We recently had a chance to sit down with Dr. Jeffrey Wuhl, a cardiologist with Kelly Cardiovascular Group at Lankenau Medical Center in Wynnewood, Pennsylvania. As a specialist in cardiovascular disease, Dr. Wuhl is no stranger to all of the obstacles people face in taking care of their ticker. He’s compiled a list of his best advice for keeping your heart healthy as you age. Stay Active. I recommend at least 30 minutes of aerobic activity (yes, even walking counts) per day at least 5 days per week. Part of my job involves performing stress tests on treadmills, and I often see people in their 70’s and 80’s who exercise regularly able to stay on longer than sedentary people in their 40’s and 50’s. It is well-established that a sedentary lifestyle is a risk factor for cardiac disease. I also strongly believe that regular exercise can improve two other cardiac risk factors, namely depression and stress. Have your blood pressure and cholesterol checked regularly. A few times per year after the age of 50 is probably sufficient in otherwise healthy patients; people with hypertension (especially if on blood pressure medication) should be checked more frequently. I often recommend to my patients with hypertension that they buy their own blood pressure cuffs and take their pressures at home on a regular basis. I also ask them to keep a blood pressure “diary” to bring in to every visit so that we can go over the numbers. Yearly fasting cholesterol (“lipid”) panels are generally sufficient, though your doctor may ask you to have it checked after the addition of a new cholesterol medication or a change in your current medication. Talk to your doctor about getting checked for Sleep Apnea. Obstructive Sleep Apnea (OSA) is a common yet undiagnosed and under treated condition which can lead to myriad cardiovascular complications. It is defined as repeated episodes of hypopnea (i.e. not breathing enough) and apnea (i.e. not breathing at all) during sleep. It is estimated that up to 20% of the general population has at least mild OSA. OSA is more common in men, African-Americans, obese patients, and current smokers. Signs and symptoms include excessive snoring, daytime sleepiness,morning headaches, poor concentration, mood changes, and even reflux or heartburn. OSA is diagnosed with polysomnography, or a “sleep study”, during which the patient is monitored overnight during sleep. The number of apneic or hypopneic events (along with any drops in blood oxygen saturation) can be measured. Untreated OSA has been shown to increase overall mortality by 3 to 6-fold; it can result in difficult-to-treat hypertension and pulmonary hypertension and has been associated with coronary artery disease, congestive heart failure, stroke, and even sudden death. Watch the salt, sugar, and fat in your diet. Sounds obvious, right? Well obvious and easy are two different things. This one also goes hand in hand with #2 above, as excessive consumption of salty foods can lead to or exacerbate hypertension, and high cholesterol foods with the wrong kinds of dietary fats can counteract even the highest dose of Lipitor. However, not all fats are created equal. “Good” fats like those found in legumes and fish may actually be beneficial. Whole grains and fresh fruits and vegetables are also key elements of a heart healthy diet. If you smoke, stop. If you don’t, don’t start. Another item that goes into the “easier said than done category”. Fortunately, we now have a variety of pharmacological and non-pharmacological tools (such as Chantix and e-Cigarettes, as well as smoking cessation classes and support groups) at our disposal to help smokers quit. But, as any doctor or counselor will tell you, these tools will be ineffective if the patient isn’t ready to quit. I often tell smokers that all the exercise and blood pressure medication in the world doesn’t come close to reducing their cardiac risk as much as quitting smoking would.
Dr. Jefferey Wuhl, MD FACC, is with the Kelly Cardiovascular Group at Lankenau Medical Center in Wynnewood, Pennsylvania. If you are interested in making an appointment with Dr. Wuhl, contact him at 610-649-7625.