Healthy Living: Improving Your Heart Health
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“Deadly” and “preventable” are the two words that came up first (and most often) in recent conversations we had about heart disease with some of Connecticut’s most reputable cardiovascular specialists.
“Deadly,” because heart and related vascular diseases have killed more Americans than any other condition “by a long shot, every year since they started keeping statistics in 1900,” says Dr. Peter Schulman, director of the Cardiology Fellowship Program at The Pat and Jim Calhoun Cardiology Center at the UConn Health Center.. Today, heart disease is responsible for one in every four deaths.
And “preventable” because, according to the Centers for Disease Control, at least 200,000 of the 600,000 deaths annually caused by heart disease and stroke could have been averted.
In the last couple of years, the heart disease upward spiral is finally “starting to trend down,” says Schulman. “When I started practicing in the early 1980s, we were seeing 75 to 100 major heart attacks per year here. Now, despite an increase in the number of patients we treat, we’re seeing 50 or fewer cases.” He attributes the decrease to “advances in medical care, fewer smokers, the use of Statin and other cholesterol-lowering drugs, and the fact that more people are adopting important lifestyle changes.”
Some risks are simply uncontrollable. These include age (the older you are, the greater your risk), gender (men are at higher risk at an early age; a woman’s risk increases after menopause), family history (one of the most significant factors overall) and race (African-Americans, American-Indians and Mexican-Americans are more likely to have heart disease than Caucasians). In addition, lower-income populations carry a “tremendously higher burden of cardiovascular disease,” according to Mehul Dalal, chronic disease director, Community Health & Prevention, with the Connecticut Department of Public Health.
The good news: There is a lot we can do to prevent heart disease, including making behavior changes that minimize the risks we can control—smoking, high cholesterol, hypertension, obesity, poor diet, inactivity, diabetes and stress. What’s more, making such changes will, nine times out of 10, contribute to better overall health. For the record, Dalal says Connecticut ranks a little lower than the national average in obesity and smoking rates, but we’re right in line with the U.S. when it comes to hypertension.
Not every health professional places the same degree of importance on every risk factor (diet, for example, is one of the most disputed), but all agree that most of us can—and should—do more to maintain heart health.
“The most common thing I hear from heart-attack patients is ‘I can’t believe this happened to me. I was doing everything right,’” says Dr. Andrew Keller, chief of Cardiovascular Services for the Western Connecticut Health Network. “I always ask: ‘Were they?’ and ‘Was there any opportunity to do more?’”
Here’s what you can do to help your heart:
Smoking is the single most preventable cause of heart disease. The dangers are indisputable; on this every cardiac expert will agree. Says Schulman: “When I have a patient who smokes, I tell them ‘I hope you enjoyed this experience of having a heart attack or angioplasty . . . because you’ll be back.’
“Put it this way: A smoker is 150 times more likely to have a heart attack than to die of lung cancer,” says Keller.
Because quitting is imperative, “stop smoking” campaigns are funded at every level of government and in private health care. There are a variety of recommended methods for quitting, many of them relying on nicotine-replacement therapy. Almost all involve a support system made up of addiction experts and/or people you trust.
Know Your Numbers
Along with smoking, high cholesterol and uncontrolled high blood pressure (or hypertension) are risk factors patients have direct control over, says Keller.
There’s really no excuse for not monitoring your numbers and taking action if and when they shift out of your comfort zone (as determined by your primary-care physician).
The following are target numbers for most otherwise healthy men and women, according to Schulman: Blood pressure of 140 (or less) over 90 (or less); and as far as cholesterol is concerned, doctors look at “bad” and “good” cholesterol, says Schulman. The LDL number (L for “lousy”) for most people should be under 130, while the HDL (H for “happy”) should in women have a value of 50 (or higher) and for men 40 (or higher).
Both high cholesterol and hypertension can be treated with medication. Unfortunately, the medications that treat cholesterol are widely misunderstood, says Keller. “We get a lot of pushback from patients who read contradictory information in the light press and on the Internet,” he says. Despite a bad rap, Statin (and other cholesterol-lowering drugs) are safe and they work, he says.
Because it can develop without symptoms over many years, hypertension is often called “the silent killer.” Unfortunately, it presents all too often in devastating fashion: as a heart attack. There are many medications known to effectively treat high blood pressure, depending on its severity.
Although high blood pressure is manageable, it’s important to note that “most of the work around managing it happens outside the doctor’s office,” says Dalal. Lifestyle changes are key. These include maintaining a healthier diet with less salt (known as the Dietary Approaches to Stop Hypertension, or DASH diet), exercising more, quitting smoking and losing weight.
Managing high blood pressure is a statewide concern, says Dalal. To that end, the DPH is rolling out community-based programs designed to increase awareness and proper treatment, including a pilot program that engages pharmacists in patient care. “It’s an easy access point that helps patients understand medication interactions,” says Dalal. In addition, the DPH offers hypertension- and diabetes-control classes at senior centers and other facilities.
Lose Weight, Move More
Obesity and inactivity are hazardous to our health. Some 68 percent of Americans are overweight and obesity levels are increasing. Unfortunately, many desk- and couch-bound folk find that a sedentary lifestyle is a hard habit to break. Regular exercise eludes them. Only 25 percent of our workforce have jobs that are considered “physically active,” which is down 50 percent since 1950.
The American Heart Association recommends 30 minutes of moderate activity five times a week for everyone. (Note: Three 10-minute periods of activity can be as beneficial as one 30-minute session.)
Dalal is in favor of taking baby steps when it comes to moving more. “If you don’t have time to build a workout into your day, then park at the far end of the parking lot and walk the rest of the way to work,” he says. “If you take a bus or train, get off one stop early. While you’re at work, take a 15-minute break and climb up and down a stairwell.”