How's this for a heart-stopper: One person dies from cardiovascular disease in the United States every 37 seconds.
The heart, the pump that distributes blood with its vital oxygen and nutrients to every finger, toe and brain cell, is a tricky piece of machinery not completely understood and requires constant maintenance to ensure it hums away long into old age.
Heart health hinges on keeping the blood flowing smoothly through arteries and veins. Unfortunately, this is not as easy as it may sound.
The artery that nourishes the heart with oxygen is especially susceptible to plaque build up to the point of blocking blood flow. This is the most common form of heart disease, the number one killer in our society, and plays some role in heart attacks.
"We don't know exactly why people have heart attacks," said Dr. Anthony DeMaria, co-director of the U.C. San Diego Cardiovascular Center. "What we do know is certain conditions markedly elevate the risk of having plaque."
Primarily, high blood pressure, high cholesterol and smoking.
"It's very, very important for people to keep cholesterol and blood pressure low," DeMaria said.
The lower the better, he added. The "normal" range has been repeatedly lowered over the years and being at the bottom end of that range is preferred.
That said, 25 percent of heart attacks occur with none of the known risk factors, which means there is still more research to be done, DeMaria said.
Maintaining a healthy diet, exercising and living a stress-free life are all major components to lowering blood pressure and cholesterol.
"Heart health is really overall health," said MaryKay Mullally, a wellness and weight-loss coach based in Carmel Valley.
But, within that, Mullally said nutrition is more critical than exercise: "I put a big emphasis on what goes into my body first, and what I do with it next."
To give that ticker some love, Mullally recommended leafy greens for their nutrients, fruits, veggies, and healthy fats like avocados, olives, flax seed oil and olive oil. The marathoner adheres to a raw vegan diet, avoiding animal products, including meat, butter and cheese because of their high saturated fat content, which ups bad cholesterol.
But that doesn't mean meat-lovers have to give it up completely, she said, just consume in moderation.
DeMaria agreed: "I tend to feel it's less important what you eat than how much of it."
Exercise is statistically proven to have heart health benefits.
"People who exercise live longer, and have less health problems than people who are sedentary," DeMaria said.
Exactly why is still up for debate in the scientific community; theories include conditioning the heart so it doesn't have to regularly work as hard, increasing blood production, and reducing clotting.
John Lenz, general manager at Fitness Together in La Jolla, said cardiovascular exercise gets the heart pumping harder, which increases metabolism, which burns more calories. It also increases circulation, which can help improve blood pressure.
"I ask my clients 'Have you sweat today?'" Lenz said. "If you are sitting in the front of the computer all day, you're not getting your heart rate up at all. You have to make a point to be active."
Mullally encouraged those who are not currently active to start small - walk the dog for 10 minutes a day. Ideally, she advised 30 to 45 minutes of cardio four to five days a week.
She also suggested yoga for flexibility, strength and establishing a mind-body connection.
"When you feel good, are aware of what your body is feeling, you tend to make better choices," she said.
Knowns and unknowns
Actively maintaining a healthy heart can only get a person so far if high blood pressure or cholesterol are hereditary. Age is also an unavoidable factor - risk for heart disease greatly increases as both men and women age.
That's when drugs come in, DeMaria said: "We do have medications that work incredibly well to lower blood pressure and cholesterol, shown to prolong survival."
Awareness about heart health has increased over the years; one person dying from heart disease every 37 seconds is actually a 26 percent improvement from 1995 to 2005.
"Judging by cocktail parties people are very concerned about their hearts, they understand the prevalence of heart disease," DeMaria said. "However, I think sometimes awareness and concern does not translate to action."