Keeping your heart healthy can seem like a daunting task; you have to eat right, exercise and manage things like your cholesterol. Not sure where to start? Jason Robin, MD, Cardiology at NorthShore provides some tips for how you can prevent heart disease, be aware of symptoms of a potential condition and improve your quality of life with a healthy heart:

When diet and exercise are not enough, what’s the best way to keep a healthy heart?
Diet and exercise are part of the equation, but often we need to use medications to keep our heart healthy. One of the most used medications which has consistently shown benefits is “the statin”; Lipitor, Crestor, Zocor, etc.

Are there any side effects to worry about with statins? Are there people who shouldn’t be on them?
As with any intervention, we must always look at risks vs. benefits. As a whole, statins are VERY safe and have proven time again to reduce risk. Some people will develop muscles aches with statins. This is almost always benign, but we can check muscle enzymes to make sure there is no breakdown of the muscle – that is a VERY rare event, and when it does occur, we will temporarily stop the medication. Liver enzymes can also increase in some people so we check this after we start the medication or if we increase the dose. The likelihood of causing serious liver damage with a statin is very close to 0%. We even put people who have cirrhosis on statins! If your risk is high (previous cardiac event, known diabetes, LDL>190 or 10 year risk>7.5%), almost certainly you should be on a statin.

What is a silent heart attack? Does it really mean there are no signs?
It is not uncommon for us to perform an EKG, echocardiogram, stress test or angiogram to find out a coronary artery closed off and the patient does not recall it. Often seen in older patients who are less sedentary or in people who ignore symptoms.

If you had someone in your family die young from a heart attack, at what age should that person’s children start seeing a cardiologist?
When I hear stories of fathers having heart attacks in their 20s-40s, I like to start seeing the kids once they are post-adolescent. These are the kids who I may start statin therapy on at a young age and consider studies such as a 64 slice CT of the heart to look for early subclinical coronary disease. Also very important to make sure that the cause of death was indeed a myocardial infarction/heart attack. If it was due to a hereditary heart muscle or primary electrical problem, that takes us down a different path.

Can children have high cholesterol? My daughter is 12 and overweight, and I’m worried about the long term effects on her heart health, but I don’t know how to address this without making her feel self-conscious.
Yes, kids can have high cholesterol. Sometimes, pediatricians only check the total which is not very useful since the total may be high because the good HDL is also very high. It is great that you are thinking about this now. Plaque starts to develop very early on in life- teens and 20s. Unless her cholesterol is dangerous high (seen with familiar hyperlipidemia-very rare), I would not expose her to a statin yet, and work on lifestyle modifications. Talk to your pediatrician on lifestyle changes. Sometimes, a dietician can be useful. I send my patients to Lisa Bookstein in Highland Park – she is great!

I’ve been reading about the harm sitting too long can do to your heart. Is this something you really should be concerned about? How often should you be getting up if you do have a 9 hour a day desk job?
The main issue with sitting too long is you are not burning calories. It is more of a long term issue as being sedentary all the time will lead to weight gain, insulin resistance and diabetes. Make sure you exercise before or after work. If you are worried about blood clots in the legs, as long as you stand up and walk around for a few minutes every hour, you should be fine. But do MOVE MORE!

You can visit the Cardiovascular Institute for more heart health information, and read more of Dr. Robin’s responses in our Heart Health & Disease Prevention chat.