The term “heart disease” is an umbrella term that includes a variety of heart conditions, including coronary heart disease, atrial fibrillation, and cardiomyopathy to name a few. In the United States, someone has a heart attack every 40 seconds.
Heart disease does not discriminate; it is the leading cause of death for both men and women, and it touches every race and ethnic group across the globe.
The Truth About Heart Disease
Dr. Jeffrey Wuhl, a cardiologist with the Bryn Mawr Specialists Association--Cardiology Group at Bryn Mawr Hospital outside of Philadelphia, is no stranger to all of the obstacles people face in taking care of their ticker. “Many people who come to see me already know they have an issue with their cardiovascular health,” says Dr. Wuhl. “Especially if they had a parent who had heart disease. When it runs in the family, you are at greater risk of developing heart disease yourself.”
The Centers for Disease Control estimates that 1 in every 4 deaths are due to a form of heart disease, making it the leading form of death for both men and women. And every year three-quarters of a million people have a heart attack, a quarter of which are recurring episodes. Those who are most at risk of experiencing a heart attack are those who smoke, have high blood pressure, high cholesterol, or suffer from obesity.
“The good thing about cardiovascular health is that it can almost always be improved,” says Dr. Wuhl. “Heart attack prevention takes commitment and dedication to make certain life changes, but it’s not impossible.”
Heart Attack Prevention
According to Dr. Wuhl, there are five key guidelines to heart attack prevention as you age:
Stay Active. “I recommend at least 30 minutes of aerobic activity--and, yes, even walking counts--per day at least 5 days per week,” says Dr. Wuhl. “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 that are able to stay on longer than sedentary people in their 40’s and 50’s.” Research has shown that a sedentary lifestyle is a risk factor for heart disease, but regular exercise can be a ticket to heart attack prevention, as well as improve two other cardiac risk factors: 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 for heart disease 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,” says Dr. Wuhl. “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 undertreated condition which can lead to myriad cardiovascular complications. It is defined as repeated episodes of hypopnea (not breathing enough) and apnea (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 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,” Dr. Wuhl says. “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.”
Follow a heart-healthy diet. A heart-healthy diet doesn’t mean you can’t enjoy your meals, it simply means that you have to watch the salt, sugar, and fat in your diet. Following a heart-healthy diet goes hand in hand with monitoring your blood pressure. “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 medication, Dr. Wuhl says. “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 and ideal for heart attack prevention.”
If you smoke, stop. If you don’t, don’t start. “I know we doctors love giving out this advice, but it falls into the ‘easier said than done’ category,” says Dr. Wuhl. Fortunately, there are 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 risk of heart disease as much as quitting smoking would.”
Dr. Jefferey Wuhl, MD FACC, is with the Bryn Mawr Medical Specialists Association-Lankenau Cardiology Group at Bryn Mawr Hospital in Pennsylvania. Learn more about Dr. Wuhl at http://bmmsa.com/departments/cardiology/