MINNEAPOLIS/ST. PAUL (1/31/2023) — February is American Heart Month, dedicated to understanding risk factors for heart disease and how to live a heart-healthy lifestyle. Caring for your heart can be challenging as you go about your daily life. Jeremy Van’t Hof, MD, MS, with the University of Minnesota Medical School, talks about how to show your heart the love it deserves every day. 

Q: How does stress affect the heart?

Dr. Van’t Hof: It’s important to remember that not everyone experiences stress in the same way and what may seem simple or non-worrisome to one person may bring a great deal of stress to another. Stress becomes a heart health problem when it becomes a regular or chronic situation. Chronic stress can result in changes in hormone levels, like adrenaline, which may negatively affect the heart and blood vessels. The indirect effects of chronic stress are probably even more important. When one feels chronic stress or anxiety, sticking with heart-healthy lifestyle habits becomes much harder. Stress often leads to unhealthy eating as people lack the time or motivation to prepare a healthy meal or look to “comfort foods” to feel better. People with chronic stress may also have difficulty finding time to exercise regularly and sleep a healthy amount. The combination of chronic stress and an unhealthy lifestyle can lead to high blood pressure, weight gain, high cholesterol and diabetes — all risk factors for heart disease. 

Q: Good nutrition and a healthy heart go hand in hand. What are your nutrition tips for a healthy heart?

Dr. Van’t Hof: There is a wide variation in how people eat and what food they choose. Almost everyone can find some way to improve their diet, but the changes will differ for everyone. In general, the healthy choice will be to eat foods that are not processed, low in added sugars and sodium and limited in saturated fat. I encourage people to increase fruits, vegetables, whole grains, and beans  or legumes in their daily meals. If fast food is something people regularly eat, that is a place to start cutting back. Drinks with added sugar, like soda or some fruit juices, should be eliminated if possible. Healthy eating should be a long-term lifestyle change and not a short-term fad. It is important to set goals and make sustainable changes. 

Q: Why is exercise important for heart health?

Dr. Van’t Hof: Regular exercise has many health benefits. It leads to lower blood pressure, lower cholesterol, better control of blood sugar and a better ability to maintain a healthy weight. Regular exercise can help reduce stress and improve sleep quality. More physically active people have a lower risk for heart disease, including heart attacks and a common heart arrhythmia called atrial fibrillation. The benefits of exercise are not just for those with healthy hearts. Cardiac rehabilitation after a heart attack includes monitored exercise where a trained exercise physiologist monitors heart rate and blood pressure and provides guidance for increasing exercise workload. People who attend cardiac rehab after a heart attack live longer and have a lower risk of future heart attacks compared to those who do not go to rehab. 

Q: What are risk factors for heart disease?

Dr. Van’t Hof: The traditional risk factors that many people are aware of include high blood pressure, diabetes, high cholesterol and smoking. Other risk factors include unhealthy weight, insufficient sleep, chronic inflammatory and autoimmune diseases, and chronic stress. Genetics plays a role in heart disease, so family history is also important to consider.

Q: What work is being done at the U of M to advance heart health research?

Dr. Van’t Hof: A large spectrum of research is being done at the University of Minnesota to help improve heart health. Scientists are evaluating the effects of inflammation on the body at a cellular level, trying to discover where damage occurs and how we might prevent it. Clinical researchers are evaluating ways to detect heart and vascular disease early, before any symptoms occur, so we might be able to make lifestyle changes or start medications to prevent progression of disease. Others are investigating how our social environment or place of residence impacts heart health, diagnosis of heart disease and effectiveness of treatment in an attempt to reduce disparities in heart disease outcomes. Still, others are working with people with the sickest hearts. They help people leave the hospital and live longer, happier lives by finding new ways to provide intensive care, using heart pumps to help weak hearts, and in some cases, doing heart transplant surgery. 

Dr. Van’t Hof is a Minnesota native and cardiologist at the U of M Medical School and M Health Fairview. His clinical interests include early detection of cardiovascular disease to prevent or delay the onset of cardiovascular events, familial hypercholesterolemia, resistant hypertension and complex polyvascular disease. He believes in an integrative treatment approach combining lifestyle alterations with evidence-based medical therapy to maximize physical and mental health and quality of life.


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