The fact that our country is going through tough economic times is lost on no one. Unemployment is up, earnings are down, and our hard-wrought dollars don’t stretch as far as they used to. People would like to get healthier, but everything from health insurance premiums to gym memberships are so costly that many people are simply choosing to forego hefty investments into their personal health just so they can balance their checkbooks.
Not all investments into better health are necessarily exorbitant. Here I list seven expenses that might help you improve your heart health and shrink your waistline without breaking the bank or endangering your bottom line.
1. Automated Home Blood Pressure Cuff ($40-$80). Most people don’t have hypertension and therefore would derive no benefit from a home cuff, but for those who do (and their doctors) this can be quite helpful. When I see patients in the office I get nothing more than a snapshot of their blood pressure control. Individual pressures vary considerably over the course of hours every day. Assessing a person’s pressure based on a solitary measurement in the office would be like judging the climate of a city based on a single thermometer reading.
Advancing age, weight, and inactivity all lead to a slow rise in a person’s pressure, often to the point that the drugs that keep it under control may not be adequate 5 years from now. In my view, anyone with hypertension requiring more than just one drug to control should have a cuff at home and record their pressure at least a couple of times a week. An average of 135/85 or higher would justify a visit with your doctor about looking into ways to achieve tighter control. Bring your measurements with you every time you see your physician.
You can order these on the internet but I recommend buying them from your local pharmacist so that the staff can help you pick one with a cuff that best fits your arm.
2. Aspirin (300 coated tablets for $15). Aspirin has been preventing and treating heart attacks for years. Almost everyone with known coronary heart disease or previous stroke is on the medication and many others take it even if they’ve never had heart trouble. It works by decreasing the likelihood that your body’s platelet cells can congregate and form a clot in one of the arteries of the heart or head. It’s cheap, fairly effective, and available everywhere.
So why don’t we just put it in the water supply? The problem is twofold. First, some people have allergies to aspirin while others can’t tolerate it because of the slightly increased risk of bleeding—most particularly in the stomach—that daily dosing would impose.
Second, most young, healthy people would derive no meaningful benefit from daily aspirin intake. The U.S. Preventive Task Force recommends daily aspirin for men aged 45-79 and women aged 55-79 when “potential cardiovascular disease benefit outweighs potential harm of gastrointestinal hemorrhage.” To determine if an individual’s potential benefit outweighs the risk of bleeding you have to turn to a risk assessment calculator that takes into account your blood pressure, cholesterol, age, and smoking status. You can try this right now: click here and enter your information, then take the score you get and refer to the chart located at this link. If your risk exceeds the level posted in the chart then you should invest in a big bottle of aspirin.
Men under 45 and women under 55 are not encouraged to go on aspirin unless they have established vascular disease. For persons over 80 the expert task force has no recommendations, citing “insufficient evidence.” If you’re at either end of this spectrum and wonder about aspirin you may want to consult your doctor.
The appropriate dose of aspirin is separate discussion all together (you can refer to a previous post on this matter).
3. Pedometer ($15-$30). I’ve mentioned this recommendation before. For many people walking seems to be the best and most convenient form of exercise, whether done for a sustained period once a day or broken up into small chunks. A pedometer will help you keep to a goal of daily activity and serves as a constant reminder to park your car at the far end of the lot or take the stairs instead of the elevator.
I had a patient who trimmed down to a healthy weight just by purchasing and using a pedometer. As a long-haul truck driver he rarely had opportunity to keep to a scheduled exercise regimen. Instead, he made a point to walk 5,000 steps daily wherever he happened to find himself: truck stops, rest areas, motels. He told me he was so vigilant with this that on more than one occasion he made laps around his house late at night just to keep to his goal.
4. Chantix (about $120 per month, generally for 3 or 4 months). If you’re not a smoker you can skip this section. Chantix is a medication that blocks the physiologic nicotine withdrawal in people coming off cigarettes. It has proven effective as long as the user makes a real effort to kick the habit. The problem for most people is that their insurance doesn’t cover the cost of this relatively expensive therapy. I have argued in a previous post that the medication quickly pays for itself once you take into account all the money you save by not dumping your earnings into tobacco. If you’re a smoker and want to quit you should talk to your doctor about this one.
5. Running or Walking Shoes ($50-$150). I think walking is a great form of exercise. It’s cheap, available anywhere, and almost everyone can do it to some degree. Sure, there are some places (Iceland, Siberia, Nebraska) where outdoor strolls are an invitation to frostbite, but even inhospitable climates have gyms and malls.
You may wonder why your 25-year-old Keds aren’t adequate for daily walks. The reason comes down to things like age, muscle loss, arthritis, and age (did I say that already?). The older we get the less leg and hip strength we have and the more our joints creak and pop as we move (I don’t say this from experience since I’m only 29 years old). Good shoe stores are staffed with salespeople who can evaluate your gait and recommend a pair of shoes that will put the least amount of stress on your aging bones. You could also consult a physical therapist or podiatrist for more expert recommendations if you have a history of joint problems.
6. Low-Calorie Heart Healthy Cookbook ($10-$40). I know less about cooking than about fashion, but of course that didn’t stop me from spouting off about sartorial selections. If I had to cook for myself everyday I’d probably end up with a diet of oatmeal and frozen pizza (which is, at least, half healthy).
There are plenty of good cookbooks out there that will entice you into broadening your horizons beyond beef, potatoes, and fried foods. The New American Heart Association Cookbook, 7th ed. is an excellent tome that will help you use more legumes and vegetables and less salt and fat in your daily fare. Pick out a book and try something new and interesting once a week. You’ll find that healthy eating doesn’t have to be boring or tasteless.
7. A Partner in Exercise (free). Find a friend or relative who is willing to take on the challenge with you. Creatively design a schedule of exercise, sensible diet and weight loss goals and find some way to reward yourself and each other for successful completion. Having someone looking over your shoulder will help you stick to a program.
I say that this investment is free when in fact it’s not. In truth, having a partner in health may prove to be the most expensive item on my list. Once you start hitting your goals you’ll invariably want to descend upon the department store to purchase a whole new wardrobe or head out for a “girls trip” to a nearby city or spa for an expensive weekend of revelry. Go ahead—you deserve it. Just don’t let your spouse know that I suggested it.
The best advice I have for good cardiac health is stuff that won’t cost you a penny. Push away from your computer, turn off the television, close the refrigerator door and head outside. Get in the habit of exploring your neighborhood the way you used to when you were a kid. Go on long walks, enjoy the warm spring sunshine and watch the flowers poke their way out of the ground. Drag your spouse or friend along and make it a cheap date. Tune up your old bicycle and get acquainted with the biking trails in your town. Do something active everyday and eventually even the economic recession will start looking a little brighter.