According to the National Center for Health Statistics, if all forms of major cardiovascular diseases were eliminated, life expectancy would rise by almost 10 years. Unfortunately, experts have not yet found a way to eliminate heart disease or stroke. They have, however, identified many of the factors that contribute to these diseases. And many of these risk factors—smoking, high blood pressure, obesity, a sedentary lifestyle, and poor nutrition, for example—can be controlled.

In addition to following the advice in the previous post, here’s what you can do to stay healthy

Control high blood pressure.

Approximately one in four Americans has high blood pressure (hypertension), a major risk factor for heart disease and stroke. About half of those individuals don’t know they have it. And nearly three-quarters do not have the condition under control.

When your blood pressure is high, your heart has to work harder. This can cause the heart to eventually enlarge from the effort, weakening its ability to pump (a condition called congestive heart failure). High blood pressure also speeds up atherosclerosis, which increases the risk of heart attack and stroke. The kidneys can also be adversely affected by high blood pressure. And a recent National Institute of Aging study even showed brain shrinkage in elderly persons with long-term hypertension.

Your blood pressure is considered high if the systolic pressure (the upper number in a blood pressure reading) is 140 mm Hg or greater and/or the diastolic pressure (the lower number) is 90 mm Hg or greater. Optimal blood pressure is 120 mm Hg/80 mm Hg or below. See chapter 2 for information on how to lower blood pressure with diet.

Control your cholesterol.

According the AHA, about half of all Americans have unhealthy cholesterol levels. Although we need this soft, fatlike substance to make hormones and build cells, having too much in our blood—particularly too much low-density lipoprotein (LDL) cholesterol—contributes to atherosclerosis. The excess LDL sticks to artery walls, where it oxidizes and begins to form plaque; this buildup, in turn, contributes to heart disease and stroke. The landmark Framingham Heart Study found that heart attack rates rise 2 percent for each 1 percent increase in blood cholesterol, starting at about 200 mg/dL. And according to the AHA, your likelihood of a heart attack doubles if your total cholesterol approaches 300 mg/dL.

The ideal total cholesterol level, according to the National Cholesterol Education Program, is 140 to 200 mg/dL. LDL cholesterol levels should be under 130 mg/dL, and levels of high-density lipoprotein (HDL), which helps escort LDL cholesterol out of the body and lowers heart disease risk, should be above 40 mg/dL. See chapter 2 for ways to reduce your cholesterol levels with diet.

Get enough antioxidants.

Vitamin E, a potent antioxidant, consistently shows up in studies as a factor in lowering the risk of heart disease. An analysis of studies on the relationship of heart disease and antioxidant consumption, published in the European Journal of Clinical Nutrition, showed that those who took in the most antioxidants had a risk of heart disease about 15 percent lower than those who took in the least.

Reduce blood levels of homocysteine.

Homocysteine, an amino acid believed to damage blood vessels and contribute to fatty plaque buildup in the arteries, is found in high amounts in 40 percent of people with heart disease. It is now considered almost as important a risk factor for heart disease as elevated cholesterol levels. How can you lower your level? Make sure you’re getting enough folate and vitamin B6. Low intake of these vitamins increases blood levels of homocysteine.

Recognize heart attack symptoms.

Researchers writing in the British Medical Journal reported that about two-thirds of people who died of heart attacks didn’t recognize the symptoms as such and didn’t get help in time. Warning signs include sweating, nausea, pain in the arms and neck, and breathing problems. Few heart attacks actually are preceded by the stereotypical clutching chest pain.

Consider hormone replacement therapy (HRT).

Estrogen is thought to protect against heart disease by creating beneficial changes in lipids, lipoproteins, and fibrinogen and by triggering favorable vasomotor and antioxidant effects. Numerous studies have confirmed a reduced risk of heart disease in postmenopausal women who used estrogen—one meta-analysis of 17 studies found a 50 percent reduced risk. On a less enthusiastic note, the Heart and Estrogen/Progestin Replacement Study found that the use of HRT by postmenopausal women who already had heart disease did not prevent further heart attacks or death.