The facts are scary: Despite the progress made against heart disease in the past several decades, almost half the people who die suddenly from a heart attack or other cardiac problem have no prior symptoms. Even knowing someone's risk factors for heart disease, it's often tough to pinpoint who will actually go on to get the disease. And once blood flow to the heart muscle is blocked and a heart attack happens, it's not exactly clear why some people experience sudden cardiac arrest, which killed Meet the Press host Tim Russert last week, and others don't.
Those uncertainties, however, don't mean that you are powerless to protect yourself from dying of a heart attack. Here are steps to take to improve your odds:
1. Follow the standard prevention guidelines. The American Heart Association has three basic tips for preventing heart disease, stroke, and heart attack: Don't smoke, be more active, and make good nutritional choices. This is good general health advice, regardless of your heart disease risk.
2. Exercise. Yes, we mentioned it above, but it's worth repeating. "Exercise raises good cholesterol and lowers bad cholesterol," says Rob Michler, director and chairman of heart surgery at the Montefiore-Einstein Heart Center in New York. Worrying that exercise is going to give you a heart attack is not a valid excuse for skipping it; while it's true that exercise raises your odds of a heart attack in the moment, the long-term benefits vastly outstrip this short-term risk. (Still, check with your doctor first if you're obese, have health problems, or haven't exercised in years.)
3. Know your risk. Find out your Framingham risk score, which gives the odds of heart attack or heart disease-related death in the next 10 years. It requires you have certain basic information, like your cholesterol numbers and blood pressure. This score isn't perfect, especially for young people and for women, who can find alternative ways to gauge risk, but it's a good place to start. Talk to your doctor about your risk score, and do something about what is controllable, like your weight or tobacco habits. "Recognize when you have a risk and modify that risk as much as you can," says Steve Owens, a cardiologist at the University of Kansas Hospital in Kansas City, Kan.. If your odds of heart disease are high enough, talk with your doc about the pros and cons of medications like statins or aspirin.
4. Get a family history. "Your genetic profile is the one risk factor we can't modify," says Michler. But if you have a family history of early-onset heart disease, tell your doctor even if you're in perfect health yourself. If your father had a heart attack at 40 (even if he survived it), that's crucial information about your possible genetic risk.
5. Know the symptoms of heart problems. It's not just crushing chest pain. U.S. News wrote recently about how to know if you're having a heart attack and what to do about it and also looked at how women may not be alert to the signs of heart disease.
6. Learn CPR. Clearly, you can't perform it on yourself, but you can help someone around you who is experiencing cardiac arrest. "If people can make it until EMS arrives, then their chances of survival are wonderful," says Judith Hochman, clinical chief of cardiology at New York University, who says she's seen three recent cases of patients saved by CPR. The American Heart Association says it improves survival two to threefold and recently urged laypeople to learn how to do it. And it needn't be complicated: Chest compressions alone can help heart attack victims. Meantime, if you're in a public space like a gym or casino when someone has an attack, look for an automated external defibrillator, Hochman advises.