Your Health Checkup: 7 Steps to Reduce Risks of Heart Disease

Learn the 7 things you need to do to reduce your risk of heart disease — and which ones are most important.


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“Your Health Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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The sheer volume of new information about heart health inundates us every day, threatening to addle our brains with warnings to “drink this health smoothie,” “swallow that vitamin,” or “eat this new and improved dietary supplement.” My wife complains that, adding to the confusion, the material often changes from week to week, and she is right. As her husband/cardiologist, I have to sift through the chaos of advice to highlight what she should believe and how she should respond.

Wouldn’t it be nice if we could distill all that information down to a pocket-sized list so we could easily remember the essentials of what’s important, do what’s needed, and be responsible for it?

The American Heart Association has tried to accomplish that with what they call “Life’s Simple 7,” or LS7, a synthesis of behavioral activities that reduce the burden of heart disease.

The LS7 includes not smoking, exercising, and controlling diet, body mass index (BMI), blood pressure, cholesterol, and glucose. Previous research supports the conclusion that adherence to LS7 reduces the risk of heart disease.

However, LS7 represents an ideal lifestyle that many of us are unable to attain. Mastery of all seven components would be great, but what would happen if you could control only several and which would be most important?

A recent study tried to answer that question in a Dutch population that included 37,803 participants from the EPIC-NL (European Prospective Investigation Into Cancer and NutritionNetherlands) cohort who were about fifty years old and three quarters women. An LS7 score was calculated by assigning points for each component to create an overall ideal score (11 to 14 points) that was present in about a quarter of the participants, an intermediate score (9 or 10 points) in about a third, and an inadequate score (0 to 8 points) in the rest.

Over fifteen years, the investigators found that, compared with an inadequate LS7 score, having an ideal LS7 score was associated with a 55 percent lower risk of heart failure, and having an intermediate score was associated with a 47 percent risk reduction. Importantly, intermediate and ideal scores for glucose, smoking, BMI, and blood pressure were all significantly associated with decreased heart failure incidence compared with inadequate levels.

When should you begin to adhere to LS7?

It turns out that the impact of life style on heart disease begins at an early age. In a study of 36,030 participants followed for 17 years, those having an elevated “bad” cholesterol (LDL) greater than 100 mg/dl at age 18-39 years had a 64 percent increased risk for coronary heart disease compared to those participants with an LDL less than 100 mg/dl, independent of later adult exposures. Similarly, having a systolic blood pressure exceeding 130 mm Hg was associated with a 37 percent increased risk for heart failure compared with a systolic blood pressure less than 120 mm Hg. This study concluded that exposure as young adults to components of LS7 was associated with increased cardiovascular risks in later life, regardless of exposures later in life as adults. Thus, awareness of risk and life style changes should begin in the young.

To paraphrase the conclusion in my last column, take control of your own health by controlling your LS7 components, and become your own best cardiologist. Do it now to avoid the consequences later.

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  1. I have taken Saturday Evening Post for years, am now trying to taper of years of Protonix, because of all of a sudden I have osteoporosis and nocturnal peeing and a little brain fog, and polyps in stomach, plus loose stools after I take, I have lost over 18 pounds and eat a well balanced diet. My Gastro Dr. just hands me a new Prescription for another year after he has stretched my esophagus and tells me take your calcium. I have had it I I have told my Family Dr. what I am doing, he says call him if I run in to trouble. Bless his Heart


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