Questions about heart attack, blood pressure, BMI or stroke? Find answers here
By American Heart Association
When you’re searching for health advice online, finding simple, trustworthy answers can be hard to find. But you’ve come to the right place.
We compiled a list of questions based on popular internet searches, then ran them past Dr. Shawna Nesbitt, the John C. Vanatta III Professor of Internal Medicine in the hypertension section of the division of cardiology at UT Southwestern Medical Center in Dallas. She’s also medical director of the Parkland Hypertension Clinic.
Along with her answers, you’ll also find helpful links to information from the American Heart Association vetted by a team of medical and science advisors. (But if you think you’re dealing with a heart attack, stroke or cardiac arrest, call 911.)
What causes high blood pressure, and how can I fix it quickly?
Knowing what causes high blood pressure can help you understand why quick fixes aren’t the answer, Nesbitt said.
High blood pressure, or hypertension, damages blood vessels. Usually, that happens over time, in a “slow build,” Nesbitt said. And because blood vessels are everywhere, it can lead to problems in the heart, brain, kidneys and more.
Family history and lifestyle play a role in who develops high blood pressure, Nesbitt said. Some of the family influence is genetic, but your upbringing determines what you eat and how you exercise as a child, and “those patterns live with you for a long time.”
Stress, sleep disorders and whether you smoke also raise your risk.
Prescription medications might be needed to control high blood pressure. But lifestyle changes can help over time, Nesbitt said. Eating less sodium, or salt, and getting enough potassium through a diet full of fruits and vegetables, are important. So is staying active.
Helpful links about how to fix high blood pressure:
Top 10 things to know about the latest high blood pressure guidelines
Healthy eating: How to eat smart, lose weight and learn cooking skills
Healthy lifestyle: Help with sleep, stress management and quitting tobacco
What is my BMI? What should my BMI be?
BMI stands for body mass index. “Basically, it is a way of indexing your weight to your height,” Nesbitt said. Taller people should weigh more. Shorter people should weigh less. The National Heart, Lung and Blood Institute provides a calculator.
Keep reading before you get too focused on that number, though.
BMI was conceived as a tool for evaluating obesity in large groups of people, Nesbitt said. It’s not as good for evaluating individuals.
A BMI of less than 25 is considered minimal risk, 25 to 29.9 is considered overweight, and over 30 is considered obese. But because muscle weighs more than fat, fit people with lots of muscle will have a high BMI. And the definitions differ among people of different racial and ethnic backgrounds, Nesbitt said. What’s healthy for a Black or white woman in the U.S. might not be for a woman of South Asian background, for example.
Maintaining a healthy weight is essential for health. But as a tool for measuring weight, Nesbitt said, BMI is best thought of as “a rough estimate.”
Helpful links about BMI and maintaining a healthy weight:
Healthy for Good: Learning healthy habits for every stage of life
How can I lower cholesterol quickly?
As with blood pressure, it helps to understand what causes unhealthy cholesterol levels before you try to deal with them.
Blood cholesterol tests usually include numbers for HDL (“good”) and LDL (“bad”). Some people have a genetic predisposition for high cholesterol, which is why getting screened early is important. A diet high in saturated fat can affect cholesterol levels as well.
In time, high LDL cholesterol levels can lead to plaque buildup in the walls of your arteries, raising your risk of heart attack or stroke.
So if you need to control your cholesterol levels, “long story short, diet and exercise are the ways,” Nesbitt said. “But if you’re beyond a certain level, you’ll need medications.”
Eating more fruits and vegetables helps, Nesbitt said. Over-the-counter supplements shouldn’t be taken without consulting your doctor, though.
Helpful links about how to lower cholesterol
What your cholesterol levels mean
Do kids need their cholesterol checked?
What is aerobic exercise? What is cardio? And does walking count?
Aerobic, or cardio, exercise is activity that gets your heart rate up.
“Walking definitely counts,” Nesbitt said. Other moderate-intensity aerobic activities include biking, gardening and dancing. Vigorous-intensity aerobic activities include running, swimming laps and jumping rope.
“Any form of exercise is good for you,” Nesbitt said, but different types benefit you in different ways.
The American Heart Association recommends adults get at least 150 minutes a week of moderate-intensity aerobic exercise, 75 minutes a week of vigorous aerobic exercise, or a combination of both. Those who are able should also do muscle-strengthening activities of moderate to high intensity at least two days a week.
Hitting your aerobic exercise goals can be easier than you think, Nesbitt said. Walking from your car to your workplace counts, for example – so you can boost your minutes by parking a short distance away instead of right at the front door.
Helpful links about exercise
Fitness basics, getting active, walking and staying motivated
American Heart Association recommendations for physical activity in adults and kids
5 ways to get more out of every step you take on the road to better health
What are the signs of a heart attack in women?
Men are more likely to experience well-known heart attack symptoms such as sudden pain in the chest, Nesbitt said. “Women get things like, ‘Oh, my shoulders hurt, or ‘I'm just kind of having a little more difficulty moving around.’”
Heart attack symptoms in women also can include:
- Uncomfortable pressure, squeezing, fullness or pain in the center of their chest
- Pain or discomfort in the arms, back, neck, jaw or stomach
- Anxiety
- Shortness of breath
- Unusual tiredness and weakness
- Breaking out in a cold sweat
- Nausea
- Lightheadedness
“It's important for women to know that it’s different, because the signs are more subtle for women than they are for men,” Nesbitt said. And women’s symptoms are more likely to be overlooked or assumed to be something like indigestion or fatigue.
Helpful links about heart attack symptoms in women
Heart attack, stroke and cardiac arrest symptoms
Heart attack symptoms in women
Warning signs of a heart attack
Can heart palpitations kill you?
“Heart palpitations” describe the feeling of a heart that’s racing, Nesbitt said. That could be caused by anxiety. Or it could be an arrhythmia, an irregular heartbeat.
Either way, it’s something to discuss with a doctor, Nesbitt said, because the average person is probably not going to be able to distinguish between the two.
Arrythmias might also cause symptoms such as dizziness or sweating, Nesbitt said, but anxiety can cause the same.
So while an extra beat or two is not necessarily an emergency, Nesbitt said, you can’t know that until somebody formally evaluates you.
Helpful links about heart palpitations
What are the signs and symptoms of a stroke?
According to the American Stroke Association, signs and symptoms of a stroke include:
- Numbness or weakness of the face, arm or leg, especially on one side of the body
- Confusion, trouble speaking or understanding speech
- Trouble seeing in one or both eyes
- Trouble walking, dizziness, loss of balance or coordination
- Severe headache with no known cause
Women can also feel:
- General weakness
- Disorientation and confusion or memory problems
- Fatigue, nausea or vomiting
If you suspect someone is having a stroke, call 911 immediately. Quick treatment is essential, Nesbitt said, because with each second after a stroke, brain cells die. “And once they die, getting the function that they served back is sometimes impossible.”
Calling 911 speeds treatment to restore blocked blood flow to the brain. But if you wait too long, Nesbitt said, “those therapies don’t work.”
The American Stroke Association makes what to do easy to remember with the FAST acronym:
- F = Face drooping?
- A = Arm weakness?
- S = Speech difficulty?
- T = Time to call 911.
Helpful links about the signs and symptoms of stroke
What should I do if I think I’m having a heart attack?
Call 911.
“Unequivocally, do that first,” Nesbitt said. “Don’t do anything else. Do not pass go. Do not try to drive yourself. Do not try to be a hero. Call 911, period.”
That applies even if your chest pain seems mild, because that symptom might be just the first step, she said. “The next might be – you stop breathing.”
A heart attack is caused when blood flow that feeds the heart is blocked. The longer there is little or no blood flow to the tissue, the greater the likelihood of irreversible damage.
“So call 911,” Nesbitt said. “By far and away, that’s what you should do.”