AHA recommendations for college students' health

By Christopher Theberge

A recent article in the journal Circulation (2002 Jul 16;106(3):388-91 Volume 106 #3) insists that physicians begin assessing their patients' risk for cardiovascular disease beginning at age 20. The recommendations are part of the American Heart Association's (AHA) strategy to increase awareness early, thereby decreasing the risk of a first heart attack or stroke later in life.

"The imperative to prevent the first episode of coronary disease or stroke remains strong because many first-ever heart attacks or strokes are fatal or disabling," said Thomas Pearson, M.D., Ph.D., chairman of the consensus panel that updated the recommendations.

New research findings and expert opinions in the field of cardiovascular health encouraged the latest update of the AHA's "Guide to the Primary Prevention of Cardiovascular Diseases" published back in 1997. The guide was created because primary prevention is essential in delaying the onset of cardiovascular disease. In a public health perspective, healthcare providers can offer education to patients, thereby preventing the development of risk factors associated with the disease. A clinical approach is also used to identify and alter risk factors, thereby preventing the onset of heart disease.

Primary prevention allows healthcare providers to assess specific risk factors for disease development and categorize people according to those risks and the number of them that they have, according to the article. Increasing the awareness of the levels and significance of risk factors routinely checked by your healthcare care provider, is the risk factor screening's purpose. Recommendations include: risk factor assessment beginning at age 20, knowing your family history of heart disease, recording blood pressure, body mass index, waist circumference and pulse at least every two years, and finally measuring cholesterol and blood sugar levels at least every five years, or every two years if risk factors are present.

The screenings will allow providers to create a global risk estimation that will be used to determine a person's risk for developing heart disease. The risk estimation combines all risk factors and determines an individual's risk of developing heart disease within the next 10 years. Age, sex, smoking status, blood pressure, total cholesterol, HDL ("good") cholesterol, and in some risk scores, LDL ("bad") cholesterol and diabetes are all considered risk factors. It is recommended that adults over 40, or those with two or more risk factors have their 10-year risk for heart disease estimated every five years. If the number of risk factors increases, then individuals should have it done more often.

Cardiovascular disease (CVD) has been the No. 1 killer of Americans since 1900, except 1918. CVD claims more than 2,600 people each day, an average of one death every 33 seconds. Current estimates suggest that more than 61 million Americans have one or more types of CVD. CVD is not just an "old person's" disease either; almost 150,000 Americans killed by the disease are under 65 years of age.

College students can benefit not only from having regular screenings, but also by following the advice from the American Heart Association. There are a number of risk factors associated with heart disease and most are preventable. These include: avoiding tobacco, including second hand smoke, keeping ones blood pressure less than 140/90 mm Hg; less than 130/85 mm Hg in people with disease or heart failure and less than 130/80 mm Hg in people with diabetes, and an overall healthy eating pattern (striving towards a variety of fruits, vegetables, grains, legumes, low-fat or nonfat dairy products, fish, poultry, and lean meats). Other suggestion include; reducing saturated fats to less than 10 percent of calories, cholesterol to less than 300 mg per day, and trans-fats, limit salt intake to less than six grams per day (2,400 mg of sodium), limit alcohol intake to no more than two drinks per day in men, one drink per day in women among those who drink alcohol.

The journal also states that cholesterol should be lowered to appropriate levels. Total cholesterol less than 180 mg/dL is optimal; less than200 mg/dL is desirable. LDL cholesterol less than 100 mg/dL is optimal while 100-129 mg/dL is near optimal or above optimal. A HDL greater than or equal to 60 mg/dL is desirable.

Exercise is cited in the article as crucial to decreasing one's risk. At least 30 minutes of moderate-intensity physical activity on most, and preferably all, days of the week. This is in order to achieve and maintain a desirable weight.

College students can possibly delay or prevent heart disease by increasing the amount of physical activity they do and by following a healthy diet, while avoiding tobacco products. In addition, visiting with your physician and being screened regularly is very important as well.