TAKE CHARGE OF YOUR HEALTH One of the best ways to reduce your chance of developing coronary heart disease (CHD)—or at least postpone its onset—is to have realistic goals and to work with your doctor on the best way to reach them. Listed on this page are some targets you should strive for, with the help of your doctor, to have the best chance of holding off CHD. These are adapted from a set of American Heart Association guidelines published for physicians. Supported by an unrestricted educational grant from Pfizer Inc

A Guide to the Prevention of Coronary Heart Disease Goal: Control your blood levels of cholesterol. >> LDL (“bad”) cholesterol (your personal LDL cholesterol goal depends on how many of the following CHD risk factors you have: smoking, high blood pressure, family history of premature heart disease, low HDL cholesterol, and age [45 years or older for men, 55 years or older for women]): • less than 160 milligrams per deciliter (mg/dL) (with 0 or 1 risk factor) • less than 130 mg/dL (2 or more risk factors) • less than 100 mg/dL (if you have diabetes or another condition that significantly increases your risk for CHD) >> HDL ("good") cholesterol: • 40 mg/dL or higher (men) • 50 mg/dL or higher (women) >> Triglycerides: • less than 150 mg/dL Things your doctor may do: Regularly test and monitor your cholesterol levels. Advise you on the best diet and exercises for your needs. Prescribe appropriate drug therapy, if necessary. Goal: Control your blood pressure. >> Less than 140/90 mm Hg >> Less than 130/80 mm Hg (if you have certain conditions, such as abdominal obesity, diabetes, renal disease, or heart failure) Things your doctor may do: Show you how to adopt a healthier lifestyle by losing weight, reducing sodium (salt) intake, drinking less alcohol, eating a nutritious diet, and improving your exercise routine. Prescribe drug therapy if lifestyle changes alone do not work after a predetermined period of time. Goal: Stop smoking and limit your exposure to secondhand smoke. Things your doctor may do: Help you develop a plan for quitting. Refer you to a special program or prescribe medication, if necessary. Advise you on how to avoid secondhand smoke at work, at home, and elsewhere. Goal: Develop a healthy, nutritious, and balanced eating plan. Things your doctor may do: Recommend a personalized diet that includes fruits, vegetables, whole grains, low-fat/nonfat dairy products, fish, poultry, and lean meats. Show you how to reduce your intake of saturated fats, cholesterol, and trans-fatty acids by substituting unsaturated fatty acids from fish, vegetables, legumes, and nuts. Advise you on how to limit salt and alcohol intake. Goal: Develop a routine of at least 30 minutes of moderate exercise on most (preferably all) days of the week. Things your doctor may do: Suggest an exercise plan suited to your lifestyle that includes: a brisk walk for 20 to 40 minutes, 3 to 5 days a week; resistance training (with weights or barbells); flexibility training or stretching; and an increase in daily activities (for example, using stairs instead of elevators/escalators). Goal: Achieve and maintain a healthy weight. >> Waist circumference: • 40 inches or less (men) • 35 inches or less (women) >> Body mass index (BMI): 18.5 to 24.9 kg/m2 (your BMI indicates if you are underweight, normal weight, overweight, or obese) Things your doctor may do: Recommend a weight-control program to lower your calorie intake and improve your exercise routines. Goal: Control diabetes. >> Blood glucose (sugar) level: less than 110 mg/dL (this indicates your level at the moment it’s measured) >> Hemoglobin A1c (HbA1c): less than 7% (this indicates your average level over a 2- to 3-month period) Things your doctor may do: Test and monitor your blood glucose on a regular basis. Advise you on the proper diet and exercise programs. Prescribe drug or insulin therapy, if necessary. Goal: Avoid the formation of clots that can block the flow of blood in vessels. Things your doctor may do: Prescribe aspirin, which prevents clots from forming, after first determining that you are not aspirin intolerant or at increased risk for gastrointestinal bleeding or hemorrhagic stroke. Recommend the appropriate aspirin type (uncoated or enteric-coated, which is treated to pass through the stomach and dissolve in the intestines) and dosage (usually between 75 mg and 160 mg per day). Pearson TA et al. AHA guidelines for primary prevention of cardiovascular disease and stroke: 2002 update. Circulation. 2002;106:388-391.