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Harvard Medical School
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General Medical Questions
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Question : I am a 52-year-old man with a family history of heart disease. My doctor says my blood pressure and cholesterol are great. My latest LDL cholesterol was 98 and my HDL was 45.
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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January 11, 2012
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A:

Congratulations! You’ve already covered the primary lifestyle approaches to a healthy heart (assuming that you don’t smoke!)

From your question, it sounds like you are the type of person who is willing to take things to the next level. Here are some ideas:

First, start with increasing your duration and intensity of exercise.

Per basic recommendations, we should all get a minimum of 150 minutes of moderate intensity physical activity per week (not all at once). But most experts suggest you get 45 to 60 minutes most days of the week to promote heart health.

For someone like you, I’d add a mix of these activities into your workout routine:

  • Endurance aerobics
  • Interval training with short bursts of high intensity exercise
  • Resistance training using machines and/or free weights

Regarding your diet: a Mediterranean-style diet is a perfect place to start. Get at least 5 servings of fruits and vegetables a day. Or aim higher —for example, 8 to 10 servings a day. Don’t eat too much red meat. It’s best to eat fish, especially those rich in the omega fats. And if you do drink alcohol, a glass or two of red wine per day might be the best choice.

Since your blood pressure is normal, you don’t have to cut down on salt. But there is no downside to watching how much you take in.

You’re a male older than age 45. So many doctors would advise taking a daily aspirin, as long as you are not at risk of internal bleeding. A baby aspirin (81 milligrams) is sufficient.

Study data show that most of the vitamin supplements we thought might help prevent heart disease (vitamin E, for example) offer little benefit. The one exception is vitamin D. Although the evidence is still new, you could think about taking up to 1,000 IU of vitamin D daily.

Definitely keep up your efforts! And work with your doctor to fine tune a strategy to keep heart disease at bay.

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