The Correlation between Drinking Alcohol and Heart Diseases of Men in the age of 20 - 35 years old in Puri Indah,

West Jakarta in 2006.

Name: Robby Effendy Thio NIM: 030.06.228 English Lecturer: Drs. Husni Thamrin, MA

Chapter I
Introduction Any advice about the consumption of alcohol must take into account not only the complex relation between alcohol and cardiovascular disease but also the well-known association of heavy consumption of alcohol with a large number of health risks. One approach would be to recommend no consumption of alcohol. However, a large number of recent observational studies have consistently demonstrated a reduction in coronary heart disease (CHD) with moderate consumption of alcohol. Any prohibition of alcohol would then deny such persons a potentially sizable health benefit. This paper examines the complex relation between alcohol and coronary heart disease. I. Background

I examined the association between alcoholic drinks consumption and risk of heart diseases such as: Coronary Heart Disease (CHD). II. Problems

Drinking Alcohols have always been related to heart diseases especially for Men in the age of 20 - 35 years old in Puri Indah, West Jakarta. III. Limitation of Problems

The Limitation of this problem is the lifestyle of young men (between the age of 20 35) that is drinking alcohols and what are the effects of drinking alcohols in relation to heart diseases. IV. Objectives

The main objective is to show up what are the effects of alcohol consumption to heart diseases, in medicals point of view. V. Methods of Writing

Library Research and Internet Browsing (Collecting Information).

Chapter II
Discussion 1: Alcoholic Drinks and Drinking Alcohol

I. Alcoholic beverage (Alcoholic drinks) An alcoholic beverage is a drink containing ethanol. Ethanol is a psychoactive drug, a depressant, and many societies regulate or restrict its sale and consumption. Countries place various legal restrictions on the sale of alcoholic drinks to young people. The manufacture and consumption of alcohol is notably found (to some degree) in most cultures and societies around the world, from hunter-gatherer tribes to organized nation-states. The consumption of alcohol is often important at social events in such societies and may be an important aspect of a community's culture. II. Chemistry Ethanol (CH3CH2OH), the active ingredient in alcoholic drinks, for consumption purposes is almost always produced by fermentationthe metabolism of carbohydrates by certain species of yeast in the absence of oxygen. The process of culturing yeast under alcoholproducing conditions is referred to as brewing. It has been suggested that alcoholic impurities (congeners) are the cause of hangovers. However, it is more likely that they are caused by acetaldehyde , a toxic breakdown intermediate naturally produced by the liver as the alcohol is metabolized. Drinks with a concentration of more than 50% ethanol by volume (100 proof) are flammable liquids and easily ignited. Some exotic ones gain their distinctive flavors through intentional

ignition of the drink, such as the Flaming Dr. Pepper. Spirits with a higher proof (ABV in UK is roughly half of proof number) can be ignited with ease by heating slightly, e.g. adding the spirit to a warmed shot glass. In chemistry, alcohol is a general term for any organic compound in which a hydroxyl group (-OH) is bound to a carbon atom, which in turn is bound to other carbon atoms and further hydrogens. Other alcohols such as propylene glycol and the sugar alcohols may appear in food or beverages regularly, but these alcohols do not make them "alcoholic". Methanol (one carbon), the propanols (three carbons giving two isomers), and the butanols (four carbons, three isomers) are all commonly found alcohols, and none of these three should ever be consumed in any form. Alcohols are toxicated into the corresponding aldehydes and then into the corresponding carboxylic acids. These metabolic products cause a poisoning and acidosis. In the case of other alcohols than ethanol, the aldehydes are poisonous and the acidosis can be lethal. III. Uses In many countries, alcoholic beverages are commonly consumed at the major daily meals (lunch and dinner). Most early beers were in fact highly nutritional and served as a means of calorie distribution. Beer can be stored longer than grain or bread without fear of pest infestation or rotting, and drinking beer avoided the tooth-destroying grit that was present in hand-ground or early mill-ground flours. In places and eras with poor public sanitation, such as Medieval Europe, consumption of alcoholic drinks (particularly weak or "small" beer) was one method of avoiding water-borne diseases such as cholera. Though alcohol kills bacteria, the low concentration in beer or even wine will have only a limited effect. Probably the boiling of water, which is required for the brewing of beer, and the growth of yeast, which would tend to crowd out other microorganisms, were more important than the alcohol itself. In any case, the ethanol (and possibly other ingredients) of alcoholic beverages allows them to be stored for months or years in simple wood or clay containers without spoiling, which was certainly a major factor in their popularity. In colder climates, strong alcoholic beverages such as vodka are popularly seen as a way to "warm up" the body, possibly because ethanol is a quickly absorbed source of food energy

and dilates peripheral blood vessels (Peripherovascular dilation). This however is a dangerous myth, and people experiencing hypothermia should avoid alcohol - although it makes you feel warmer, the body loses heat and body temperature decreases, which may increase the effects of hypothermia, and eventually cause death. This is because of the dilation of blood vessels not in the core of the body; because of this increased bloodflow, the body loses its heat out of its less protected outer extremities. In many cultures, both contemporary and historical, alcoholic beverages mostly because of their neurological effects have also played an important role in various kinds of social interaction, providing a form of "liquid courage" (those who consume it "gain" confidence and lose discretion). While other psychoactive drugs (such as opium, coca, khat, cannabis, kava-kava, etc.) also have millennial traditions of social use, only coffee, tea, and tobacco are currently as universally used and accepted as ethanol. IV. Types of Alcoholic Beverages Low-alcohol-content drinks are produced by fermentation of sugar- or starch-containing products, and high-alcohol ones are produced by distillation of these. Sometimes, the alcohol content is increased by adding distilled products, particularly in the case of wines. Such fortified wines include Port and Sherry. The process involved (as well as the resulting alcohol content) defines the finished product. Beer involves a relatively short (incomplete) fermentation process and an equally short aging process (a week or two) resulting in an alcohol content generally between 3-8%, as well as natural carbonation. Wine involves a longer (complete) fermentation process, and a relatively long aging process (months or years -- sometimes decades) resulting in an alcohol content between 7-18%. Sparkling wine is generally made by adding a small amount of sugar before bottling, which causes a secondary fermentation to continue in the bottle. Distilled products are generally not made from a "beer" that would normally be palatable as fermentation is normally completed, but no aging is involved until after distillation. Most are 30% or greater alcohol by volume. Liqueurs are characterized by the way in which their flavors are infused and typically have high sugar content. Spirits typically contain 37.5% alcohol or greater and are not infused with flavors during the distilling process, however some modern spirits are infused with flavors after distilling (the Swedish vodka Absolut, for instance).

Standard alcoholic drinks in the United States all contain the same amount of alcohol, about 0.6 fl. oz. (American) each (17.75ml). A U.S. standard drink is a 12 ounce can or bottle of beer, a five ounce glass of dinner wine, or a 1.5 ounce drink of 40% distilled spirits (either straight or in a mixed drink). In the UK, alcohol content is measured in units. One unit equates to 10ml of pure ethanol (approx. fl. oz. American). A typical large glass or pint of beer contains approximately 2 units. A shot (25ml) of 40% spirit contains exactly 1 unit. The names of some beverages are determined by the source of the material fermented:

Source

Name of fermented beverage

Name of distilled beverage

barley

beer, ale, barley wine Scotch whisky, Irish whiskey Rye whiskey, Roggenkorn (type of Korn, from Germany) Bourbon whiskey Baijiu (China) Wheat whisky, Weizenkorn (type of Korn, from Germany)

rye

rye beer

corn Sorghum

corn beer

wheat

wheat beer

rice

Huangjiu,Choujiu Rice baijiu (China), Shch and Awamori (Japan), (China) , sake, sonti, soju (Korea), makkoli, tuak, thwon

juice of fruits, brandy, Cognac (France), Branntwein (Germany), other than wine (most commonly Pisco (Peru and Chile), "Rakia" also Rakiya, Rakija, apples or from grapes) Rak (The Balkans, Turkey), Singani (Bolivia) pears juice of apples applejack (or apple brandy), Calvados, cider, lambic

("hard") cider,

apfelwein perry, or pear cider; pear brandy, Eau-de-Vie (France) poire (France)

juice of pears

juice of sugarcane, or molasses juice of agave juice of rye and wheat juice of plums juice of pineapples

basi, betsa-betsa (regional)

rum (Caribbean), pinga or cachaa (Brasil), aguardiente, guaro, shch (Japan)

pulque

tequila, mezcal

desi

Daroo (Indian liquor)

plum wine

slivovitz, tzuica, palinca

tepache (Mexico)

coyol palm

coyol wine (Central America) Raki (Turkey) tsipouro, tsikoudia (Greece), grappa (Italy), Trester (Germany), marc (France), zivania (Cyprus), aguardente (Portugal) distilled mead ("mead brandy" or "honey brandy") vodka: potato mostly used in Poland and Germany, otherwise grain or potato. A strong drink called aquavit or brnnvin in Sweden, akvavit in Denmark and akevitt in Norway, and brennivn in (Iceland) is made from potato or grain. Actually, vodka is Russian for "little water" and can be done out of almost anything. - In Ireland, Poitn (or poteen) is a recently legalised drink made from potatoes. shch (Japan)

pomace

pomace wine

honey

mead

potato and/or grain

potato beer

beets Milk Gouqi Kumis or Kefir Gouqi jiu (China)

pink vodka / woman's vodka / girlie vodka (Russia) Arak Gouqi jiu (China)

Note that in common speech, wine or brandy is made from grapes unless the fruit is specified: "plum wine" or "cherry brandy" for example, although in some cases grapederived alcohol is added. Beer is generally made from barley, but can sometimes contain a mix of other grains. Whisky (or whiskey) is sometimes made from a blend of different grains, especially Irish whiskey which may contain several different grains. The style of whisk(e)y (Scotch, Rye, Bourbon, corn) generally determines the primary grain used, with additional grains usually added to the blend (most often barley, and sometimes oats).As far as American whiskey is concerned, Bourbon (corn), rye whiskey,must be at least 51% of respective constituent at fermentation, whilst corn whiskey (as opposed to bourbon) must be at least 81% - all by American law similar to the french A.O.P (appellation origon controlle). Two common distilled beverages are vodka and gin. Vodka can be distilled from any source of agricultural origin (grain and potatoes being the most common) but the main characteristic of vodka is that it is so thoroughly distilled as to exhibit less of the flavors derived from its source material. Distillers and experts however will disagree, potato vodkas display a creamy mouthfeel, whilst rye vodkas will have heavy nuances of rye (detected more easily as rye bread). Other vodkas display citrus notes (more common among domestic brands). Gin is a similar distillate which has been flavored by contact with herbs and other plant products, especially juniper berriesbut also including angel root, licorice, cardamom, grains of paradise, Bulgarian rose petals, and many others. The name comes from the Dutch or French word for Juniper, jenever or genever.

V. Measurements of Alcohol Consumption

Many beverages contain alcohol in varying amounts, necessitating standardization of the quantity of alcohol contained in various drinks. In general, the amount of absolute alcohol in grams is determined by the number of beverages consumed per day times the amount of alcohol in each beverage. In general, a 12-ounce bottle of beer, a 4-ounce glass of wine, and a 1 1/2-ounce shot of 80-proof spirits all contain the same amount of alcohol (one half ounce). Each of these is considered a "drink equivalent." Recent studies have tried to determine whether specific beverages have unique protective or deleterious effects. The interpretation of this research is complex because one person often consumes several types of beverages.

Chapter III

Discussion 2: Heart Diseases

Heart Diseases Also called: Cardiac disease Heart disease is the number one killer in the world. It is also a major cause of disability. There are many different forms of heart disease. The most common cause of heart disease is narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself. This is called coronary artery disease and happens slowly over time. It's the major reason people have heart attacks. Other kinds of heart problems may happen to the valves in the heart, or the heart may not pump well and cause heart failure. Some people are born with heart disease. Heart disease is any disorder that affects the heart's ability to function normally. Various forms of heart disease include:

Alcoholic cardiomyopathy Aortic regurgitation Aortic stenosis Arrhythmias Cardiogenic shock Congenital heart disease Coronary artery disease (CAD)Dilated cardiomyopathy Endocarditis Heart attack (myocardial infarction) Heart failure Heart tumor Hypertrophic cardiomyopathy Idiopathic cardiomyopathy Ischemic cardiomyopathy Acute mitral regurgitation Chronic mitral regurgitation Mitral stenosis Mitral valve prolapse Peripartum cardiomyopathy Pulmonary stenosis Stable angina Unstable angina Tricuspid regurgitation

You can help reduce your risk of heart disease by taking steps to control factors that put you at greater risk:

Control your blood pressure

Lower your cholesterol Don't smoke Get enough exercise

The most common heart disease is coronary artery disease. I. Coronary Heart Disease Alternative names Coronary artery disease; Arteriosclerotic heart disease; CHD; CAD Definition Coronary heart disease (CHD) is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CHD is also called coronary artery disease. Causes, incidence, and risk factors Coronary heart disease is usually caused by a condition called atherosclerosis, which occurs when fatty material and a substance called plaque builds up on the walls of your arteries. This causes them to get narrow. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms. Coronary heart disease (CHD) is the leading cause of death for men and women. According to the American Heart Association, more than 15 million people have some form of the condition. Men in their 40s have a higher risk of CHD than women. But, as women get older, their risk increases so that it is almost equal to a man's risk. See: Heart disease and women Many things increase your risk for CHD. Bad genes (heredity) can increase your risk. You're more likely to develop the condition if someone in your family has had it -- especially if they had it before age 50. Your risk for CHD goes up the older you get. The following factors also increase your risk of CHD:

Diabetes High blood pressure High LDL "bad" cholesterol Low HDL "good" cholesterol Menopause Not getting enough physical activity or exercise Obesity Smoking

Higher-than-normal levels of inflammation-related substances may also increase your risk for a heart attack. Such substances include C-reactive protein and fibrinogen. Increased levels of a chemical called homocysteine, an amino acid, are also linked to an increased risk of a heart attack. Symptoms Symptoms may be very noticeable, but sometimes you can have the disease and not have any symptoms. Chest pain or discomfort (angina) is the most common symptom. You feel this pain when the heart is not getting enough blood or oxygen. How bad the pain is varies from person to person. There are two main types of chest pain:

Atypical chest pain -- often sharp and comes and goes. You can feel it in your left chest, abdomen, back, or arm. It is unrelated to exercise and not relieved by rest or a medicine called nitroglycerin. Atypical chest pain is more common in women. Typical chest pain -- feels heavy or like someone is squeezing you. You feel it under your breast bone (sternum). The pain usually occurs with activity or emotion, and goes away with rest or a medicine called nitroglycerin.

Adults with typical chest pain have a higher risk of CHD than those with atypical chest pain. Other symptoms include:

Shortness of breath Heart attack -- in some cases, the first sign of CHD is a heart attack

Signs and tests Many tests help diagnose CHD. Usually, your doctor will order more than one test before making a definite diagnosis. Tests may include:

Electrocardiogram (ECG) Exercise stress test Echocardiogram Nuclear scan Coronary angiography/arteriography Electron-beam computed tomography (EBCT) to look for calcium in the lining of the arteries -- the more calcium, the higher your chance for CHD Coronary CT angiography Magnetic resonance angiography

Complications

Heart attack Heart failure Unstable angina Sudden death

Prevention See your health care provider regularly. Tips for preventing CHD or lowering your risk of the disease:

Avoid or reduce stress as best as you can. Don't smoke. Eat well-balanced meals that are low in fat and cholesterol and include several daily servings of fruits and vegetables. Get regular exercise. If your weight is considered normal, get at least 30 minutes of exercise every day. If you are overweight or obese, experts say you should get 60 to 90 minutes of exercise every day. Keep your blood pressure, blood sugar, and cholesterol under control.

Moderate amounts of alcohol (1 glass a day for women, 2 for men) may reduce your risk of cardiovascular problems. However, drinking larger amounts does more harm than good. If you have one or more risk factors for coronary heart disease, talk to your doctor about possibly taking an aspirin a day to help prevent a heart attack or stroke. Low-dose aspirin therapy may be prescribed if the benefit is likely to outweigh the risk of gastrointestinal side effects. New guidelines no longer recommend hormone replacement therapy, vitamins E or C, antioxidants, or folic acid to prevent heart disease.

Chapter IV

The Effects of Drinking Alcohol to Heart Diseases

I. Relation Between Alcohol Consumption and Total Mortality A large number of observational studies have consistently demonstrated a J-shaped relation between alcohol consumption and total mortality. This relation appears to hold in men and women who are middle aged or older. The lowest mortality occurs in those who consume one or two drinks per day. In teetotalers or occasional drinkers, the rates are higher than in those consuming one or two drinks per day. In persons who consume three or more drinks per day, total mortality climbs rapidly with increasing numbers of drinks per day. A number of studies have dissected the J-shaped curve into specific diseases. It is clear that a stepwise decline in CHD death occurs with increasing drinks per day. Because CHD accounts for one third or more of total deaths, those with no alcohol consumption have higher total mortality than those drinking one to two drinks per day. On the other hand, mortality due to a large number of other diseases increases with an increasing number of drinks consumed per day. Diseases related to heavy consumption of alcohol and alcoholism include stroke, alcoholic cardiomyopathy, several kinds of cancer, cirrhosis, and pancreatitis, as well as accidents, suicide, and homicide. It should be noted that heavy consumption of alcohol is a major cause of hypertension, so that the diseases related to hypertension, such as stroke, are generally related to alcohol consumption. Heavy consumption of alcohol also appears to affect heart muscle and possibly arterial tissues directly. Alcoholic cardiomyopathy is a common diagnosis in long-term alcoholics. While the relative and absolute risks of these diseases are negligible at one or two drinks per day, the mortality rates rise sharply. The J-shaped distribution for total mortality is then the sum of the protective effect on CHD mortality and the detrimental effect of high levels of consumption on these other causes of death. II. Protective Effects of Alcohol Against CHD More than a dozen prospective studies have demonstrated a consistent, strong, doseresponse relation between increasing alcohol consumption and decreasing incidence of CHD. The data are similar in men and women in a number of different geographic and ethnic groups. Consumption of one or two drinks per day is associated with a reduction in risk of

approximately 30% to 50%. Studies of coronary narrowings defined by cardiac catheterization or autopsy show a reduction in atherosclerosis in persons who consume moderate amounts of alcohol. In general, the inverse association is independent of potential confounders, such as diet and cigarette smoking. Concerns that the association could be an artifact due to cessation of alcohol consumption in persons who already have CHD have largely been disproved. No clinical trials have been performed to test the alcohol-CHD relation. However, the large numbers of observational studies support a true protective effect of moderate consumption of alcohol. III. Mechanisms for Cardioprotective Effects of Moderate Consumption of Alcohol Recent analyses suggest that approximately 50% of the protective effect of alcohol is mediated through increased levels of HDL cholesterol. HDL removes cholesterol from the arterial wall and transports it back to the liver and probably has several other protective effects on the arterial system. A number of epidemiological studies and small clinical trials have demonstrated that moderate consumption of alcohol raises HDL cholesterol levels. When HDL cholesterol was added to computer models predictive of CHD, about half the benefit of alcohol in protecting against CHD could be attributed to its effect on HDL levels. A number of other mechanisms have been proposed to explain the other half of the protective effect of alcohol against CHD. One or two alcoholic drinks per day apparently do not affect other major risk factors, such as LDL cholesterol and blood pressure. Several studies have suggested that alcohol may affect blood clotting, either by causing the blood to clot less avidly through effects on coagulation factors and platelets or by enhancing the ability of the blood to break up clots when they form. These studies are supported by epidemiological data that suggest that acute alcohol consumption causes a short-term beneficial effect in protection against CHD in addition to long-term effects. Other studies have focused on the nonalcoholic components of alcoholic beverages, particularly in red wine and dark beer, which may have antioxidant properties. However, the epidemiological evidence favoring one type of beverage over another is inconsistent, possibly because of large differences in diet, smoking, and other risk behaviors among drinkers. Again, at least half of the inverse association between alcohol and CHD appears to be directly linked to alcohol through increased HDL cholesterol levels. IV. Recommendation

It is unlikely that a randomized, controlled trial of alcohol consumption will ever be performed to establish a direct link between alcohol consumption and reduction in CHD and to define the risks and benefits of encouraging consumption of alcohol. In lieu of this scientific base, a number of scientific facts can be brought to bear on the development of recommendations about alcohol consumption. First, the beneficial effects of alcohol are limited to one or two drinks per day. Second, heavier consumption is related to a number of health problems. Third, it is clear that persons with medical and social conditions made worse by alcohol should not consume any alcohol whatsoever, including persons with prior diagnoses of hypertriglyceridemia, pancreatitis, liver disease, porphyria, uncontrolled hypertension, and congestive heart failure. Pregnant women and persons on certain medications that interact with alcohol should also refrain from consumption. Persons with a personal or strong family history of alcoholism are at risk for alcohol addiction and should avoid all alcoholic beverages. These facts preclude widespread public health recommendations to either encourage or prohibit alcohol consumption. For example, in the United States 100 000 excess deaths can be attributed to alcohol-related diseases each year. On the other hand, if current consumers of alcohol all abstained from drinking, approximately 80 000 excess deaths would occur. Most of the excess deaths due to alcohol occur in people younger than 45 years, whereas deaths reduced by alcohol are generally in age groups with high CHD rates, ie, 45 years or older. In either case, general public health education messages about alcohol may be difficult to develop, so that they target only persons for whom moderate consumption of alcohol would have a positive cost-benefit ratio. Therefore, the following recommendations may be made for the individual patient who is considering beginning or continuing to drink alcohol. 1. Consult a physician for an assessment of the benefits and risks of alcohol consumption. Persons with a personal or family history of alcoholism, hypertriglyceridemia, pancreatitis, liver disease, certain blood disorders, heart failure, and uncontrolled hypertension, as well as pregnant women and persons on certain medications that interact with alcohol, should not consume any alcohol. Any recommendations should be tailored to the individual patient's risks and potential benefits.

2. If no contraindications to alcohol consumption are present, moderate consumption of alcohol (one or two drinks per day) may be considered safe. 3. Alcohol should never be consumed when operating machinery or motor vehicles. 4. The risks and benefits of alcohol consumption should be reviewed periodically as part of regular medical care. In the event of excess consumption, problem drinking, or deleterious consequences of drinking, recommendations for alcohol consumption should be revised. 5. Adolescents and young adults should be targeted for assessment and advice before potentially deleterious habits of consumption become established.

Chapter V

Conclusion
I. Drinking Alcohols For many people, moderate drinking is probably safe. It may even have health benefits, including reducing your risk of certain heart problems. Moderate drinking is one drink a day for woman or anyone over 65, and two drinks a day for men under 65. Some people should not drink at all, including alcoholics, children, pregnant women, people on certain medicines and people with some medical conditions. If you have questions about whether it is safe for you to drink, speak with your healthcare provider. Anything more than moderate drinking can be risky. Binge drinking - drinking five or more drinks at one time - can damage your health and increase your risk for accidents, injuries and assault. Years of heavy drinking can lead to liver disease, heart disease, cancer and pancreatitis. It can also cause problems at home, at work and with friends. National Institute on Alcohol Abuse and Alcoholism II. Heart Disease Heart disease is a number of abnormal conditions affecting the heart and the blood vessels in the heart. Types of heart disease include:
Coronary artery disease (CAD) is the most common type and is the leading cause of

heart attacks. When you have CAD, your arteries become hard and narrow. Blood has a hard time getting to the heart, so the heart does not get all the blood it needs. CAD can lead to:
o Angina. Angina is chest pain or discomfort that happens when the heart does not get

enough blood. It may feel like a pressing or squeezing pain, often in the chest, but sometimes the pain is in the shoulders, arms, neck, jaw, or back. It can also feel like indigestion (upset stomach). Angina is not a heart attack, but having angina means you are more likely to have a heart attack.
o Heart attack. A heart attack occurs when an artery is severely or completely blocked, and

the heart does not get the blood it needs for more than 20 minutes. Heart failure occurs when the heart is not able to pump blood through the body as well as it should. This means that other organs, which normally get blood from the heart, do not get enough blood. It does NOT mean that the heart stops. Signs of heart failure include:
o

Shortness of breath (feeling like you can't get enough air)

o Swelling in feet, ankles, and legs o Extreme tiredness Heart arrhythmias are changes in the beat of the heart. Most people have felt dizzy, faint,

out of breath or had chest pains at one time. These changes in heartbeat are, for most

people, harmless. As you get older, you are more likely to have arrhythmias. Don't panic if you have a few flutters or if your heart races once in a while. Prevent Heart Disease You can reduce your chances of getting heart disease by taking these steps:
Know your blood pressure. Your heart moves blood through your body. If it is hard for

your heart to do this, your heart works harder, and your blood pressure will rise. People with high blood pressure often have no symptoms, so have your blood pressure checked every 1 to 2 years. If you have high blood pressure , your doctor may suggest you make some lifestyle changes, such as eating less salt (DASH Eating Plan) and exercising more. Your doctor may also prescribe medicine to help lower your blood pressure.
Don't smoke. If you smoke, try to quit. If you're having trouble quitting, there are products

and programs that can help:

Nicotine patches and gums Support groups Programs to help you stop smoking

Ask your doctor or nurse for help. For more information on quitting, visit Quitting Smoking.
Get tested for diabetes . People with diabetes have high blood glucose (often called

blood sugar). People with high blood sugar often have no symptoms, so have your blood sugar checked regularly. Having diabetes raises your chances of getting heart disease. If you have diabetes, your doctor will decide if you need diabetes pills or insulin shots. Your doctor can also help you make a healthy eating and exercise plan.
Get your cholesterol and triglyceride levels tested. High blood cholesterol can clog your

arteries and keep your heart from getting the blood it needs. This can cause a heart attack. Triglycerides are a form of fat in your blood stream. High levels of triglycerides are linked to heart disease in some people. People with high blood cholesterol or high blood triglycerides often have no symptoms, so have your blood cholesterol and triglyceride levels checked regularly. If your cholesterol or triglyceride levels are high, talk to your doctor about what you can do to lower them. You may be able to lower your cholesterol and triglyceride levels by eating better and exercising more. Your doctor may prescribe medication to help lower your cholesterol.
Maintain a healthy weight. Being overweight raises your risk for heart disease. Calculate

your Body Mass Index (BMI) to see if you are at a healthy weight. Eat a healthy diet and exercise at a moderate intensity for at least 30 minutes most days of the week. Start by adding more fruits, vegetables, and whole grains to your diet. Take a brisk walk on your lunch break or take the stairs instead of the elevator.
If you drink alcohol, limit it to no more than one drink (one 12 ounce beer, one 5 ounce

glass of wine, or one 1.5 ounce shot of hard liquor) a day.

 Find healthy ways to cope with stress. Lower your stress level by talking to your friends,

exercising, or writing in a journal. III. The effects of Alcohol to Heart Diseases Therefore, I came out to a conclusion in 3 points: First, the beneficial effects of alcohol are limited to one or two drinks per day. Second, heavier consumption is related to a number of health problems. Third, it is clear that persons with medical and social conditions made worse by alcohol should not consume any alcohol whatsoever, including persons with prior diagnoses of hypertriglyceridemia, pancreatitis, liver disease, porphyria, uncontrolled hypertension, and congestive heart failure. Pregnant women and persons on certain medications that interact with alcohol should also refrain from consumption. Persons with a personal or strong family history of alcoholism are at risk for alcohol addiction and should avoid all alcoholic beverages.

Reference: 1. Thomas A. Pearson, MD, PhD; From the Nutrition Committee of the American Heart Association.

2. www.wikipedia.com. Alcoholic Beverages. 3. www.nlm.nih.gov/medlineplus/ency/article/000147.htm