, your provider may advise avoiding sex. Make sure you know the symptoms that could mean your heart is working too hard. They include: Chest pain or pressure Feeling lightheaded, dizzy, or faint Nausea Trouble breathing Uneven or fast pulse If you have any of these symptoms during the day, avoid sex and talk to your provider. If you notice these symptoms during (or soon after) having sex, stop the activity. Call your provider to discuss your symptoms.After heart surgery or a heart attack, your provider may say it is safe to have sex again. But your health issues may change the way you feel about or experience sex and close contact with your partner. Besides being worried about having a heart attack during sex, you may feel: Less interested in having sex or being close with your partner Like sex is less enjoyable Sad or depressed Feel worried or stressed Like you are a different person now Women may have trouble feeling aroused. Men may have trouble getting or keeping an erection, or have other problems. Your partner may have the same feelings you are having and may be afraid to have sex with you.If you have any questions or concerns about intimacy, talk to your provider. Your provider can help you find out what is causing the problem and suggest ways to deal with it. It may not be easy to talk about such private things, but there may be a treatment that could help you. If you find it hard to talk to your heart doctor about these topics, talk to your primary care provider. If you are depressed, anxious, or afraid, medicine or talk therapy may help. Classes in lifestyle change, stress management, or therapy may help you, family members, and partners. If the problem is caused by side effects of medicine you are taking, that medicine may be adjusted, changed, or another medicine may be added. Men who have trouble getting or keeping an erection may be prescribed a medicine to treat this. These include medicines like sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). The above medicines may not be safe if you are taking other medicine. DO NOT take them if you are taking nitroglycerin or nitrates. Taking both kinds of these medicines can lead to a life-threatening drop in blood pressure. DO NOT buy these medicines through the mail or another doctor who does not know your full health history. To get the right prescription, talk to the doctor who knows your health history and all the medicines you take.If you have new symptoms of heart trouble during sexual activity, stop the activity. Call your provider for advice. If the symptoms do not go away within 5 to 10 minutes, call 911.Levine GN, Steinke EE, Bakaeen FG, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2012;125(8):1058-1072. PMID: 22267844 www.ncbi.nlm.nih.gov/pubmed/22267844. Morrow DA, de Lemos JA. Stable ischemic heart disease.Encyclopedia Entry for Heart Disease :Heart disease and women. CAD - women; Coronary artery disease - women.Heart, section through the middle Heart, section through the middle Heart, front view Heart, front view Acute MI Acute MI Healthy diet Healthy diet.Fihn SD, Blankenship JC, Alexander KP, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. Circulation. 2014;130(19):1749-1767. PMID: 25070666 www.ncbi.nlm.nih.gov/pubmed/25070666. Gulati M, Bairey Merz CN. Cardiovascular disease in women.