Dr. Eric Stecker, cardiologist at Oregon Health Sciences University in Portland, has your best interests at heart. He understands how challenging it can be to live a heart healthy lifestyle. Every day, new studies provide us with conflicting information about the best way to ensure cardiac health. That's why we asked Dr. Stecker to provide a road map to heart health in eight easy steps.

1. Know your risks

Everybody's at risk for heart disease. That's why routine doctor's appointments include a blood pressure check and a stethoscope on your chest. Dr. Stecker says, "Everyone should undergo regular screening for risk factors like high blood pressure, diabetes, and high cholesterol that lead to heart disease or make existing heart problems worse. Different people need different types of screening, though. For example, most high school athletes don't need an echocardiogram unless there's a family history of cardiac arrest. Most healthy young people only need screening intermittently, whereas older people need more." Dr. Stecker hesitates to specify exactly what tests are appropriate, because everyone's risk factors and history are unique. The important thing is to have that heart-to-heart chat with your doctor about how often you should be screened.

2. Quit smoking

The American Journal of Public Health published a 2002 report that makes it official: "People who quit smoking add years to their lives regardless of the age at which they quit." Need more convincing? Dr. Stecker spells it out. "Quitting smoking is the single most important thing you can do for your health." While he understands that's a huge challenge for smokers, he emphasizes that people need to get help and quit. "There are tons of resources to help. Ask your family doctor or cardiologist." You can also start by calling 1-800-QUIT-NOW or visiting smokefree.gov.

3. Just lose it

Here's another news flash: Being overweight is bad for your heart. Dr. Stecker says: "I'm not talking about 10 to 15 pounds, but about being significantly overweight. It's a risk factor both directly for cardiovascular disease and for indirect risks like diabetes." He's not specific about how patients lose the weight, as long as they lose it. "There's a range of lifestyle changes, medications, and in extreme cases, even surgeries that help." He says obesity is the problem, not specifically how many grams of fat or fiber people consume. "You need some diet and exercise program you can live with indefinitely that limits calories and leads to slow, steady weight loss." Dr. Stecker is nonspecific about which weight loss programs are best, but says that diets rich in things like cheese and red meat "increase risk for high cholesterol and are calorie-dense," and adds, "I encourage people not to go overboard with them. Diets lower in simple carbohydrates help some people lose weight, control glucose and diabetes." Should people go vegetarian? "That's a pretty significant change," Dr. Stecker says. "I don't counsel people to be vegetarian, but I congratulate people who are."

4. Just move it

Come on, people. We've talked about this. Exercise! Dr. Stecker has good news, though. "You don't need to run marathons to help your health. Regular walking at an easy pace is very helpful. Just start exercising. Do it regularly as much as you can." Now, how hard is that?

5. Take your medicine

We live in a pill-popping society where there's a medication for everything that ails you. It's no wonder people are confused about which ones they really need and which they can talk to their doctors about doing without. Dr. Stecker advises patients not to skimp on heart medications and that if they're worried they should take their prescriptions to their cardiologist for a thorough review. "Heart medications are proven to prevent death and disability. Many patients want to get off medicines or are concerned they're hurting themselves. That's a valid concern, but we know the side effects are outweighed by significant benefits."

6. Learn CPR

There's more to CPR than chest compressions and mouth-to-mouth breathing. "Recognizing the signs of cardiac arrest or stroke and acting quickly," says Dr. Stecker, "dramatically improves chances of survival." Symptoms for women are different from what they are for men. Getting emergency medical personnel to the patient's side quickly, especially with a defibrillator, is crucial. "With a defibrillator, seconds count," says Dr. Stecker.

7. Lose the stress

Many medical studies have made the link between high stress, high blood pressure and even heart attacks. However, they aren't clear on how best to reduce stress. Though some tout the benefits of yoga and others say it's all about meditation, Dr. Stecker says it's not that easy. "Reporting that higher stress is associated with more heart attacks is very different than saying certain changes actually reduce your risks. It's really individual. For some, it's anxiety and depression, and you have clear venues there--see a psychiatrist. For others, it's the way their life is organized." Dr. Stecker admits that most doctors don't focus enough on stress, but the connection between heart health and mental health is clear.

8. Get with the beat

When your heart skips a beat, don't assume it's love. Dr. Stecker explains that there are different kinds of cardiac arrhythmias. "Some are totally benign and don't require treatment unless they're causing symptoms; some we can cure easily with procedures and medications." Still others, however, are dangerous and even life-threatening. Dr. Stecker urges people to see their doctor. "Sometimes people worry when they shouldn't, or don't worry when they should. It all goes back to screening."
 
So now you know the steps to take for better heart health. And maybe you've already taken some. If so, congrats. If not, get with the program. Your heart will love you for it!

Jeanne Faulkner

Jeanne Faulkner is a freelance writer and registered nurse in Portland, Ore. Her work appears regularly in Pregnancy and Fit Pregnancy, and she has contributed articles to the Oregonian, Better Homes & Gardens, Shape and other publications.