On this, the most heart-shaped day of the year, put down that box of chocolates for a moment and consider the mighty organ nestled in the middle of your chest. Today, your heart will beat about 100,000 times, pumping roughly 2,000 gallons of blood. Just a bit bigger than your fist, your heart is designed to keep on beating for a lifetime. But a lot can go wrong. Heart disease and stroke together account for about one in three deaths each year in the United States. Medical science is making major advances in repairing damage and preventing disease — the American Heart Association estimates declines in death rates for heart disease and stroke meant 221,000 lives were saved in 2007. But junk-food-loving, exercise-loathing lifestyles threaten to swamp those gains in the years to come. Here is a Valentine's Day look at some of the good and bad news on heart health in America, and a list of risk factors to help you see where you stand.
Start with prevention
"People really believe they're following ideal cardiovascular health practices because they're taking their cholesterol and blood pressure medications. But in fact, if you can prevent risk factors from developing by age 50, your chances of dying of a cardiovascular event by age 90 are close to zero.''
Donna Arnett, an epidemiologist and board president of the American Heart Association Greater Southeast Affiliate
Sadly, few Americans meet that yardstick.
The good news
Deaths from heart disease declined 27.8 percent from 1997 to 2007 (the most recent final data available). That's mostly thanks to better medications, technology and guidelines that help doctors know what works best to prevent and treat cardiovascular disease.
The bad news
The gains are coming at a high cost. From 1997 to 2007, inpatient cardiovascular operations and procedures increased 27 percent. The estimated cost of heart disease and stroke in 2007 (including lost productivity) was $286 billion. And with obesity continuing to rise, heart disease is becoming more common in the young.
The good news
From 1997 to 2007, the stroke death rate fell by 44.8 percent. In December, the Centers for Disease Control and Prevention released a preliminary report indicating that for the first time in 50 years, stroke has fallen from the third to the fourth leading cause of death. (The top three are heart disease, cancer and lung diseases.)
The bad news
Even as stroke declines among older people, doctors last week reported an alarming rise in strokes among young and middle-aged Americans, likely due to obesity. Stroke remains a leading cause of serious, long-term disability, costing an estimated $73.7 billion in 2010.
HOW'S YOUR HEART?
Here are six major risk factors for heart disease and stroke, how Americans are doing in regard to them and targets to achieve optimal heart health. For much more help improving these risk factors, see the American Heart Association's program at heart.org/mylifecheck.
STATUS: More than 67 percent of adults are overweight (body mass index over 25) or obese (BMI over 30); nearly 34 percent are obese. Among ages 2 to 19, 32 percent are overweight or obese; 16 percent are obese — about triple the rate of 1963.
TARGET: BMI of 18.5 to 24.9 for adults. For a 6-foot person, that's no more than 183 pounds. But losing even a small amount — such as 10 percent of current weight — can help.
Factor: Physical activity
STATUS: More than half of U.S. adults don't get enough physical activity to provide health benefits.
TARGET: At least 150 minutes a week of moderate activity for adults; for children, at least 60 minutes a day of moderate or vigorous activity.
Factor: Cigarette smoking
STATUS: 23 percent of men and 18 percent of women are smokers, much better than historic peaks. But declines in use have been slowing and 19.5 percent of high school students report current tobacco use.
TARGET: If you smoke, quit. The longer you stay stopped, the better for your heart health.
STATUS: 33.5 percent of U.S. adults have high blood pressure; 80 percent are aware of it, but less than half have it under control.
TARGET:Systolic reading (the upper number) of less than 120 and diastolic reading (the lower number) of less than 80, without drug therapy. Lifestyle changes, then drug therapy if needed, can get it under control.
Factor: High cholesterol
STATUS: 15 percent of U.S. adults have total serum cholesterol of 240 mg/dL or higher.
GOAL: Less than 200. Lifestyle changes, then drug therapy if needed, can get most people there.
STATUS: 8 percent of adults have been diagnosed with diabetes mellitus; 36.8 percent have prediabetes.
GOAL: Fasting plasma glucose (also known as fasting blood sugar) less than 100 mg/dL. Lifestyle changes can manage many cases of Type 2 diabetes; others will need drug therapy.
Sources: American Heart Association, U.S. Centers for Disease Control and Prevention, Texas Heart Institute.