Editor’s Note:
AHMC Healthcare invited leading physicians from three major Taiwan medical centers to share the latest insights on heart and lung care, muscle health, chronic disease prevention, and precision medicine. Cultural Express launches a five-part series this week.
“Protect your heart before it strikes.” The recent heart attack and emergency hospitalization of NTU Hospital President Ming-Shing Wu has renewed public focus on cardiovascular prevention.
Dr. Ju-Chi Liu, vice superintendent of Shuang Ho Hospital, warns that heart disease often builds silently for years.
Drawing on the American Heart Association’s 2026 report, he highlights 10 key updates on diet, exercise, screening, and medication to help people identify risks early and prevent disease before it begins.
Risks Stack, Danger Multiplies
Cardiovascular disease includes hypertensive heart disease, coronary artery disease, arrhythmia, cardiomyopathy, stroke, and valvular heart disease.
Major risk factors include high blood pressure, diabetes, abnormal cholesterol, smoking, and obesity. Age, sex, family history, and certain chronic inflammatory diseases can further raise the risk.
These factors do not act alone—they compound one another. Research shows that high blood pressure alone raises heart attack risk about 1.9 times.
When combined with smoking, diabetes, and abnormal cholesterol, the risk may rise more than 42-fold.
Controlling blood pressure alone is therefore not enough. Blood sugar, cholesterol, weight, smoking, and daily habits must all be managed together.
Liu warned that atherosclerosis can begin early and progress silently. Even a partially blocked artery can suddenly rupture, form a clot, and trigger a heart attack or sudden cardiac death.
No chest pain does not always mean healthy arteries.
Ten Updates, Smarter Prevention
Liu said the American Heart Association’s 2026 guidance shifts cardiovascular care from treating disease after it occurs to preventing it before it begins. He highlighted 10 major updates:
- Start healthy habits early.
Healthy habits should start early, while children with familial hypercholesterolemia need prompt evaluation and treatment. - Assess risk more broadly.
The updated PREVENT model looks beyond age, blood pressure, and cholesterol. It also considers heart, kidney, and metabolic health to estimate a person’s future cardiovascular risk. - Consider treatment sooner.
People with a 3% to 5% risk of cardiovascular disease within 10 years may discuss cholesterol-lowering treatment with their doctors. Those with a 5% to 10% risk may need more active evaluation and prevention. - Set clearer cholesterol goals.
For people at average risk, LDL-C—the “bad” cholesterol—should generally remain below 100 mg/dL. The goal is below 70 for those at higher risk and below 55 for those at very high risk. The greater the risk, the lower the target. - Consider ApoB testing.
ApoB measures plaque-forming cholesterol particles and is especially useful for people with high triglycerides, diabetes, or persistent risk despite controlled LDL-C. - Check lipoprotein(a) at least once.
Lp(a) is largely inherited and often missed in routine screenings. High levels may signal lifelong heart risk, especially in those with a family history of early heart disease. - Use coronary calcium scoring when needed.
When heart risk is unclear, a coronary calcium scan can reveal hidden plaque. Men over 40 and women over 45 may consider testing with their doctor. - Expand the use of statins.
Statins lower LDL cholesterol and help prevent heart attacks and strokes. People with diabetes, advanced kidney disease, or HIV may benefit even when cholesterol levels are not very high. - Lower cholesterol more aggressively in high-risk patients.
When statins alone are not enough, physicians may add other cholesterol-lowering medicines to further reduce the risk of heart attack and stroke. - Treat very high triglycerides promptly.
Triglyceride levels of 1,000 mg/dL or higher are not only a cardiovascular concern—they can also trigger acute pancreatitis. Prompt treatment and dietary changes are essential.
Smart Habits, Strong Hearts
Liu emphasized that even the most advanced tests and medicines cannot replace a healthy lifestyle.
Choose more vegetables, fruits, whole grains, fish, nuts, and lean protein. Limit fried and processed foods, sugary drinks, refined carbs, and excess salt.
Adults should aim for 150 minutes of moderate or 75 minutes of vigorous exercise weekly to support blood pressure, cholesterol, blood sugar, weight, and stress control.
For many adults, a blood pressure below 130/80 mmHg is an important goal, although treatment should be adjusted for age, health conditions, and individual needs.
Aspirin is also no longer recommended for everyone as a preventive measure. Because it can increase the risk of bleeding, it should not be taken regularly without medical guidance.
Liu concluded that knowing one’s blood pressure, blood sugar, and cholesterol is only the first step. Lasting heart protection comes from healthier daily choices, regular medical follow-up, and controlling risks before disease begins. (Health Column: Part 1 of 5)
Click to view the lecture presentation