Ask Dr. Hallberg: 'Simple Seven' steps for heart health not so simple

How healthy is your heart? The American Heart Association has issued guidelines for ideal cardiovascular health called Life's Simple Seven. They include things like being a non-smoker, eating healthy and keeping cholesterol low. But following all of the "Simple Seven" just might not be so simple.

MPR's Tom Crann spoke with Dr. Jon Hallberg about the recommendations. Hallberg is a physician in family medicine at the University of Minnesota and medical director of the Mill City Clinic in Minneapolis.

Tom Crann: In a study of over 17,000 people, only two met all of the criteria for optimal heart health. What does that tell us?

Dr. Jon Hallberg: The "Simple Seven" is not quite so simple. It just goes to show how nearly impossible it is to accomplish all of these goals, which by themselves are really not that difficult in some ways, but to try to do all seven of them all the time? It's almost impossible.

Crann: What would you say to someone, a patient, who comes to the clinic, looks at that list and then gets overwhelmed, and then says, "Why even try?"

Hallberg: It's so easy to get overwhelmed. So, here's the good news: If people followed five of those criteria -- not six, not seven, but five of them -- as a group, their death rate was 55 percent lower than the rest the group. That's cutting your death rate in half. Then, they found if you sort of chip away at one of the other categories, each category starts to decrease your rate by 15 percent, so chipping away one step at a time is the goal. And I think we're used to this in a way in health care, with diabetic care, there we have 12 to 13 different things we look, but there are five key ones and we all know how hard it is get within those five key ranges. Here are seven. So, you can't get overwhelmed as a provider or as a patient. You just have to say, "Let's go after this one and go after it, and make that happen."

Crann: Which one of those is actually the most challenging, do you think, for most patients?

Hallberg: Oh, there's no question: It's the diet. That is so difficult. To get to eat that well in our society is really tricky unless you can truly take the time to make your own food.

Crann: Make your own lunch?

Hallberg: Absolutely. To go to the farmers markets and doing "locavore" and kind of all the green aspects of eating we try to do is really hard to do.

Crann: Which one of those is the easiest, the one used say to a patient, "This one, you'll be able to do" and it's the most encouraging and does the most good?

Hallberg: I think the one that has the most bang for the buck is simply not being a smoker. There's no question that if someone's a smoker that's probably the single greatest thing that's going to put them at risk for heart disease and stroke. That being said, if you are smoker it's probably one of the hardest things to quit. So, the strategy might be to go after some of the other things first before you tackle that, but I don't think there's any question that it's the most important piece.

Crann: So, this information about what they're calling "Life's Simple Seven" is not the only thing to come out of the American Heart Association meeting this week. There were a lot of other findings, but how influential are these meetings?

Hallberg: There's no question that the American Heart Association annual meeting is the one that really, it's kind of the granddaddy of them all. Just everyday there are multiple things coming out of it. So, I think we, in the clinics, are sort of looking at this -- we're processing it a little bit. This is sort of interesting because this initiative was announced in January and these are sort of just the findings of the study. It's simple. I really like that.

I'm much less interested in the newest drug being shown to be effective in a particular situation. That kind of stuff I'd look at very, very cautiously because it's a drug, it's something new. The technology stuff is a little bit less interesting to me as well because, as they always say, more and more studies are needed. But in a case like this, you've got 17,000 people who were followed for five years. I think we can actually learn something from this.

(Interview transcribed and edited by MPR reporter intern Anissa Stocks.)