February is American Heart Month. It’s the perfect opportunity to discuss heart disease, the leading cause of death in the United States.
Coronary heart disease, the most common type of heart disease, is like a plumbing problem. As plaque builds up in the coronary arteries – those that supply blood to the heart – blood flow is impaired, which can cause a heart attack and weakened heart muscle over time.
The big risk factors that contribute to heart disease are:
§ Obesity (especially belly fat, the deadly visceral fat surrounding your vital organs that can trigger inflammation, arterial plaque formation and blood clotting);
§ High blood pressure (hypertension);
§ Family history of heart disease; and
§ Age (More than half of men age 55 and older, and post-menopausal women will develop heart disease.)
Emotional risk factors that also play a critical role in heart health include:
§ Depression; and
Distinct heart disease symptoms rarely appear until the coronary arteries are already 50 to 60 percent blocked. It’s important for people to consult with a doctor to look more intensively for risk factors while they’re still probably at only 30 to 40 percent blockage, well before the appearance of cardiac symptoms. Common symptoms include chest pain, shortness of breath, fatigue, cold sweat, pain in the arms, legs, neck, jaw, throat, upper abdomen or back; women may experience nausea or stomach distress.
Try to recognize vascular disease before it becomes a symptom. If you are low risk (meaning you don’t suffer from major risk factors), then an episode of indigestion is probably just indigestion. However, if you are at high risk, you should consult your doctor.
As a cardiologist with more than 20 years of experience, my best advice is to lead a healthy lifestyle, listen to your body and do everything you can to banish stress from your life. Here are five steps you can take now to prevent heart disease.
Follow a Mediterranean diet, emphasizing plenty of fruits and vegetables, whole grains and lean protein. And eat in moderation. (I can’t stress this enough.)
Exercise four to six times a week for 30-60 minutes, which will greatly improve your heart health. Strength training to build muscle mass is another great way to burn off calories and fat to manage your weight. This is especially true for women. Consistency is the key.
Emotional triggers – stress, anxiety and depression – can also cause heart attacks. At Marin General Hospital, 20 percent of heart attacks suffered by women are stress-induced, and occur without significant coronary blockage. This phenomenon is much more common in women and is called “Takotsubo cardiomyopathy,” which is sometimes referred to as Broken Heart Syndrome.
We’re seeing more early vascular disease from people in their 40s and 50s, mainly due to living in a high-stress area. To avoid the effects of stress on your heart, find healthy ways to deal with stress. This can be in the form of meditation, Tai chi or walking quietly and smelling the redwoods.
Look for changes in your tolerance for exercise and normal exertion to recognize symptoms. I recently had a patient whose first indication of a problem was unusual discomfort in his neck and shoulders and shortness of breath while walking short distances. Initially, he dismissed it, but the next day the same symptoms appeared while he was walking around his house. He went to the emergency room where doctors found a partially-blocked artery.
By acting on the suspicion that something big might be happening, the doctors were able to open the blockage with angioplasty (an artery-widening procedure) and avert major damage. If he had waited until the discomfort was constant, he would likely have suffered much more damage. Modern medicine gave him a different outcome, a second chance.
Exercise or eating healthfully alone won’t eliminate the risks of developing heart disease. About 30 years ago, Jim Fixx, an apostle of running and fitness, dropped dead from a heart attack at age 52 after his daily run. While he was exceeding his exercise quota, he was affected by several other major risk factors, including many years of obesity, smoking and a family history of heart disease. Healthy lifestyle changes must be done in conjunction with other healthy practice-forming habits.
Dr. Wexman, a Greenbrae cardiologist, is managing partner of Cardiovascular Associates of Marin and chairman of the board of Meritage Medical Network, an award-winning physician-run network of 700 primary care and specialist physicians serving nearly half a million North Bay residents.
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