Self-Care strategies for heart attack and stroke prevention: Part 1

Heart attacks and strokes represent urgent health challenges in Canada, affecting not only individuals but also placing immense pressure on the health care system. According to Statistics Canada, heart disease emerged as one of the leading causes of death in 2021, accounting for approximately 20 per cent of all fatalities in the country.

In addition, strokes strike around 50,000 Canadians each year, often resulting in long-lasting disabilities and escalating healthcare expenses. Health Canada underscores the fact that many risk factors associated with heart attacks and strokes, such as high blood pressure and smoking, are largely preventable through meaningful lifestyle changes and effective self-care strategies. By embracing a proactive stance on health, individuals can not only diminish these risks but also enhance their overall well-being and quality of life. Here are eight straightforward yet impactful strategies to nurture both your heart and brain.

1. Understand your risk factors 

Knowing what increases your chances of having a heart attack or stroke is essential for taking preventive action. Here are some important risk factors to consider:

• High blood pressure : Often called the “silent killer,” high blood pressure usually has no noticeable symptoms. It occurs when your heart works too hard to pump blood throughout your body. Regularly monitoring your blood pressure at home or during doctor visits is crucial. If it's too high, lifestyle changes and medication may be necessary.
• High cholesterol : Cholesterol is a fatty substance that can build up in your arteries, narrowing them and restricting blood flow. This can lead to blocks that cause heart attacks or strokes. There are two types: LDL (bad cholesterol) that can clog arteries and HDL (good cholesterol) that helps remove plaque from arteries. Ask your doctor about your cholesterol test to know if you numbers are high.
• Diabetes : This condition affects how your body processes sugar, leading to high blood sugar levels. Over time, diabetes can damage blood vessels and increase the risk of heart disease and stroke. Managing diabetes through a balanced diet, regular exercise, and medication, is essential.
• Family history : If you have family members who have experienced heart disease or strokes, you may be at higher risk. Discuss your family history with your health-care provider to better understand your risk and take proactive measures.
• Age : The risk of heart attacks and strokes increases with age. Men over the age of 45 and women over the age of 55 are at a higher risk. As you get older, it's essential to be more vigilant about heart health and regular check-ups.
• Gender : Generally, men are at a higher risk for heart attacks earlier in life than women. However, after menopause, women's risks increase and may become equal to or greater than that of men. Hormonal changes can affect heart health, making it important for women to monitor their cardiovascular risk as they age.
• Obesity : Carrying excess weight, particularly around the abdomen, can increase the risk of heart disease and stroke. Obesity is linked to high blood pressure, high cholesterol and diabetes. Maintaining a healthy weight through diet and exercise is crucial for reducing risk.
• Physical inactivity : A sedentary lifestyle can lead to obesity and increase the risk of heart disease and strokes. Regular physical activity helps to maintain a healthy weight, lowers blood pressure, and strengthens the heart muscle.
• Diet : A diet high in saturated fats, trans fats, sugar, and salt can increase your risk of heart disease and stroke. Processed foods, sugary drinks, and large portions contribute to weight gain and cardiovascular problems. Opting for nutritious foods can reduce these risks.
• Smoking : Smoking is one of the most significant risk factors for both heart attacks and strokes. Tobacco damages blood vessels and raises blood pressure, leading to increased cholesterol levels and plaque build-up in arteries. Quitting smoking dramatically reduces these risks.
• High alcohol consumption : Drinking too much alcohol can raise blood pressure and contribute to irregular heartbeats, along with excessive caloric intake and weight gain. Limiting alcohol to moderate levels—two drinks a week—can help protect your heart health.
• Chronic stress : Long-term stress can contribute to high blood pressure and increase your risk of heart disease. Stress may cause some people to engage in unhealthy habits, such as overeating, smoking, or drinking too much alcohol, which can further elevate risk.

Self-Care approach to heart attack and stroke prevention

After understanding your risk factors for heart attacks and strokes, it’s essential to adopt a proactive self-care approach to mitigate those risks. This involves implementing lifestyle changes and utilizing effective strategies that promote heart and brain health. Here’s how you can take charge of your well-being:

1. Adopt a heart-healthy diet

A heart-healthy diet is vital in preventing heart attacks and strokes. The food you eat can have a significant impact on your heart health, blood pressure, cholesterol levels, and overall well-being. Below are guidelines on adopting a heart-healthy diet, incorporating the DASH diet, and aligning with the recommendations from Canada’s Food Guide.

a. Understanding the DASH Diet

The Dietary Approaches to Stop Hypertension (DASH) diet is a scientifically-backed eating plan designed to help lower blood pressure and improve heart health. Here are the key components of the DASH diet:

• Focus on fruits and vegetables : The DASH diet encourages eating four to five servings of each per day. Fresh, frozen, or canned (without added sugar or salt) options are all great. Fruits and vegetables are rich in vitamins, minerals, and antioxidants and can help lower blood pressure.
• Whole grains : Aim for six to eight servings of whole grains daily, such as brown rice, whole wheat bread, and oatmeal. Whole grains contain fibre, which helps lower cholesterol levels and improves digestion.
• Lean proteins : Include two or fewer servings of lean meats, poultry or fish per day. The DASH diet emphasizes plant-based proteins, such as legumes (beans and lentils), nuts, and seeds. Fish, particularly fatty fish rich in omega-3 fatty acids, like salmon and mackerel, are excellent choices due to their heart-protective properties.
• Low-fat dairy : Incorporate two-three servings of low-fat or fat-free dairy products each day. This provides calcium and vitamin D, which are vital for heart health.
• Healthy fats : Choose healthy fats, such as those found in avocados, nuts, seeds and olive oil. Limit saturated fats (found in butter and fatty meats) and avoid trans fats (commonly found in processed foods).
• Reduce sodium intake : The DASH diet recommends limiting sodium to 2,300 mg per day or less. If you have high blood pressure, consider reducing it even further to 1,500 mg per day. Read food labels and choose low-sodium options when possible.

b. Canadian Food Guide recommendations

Canada’s Food Guide offers practical advice on building a heart-healthy diet. Here are its key recommendations that align with the DASH diet principles:

• Eat a variety of foods : Aim to consume foods from all four food groups: fruits and vegetables, whole grains, protein foods, and healthy fats. This variety ensures you get all essential nutrients.
• Emphasize plant-based foods : Canada’s Food Guide highlights the importance of plant-based proteins, such as beans, lentils, tofu, and nuts. These foods are high in fibre and generally lower in saturated fat compared to animal proteins.
• Choose whole grain options : The guide recommends opting for whole grains over refined grains. Look for foods labelled as "100% whole grain" to maximize fibre and nutrients.
• Prioritize fruits and vegetables : Fill half of your plate with fruits and vegetables at every meal. The guide suggests aiming for fresh, frozen, or canned options without added sugars or salt.
• Limit processed foods and sugars : Minimize your intake of processed foods high in salt, sugar, and unhealthy fats. Cooking at home using whole, fresh ingredients can help reduce your consumption of processed foods.
• Stay hydrated : Drink plenty of water instead of sugary drinks. Canada's Food Guide emphasizes water as the best choice for hydration.

c. Practical tips for the DASH Diet and Canadian Food Guide

• Plan your meals : Take time each week to plan your meals and snacks. Aim to include a variety of foods from each food group in your planning.
• Experiment with new recipes : Search for heart-healthy recipes that highlight fruits, vegetables, whole grains, and lean proteins. Try new cooking methods such as grilling, steaming, or roasting to enhance flavour without adding unhealthy fats.
• Read food labels : Pay attention to nutrition labels when grocery shopping. Look for products that are low in saturated fat, cholesterol, and sodium.
• Practice portion control : Be mindful of portion sizes. Using smaller plates can help control portions and prevent overeating.
• Make gradual changes : If these dietary changes feel overwhelming, start small. Incorporate one or two recommendations into your daily meals and gradually increase as you become more comfortable.

2. Stay physically active

Regular physical activity is crucial for maintaining a healthy heart and reducing the risk of heart attacks and strokes. Exercise strengthens your heart, improves circulation, helps manage weight, and boosts mental well-being. Here’s a more detailed look at how to incorporate physical activity into your daily routine:

a. Aim for 150 minutes of moderate exercise each week

To promote cardiovascular health, aim for at least 150 minutes of moderate aerobic exercise each week. This can be broken down into manageable segments:

• Setting daily goals : Aim for about 30 minutes of moderate exercise, five days a week. This could include activities like brisk walking, cycling, swimming, or dancing.
• Finding activities you enjoy : The best exercise is one that you enjoy. Experiment with different activities to find what you love. This might include group classes, team sports, or outdoor adventures like hiking or kayaking.
• Incorporating activity into your day : Look for opportunities to be active throughout your day. This could mean taking the stairs instead of the elevator, walking or biking to work, or parking farther away from the entrance of a store.

b. Incorporate strength training

In addition to aerobic exercise, include strength training exercises at least twice a week. Strength training is beneficial for:

• Building muscle : It helps develop muscle strength and endurance, which supports overall body functioning and metabolism.
• Improving bone density : Strength training can help increase bone density and reduce the risk of osteoporosis.
• Options for strength training : You can use free weights, resistance bands, or your body weight for exercises such as squats, push-ups, and lunges. Many gyms offer strength training classes, or you can follow online tutorials at home.

c. Engage in flexibility and balance exercises

Incorporate flexibility and balance exercises into your routine, especially as you age. These exercises can aid in:

• Improving mobility : Stretching helps maintain flexibility and range of motion in your joints, which can enhance your overall mobility.
• Preventing falls : Balance exercises, such as yoga or tai chi, are particularly valuable for older adults, reducing the risk of falls by improving stability and coordination.

d. Make exercise a habit

Establishing a routine can help ensure you stay active regularly:

• Schedule your workouts : Treat physical activity like an important appointment. Block off time in your calendar to exercise, just as you would for a work meeting or a doctor’s visit.
• Find a workout buddy : Exercising with a friend or family member can make workouts more enjoyable and hold you accountable. It’s also a great way to socialize.
• Track your progress : Consider using a fitness tracker or app to monitor your activity levels. Setting goals and tracking progress can be motivating and help you stay on target.

e. Stay active throughout the day

Even small amounts of movement can add up throughout the day. Consider these tips:

• Break up long sitting periods : If you have a job that requires prolonged sitting, take short activity breaks every hour. Stand up, stretch, or take a quick walk around your office or home.
• Incorporate movement into daily tasks : Activities like gardening, cleaning, or playing with children can count as exercise. Look for ways to be more active in your daily routines.

f. Listen to your body

While being active is essential, it’s important to listen to your body and be mindful of any limitations:

• Start slowly : If you’re new to exercise, start with lighter activities and gradually increase intensity and duration as your fitness improves.
• Consult with your doctor : Before starting any new exercise program, particularly if you have existing health concerns or conditions, consult your health-care provider to establish a plan that is safe and effective for you.

3. Manage stress effectively

Managing stress is essential for maintaining heart health and preventing conditions like heart attacks and strokes. Chronic stress can lead to high blood pressure, unhealthy eating habits, physical inactivity, and other risk factors that negatively affect your cardiovascular health. Here are detailed strategies to help you manage stress effectively:

• Practice mindfulness and relaxation techniques : Dedicate time daily for mindfulness exercises or meditation to help calm your mind and reduce anxiety.
• Engage in deep breathing : During stressful moments, practice deep breathing techniques to help regain control and foster relaxation.
• Participate in enjoyable activities : Make time for hobbies or activities that you love, as they can be fantastic stress relievers.

4. Maintain a healthy weight

Achieving and maintaining a healthy weight is crucial for heart health. Consider:

• Setting realistic goals : Focus on gradual weight loss if needed, aiming to lose one to two pounds per week through small adjustments in diet and exercise.
• Monitoring portions : Pay attention to portion sizes to prevent overeating. Using smaller plates can help control servings.
• Tracking food intake : Consider keeping a food journal or using an app to log meals. This practice can help you identify eating patterns and make healthier choices.

5. Limit alcohol and quit smoking

Limiting alcohol consumption and quitting smoking are two critical components of a heart-healthy lifestyle. Both habits significantly increase the risk of heart disease and stroke, and addressing them can lead to immediate and long-term health benefits. Here’s a detailed look at how you can effectively manage these lifestyle choices to enhance your heart health.

a. Understanding alcohol and heart health 

While moderate alcohol consumption may have some health benefits for certain individuals, excessive drinking poses substantial risks. Here are some points to consider:

• Moderation matters : The Canadian Low-Risk Alcohol Drinking Guidelines was recently updated and now suggest limiting alcohol to a maximum of twp drinks per week.
• Health risks : Heavy drinking can lead to high blood pressure, heart failure, and stroke. It can also contribute to weight gain and obesity, which further increases cardiovascular risk.
• Binge drinking : Engaging in binge drinking (defined as consuming 4 or more drinks on a single occasion for women and 5 or more for men) can severely affect heart and brain health, leading to acute incidents like heart attacks or strokes.

b. Benefits of Limiting Alcohol

By reducing alcohol intake, you can experience numerous health benefits:

• Lower blood pressure : Cutting back on alcohol can help lower high blood pressure, reducing heart strain.
• Weight management : Alcohol is high in calories. Reducing intake can help in maintaining a healthy weight.
• Improved sleep : Excessive alcohol can disrupt sleep patterns, leading to fatigue and increased stress. Limiting alcohol can promote better rest.
• Enhanced mental clarity : Reducing consumption can lead to improved cognitive function and emotional health, decreasing anxiety and depression levels.

c. Strategies for reducing alcohol consumption

Implementing practical strategies can help you limit alcohol intake:

• Set limits : Decide in advance how many drinks you will consume and stick to that limit.
• Opt for alcohol-free days : Designate certain days of the week as alcohol-free to reduce overall consumption.
• Choose smaller servings : If you do drink, opt for smaller serving sizes or lower-alcohol options like beer or wine instead of cocktails.
• Alternate with water : Drink water or non-alcoholic beverages between alcoholic drinks to stay hydrated and pace yourself.

d. The Impact of smoking on heart health

Smoking is one of the most significant risk factors for heart disease and strokes:

• Damage to blood vessels : Nicotine and other chemicals in cigarette smoke cause inflammation, making blood vessels narrower and increasing blood pressure.
• Increased clotting risk : Smoking encourages blood clot formation, which can lead to heart attacks and strokes.
• Reduced oxygen supply : Smoking reduces the amount of oxygen that gets to your heart and other vital organs.

e. Benefits of quitting smoking

Quitting smoking has immediate and long-lasting health benefits:

• Improved heart health : Within just a few weeks of quitting, your heart rate and blood pressure begin to return to normal.
• Reduced risk of disease : After one year of quitting, your risk of heart disease is reduced by half compared to that of a smoker.
• Better lung function : As your lungs heal, you may notice improved breathing and increased exercise tolerance.
• Enhanced overall well-being : Quitting smoking can lead to better skin, improved energy levels, and a lower risk of various cancers and other health issues.

f. Effective strategies to quit smoking

Stopping smoking can be challenging, but many effective strategies can support your journey:

• Set a quit date : Choose a specific date to stop smoking and prepare yourself mentally.
• Seek support : Consider joining a support group or utilizing smoking cessation programs. Friends and family can also provide encouragement and support.
• Nicotine Replacement Therapy (NRT) : NRT options, such as patches, gum, lozenges, inhalers, or prescription medications, can help manage withdrawal symptoms.
• Identify triggers : Recognize what situations prompt your urge to smoke (stress, coffee, alcohol) and develop strategies to cope without cigarettes.
• Clean your environment : Remove cigarettes, ashtrays, and any other smoking-related items from your home, car, and workplace to reduce temptation.

g. Seeking professional help

If you’re struggling to reduce alcohol consumption or quit smoking on your own:

• Consult a healthcare provider : They can provide resources, understand your specific needs, and develop a personalized plan for reducing alcohol intake or quitting smoking.
• Counselling and Behavioural Therapy : Cognitive Behavioural Therapy (CBT) can be particularly effective in identifying triggers and developing coping strategies.

6. Regular screenings and check-ups

Regular screenings and check-ups are vital components of maintaining good heart health and preventing serious conditions such as heart attacks and strokes. These proactive health measures allow for early detection of risk factors and the ability to manage them before they develop into significant health issues. Here's an in-depth look at the importance of regular screenings and how to effectively incorporate them into your health routine.

a. Understanding the importance of regular screenings

• Early detection : Many heart-related problems, such as high blood pressure and elevated cholesterol levels, often do not present obvious symptoms. Regular screenings can help detect these conditions early, allowing for timely intervention and management.
• Monitoring existing conditions : If you already have risk factors such as high blood pressure, high cholesterol, or diabetes, regular check-ups are essential. They help monitor these conditions and ensure that your management plan is effective.
• Preventive care : Regular screenings promote a preventive care approach. By identifying and addressing issues early, you can significantly reduce the risk of developing serious health complications.

b. Key Screenings for heart health

Several specific health screenings should be part of your routine check-ups:

• Blood pressure measurements : Blood pressure should be checked at least once a year for adults. If you have risk factors, more frequent monitoring may be necessary. Normal blood pressure is typically below 120/80 mmHg.
• Cholesterol levels : Adults should have their cholesterol checked every four to six years, starting at age 20. If your levels are high or you have other risk factors, your doctor may recommend more frequent testing. Healthy total cholesterol levels should generally be below 5.2mmol/L.
• Blood sugar tests : Screening for diabetes is typically recommended every three years for adults over 40 or younger if you have risk factors. Maintaining healthy blood sugar levels (typically under 5.6mmol/L when fasting) is crucial for heart health.
• Body Mass Index (BMI) : Your BMI is calculated using your weight and height to assess whether you are in a healthy weight range. Regular assessments can help guide discussions about diet and exercise.
• Electrocardiogram (ECG) : If you have risk factors such as heart disease, your doctor may recommend an ECG to assess heart rhythm and identify potential issues.

c. Creating a personalized screening schedule

To establish an effective schedule for screenings, consider the following:

• Age : Different age groups have varying recommendations for screenings. Ensure you know the guidelines based on your age.
• Family history : If there is a history of heart disease or stroke in your family, you may need more frequent screenings or additional tests.
• Existing health conditions : If you have conditions such as obesity, diabetes, or high blood pressure, work with your healthcare provider to develop a more personalized screening schedule based on your health needs.
• Lifestyle factors : Consider your lifestyle choices. If you smoke, consume alcohol, or have a sedentary lifestyle, discuss with your doctor how these factors may necessitate more frequent screenings.

d. Incorporating screenings into your routine

Here are some tips on how to ensure that screenings become a regular part of your health routine:

• Schedule regular appointments : Make annual check-ups part of your calendar. This makes it easier to stay on top of your health screenings.
• Use reminders and alerts : Set reminders on your phone or calendar to prompt you to schedule screenings or follow-up appointments.
• Educate yourself : Stay informed on what screenings you need and when. Knowledge empowers you to prioritize your health effectively.
• Bring up concerns : At each visit, don’t hesitate to discuss any concerns or symptoms you may have noticed. Open communication with your healthcare provider is vital for effective care.

e. Understanding and acting on results

After each screening, it’s essential to:

• Understand your results : Make sure you understand what the results mean for your health. Your healthcare provider can explain any significant numbers, such as cholesterol levels or blood pressure readings.
• Follow recommendations : If your results indicate a potential problem, follow your doctor’s advice regarding lifestyle changes, medication, or further testing. Early action can lead to better outcomes.
• Make changes together : If lifestyle changes are recommended (diet, exercise, stress management), work with your healthcare provider to create a realistic plan that fits your needs.

7. Educate yourself about symptoms

Knowing the signs and symptoms of heart attacks and strokes is essential for prompt recognition and treatment. Understanding these warning signs can be life-saving and significantly improve outcomes. Here’s an in-depth look at what to look out for regarding both conditions:

Heart attack symptoms

A heart attack, or myocardial infarction, occurs when blood flow to a part of the heart is blocked, leading to damage. It’s crucial to recognize symptoms early. Here are common signs:

1. Chest discomfort or pain :
   • Often described as a feeling of pressure, squeezing, fullness, or pain in the centre or left side of the chest.
   • It may last for more than a few minutes or go away and come back.

1. Radiating pain :

1. • Discomfort may radiate to the shoulders, neck, arms (especially the left arm), back, jaw, or stomach.
   • Patients often describe a sensation similar to that of indigestion or heartburn.

1. Shortness of breath :

1. • This may occur with or without chest discomfort. It can happen at rest or during physical activity.
   • People may feel as if they cannot catch their breath, similar to a panic attack.

1. Other symptoms :

1. • These can include cold sweat, nausea, lightheadedness, or feeling unusually fatigued.
   • Women may experience different symptoms than men, such as jaw pain, back pain, and fatigue without typical chest pain, making awareness especially vital.

Stroke symptoms

A stroke occurs when blood flow to the brain is interrupted, depriving brain cells of vital oxygen and nutrients. Fast recognition of stroke symptoms is critical, as prompt treatment can minimize brain damage. The acronym F.A.S.T. is a helpful way to remember the key signs:

1. F - Face drooping :
   • Ask the person to smile. Does one side of their face droop or feel numb?
   • A lopsided smile is a strong indicator of a stroke.

1. A - Arm weakness :

1. • Ask the person to raise both arms. Does one arm drift downward or feel weak?
   • Weakness or numbness in one arm is another common symptom.

1. S - Speech difficulty :

1. • Listen for slurred speech or difficulty speaking. Ask them to repeat a simple sentence.
   • Confusion or trouble finding words is also a red flag.

1. T - Time to call emergency services :

1. • If you notice any of these symptoms, call emergency services immediately. Every minute counts when it comes to treating a stroke.

Additional stroke symptoms

Beyond the F.A.S.T. signs, other symptoms can include:

• Sudden severe headache : This may feel like a sudden, intense headache without a known cause (sometimes described as the worst headache ever).
• Sudden vision problems : This can manifest as blurred, double vision, or difficulty seeing in one or both eyes.
• Loss of coordination : Sudden dizziness, loss of balance, or trouble walking could indicate a stroke.

Importance of rapid response

Recognizing these signs early can significantly influence recovery outcomes for both heart attacks and strokes. Here’s why immediate action is crucial:

• Time Is brain : In a stroke, the phrase “time is brain” means that the longer the brain goes without blood flow, the more brain cells die, leading to permanent damage.
• Heart muscle preservation : For heart attacks, quick recognition can lead to immediate medical intervention, preserving heart muscle and improving survival rates.

Encouraging others

Educating family, friends, and loved ones about the symptoms of heart attacks and strokes can promote a collective vigilance. Encouragement and information can save lives—consider discussing these symptoms in family meetings or community health events.

Conclusion

By adopting these self-care approaches, you can significantly reduce your risks of heart attacks and strokes. Start small, make gradual changes, and always stay informed about your health. Taking control of your self-care is a powerful way to protect your heart and brain, leading to a healthier and happier life.

Remember, every step you take toward caring for yourself makes a difference!