When it comes to annual health observances, the shortest month of the year is probably the most important – that’s because February is American Heart Month. Why is heart health awareness so important? Heart disease is the leading cause of death in the United States for both men and women, taking the lives of some 600,000 Americans each year. Cardiovascular and circulatory disease are also the second-leading cause of disability in the nation.
“While not every instance of heart disease is preventable, we know that our risk is largely shaped by a variety of lifestyle choices we make,” says Dr. Triwanna Fisher-Wikoff, a primary care physician. “Everyone can help protect their heart and reduce risk by avoiding tobacco and excessive alcohol consumption, maintaining a healthy and balanced diet and getting adequate exercise. Through greater awareness for Americans of all ages, we can reduce the risk of heart disease, help people live longer and lessen the instance of debilitating illness.”
Forms of Heart Disease
The term “heart disease” encompasses several different conditions. Some of the more common heart conditions include:
Coronary Artery Disease: Coronary Artery Disease (CAD) is the most common form of heart disease and is often the root cause of heart attacks and other heart problems. CAD occurs when plaque – deposits of cholesterol and other substances – build up in the coronary arteries, the arteries that supply blood to the heart. When blood flow to the heart is impeded over a long period of time, the heart becomes weakened and heart failure can result. If blood flow is completely cut off, a heart attack will result. CAD can also cause blood clots, which may lead to stroke.
Heart Attack: A heart attack, also known as a myocardial infarction, occurs when a portion of the heart suddenly receives inadequate blood flow. The longer the heart goes without the required amount of blood flow, the greater the damage that will be done to the heart.
Each year, close to 800,000 Americans suffer a heart attack. Nearly 25 percent of these are “repeat” heart attacks – that is to say, the person has had at least one heart attack in the past.
Since time is of the essence, everyone should recognize the signs of a heart attack and know when to seek immediate medical attention:
- Chest pain or discomfort
- Pain or discomfort in the jaw, neck or back
- Feeling weak, light-headed or faint (this is more common in women)
- Pain or discomfort in arms or shoulder
- Shortness of breath
If you or someone around you suddenly begins to experience one or more of these symptoms, call 911 immediately. The sooner you seek and receive medical attention, the greater your odds of recovering from a heart attack.
Angina: Angina is chest pain caused by reduced blood flow to the heart.
Arrhythmia: Arrhythmia occurs when the heart beats irregularly. Arrhythmia increases the risk of blood clots and stroke.
Atherosclerosis: This is the narrowing of the arteries as a result of plaque buildup.
Cardiomyopathy: This condition results from the stiffening or enlargement of the heart muscle, which can cause inadequate blood pumping. Cardiomyopathy can result from many factors, including genetic ones. Uncontrolled high blood pressure is a key risk factor for this condition.
Heart failure: Heart failure – also called congestive heart failure (due to the buildup of fluids in the lungs, limbs and liver) – results from the gradual weakening of the heart muscle. The heart is still beating but no longer pumps blood correctly.
Peripheral Arterial Disease (PAD): When the arteries that supply blood to the arms and legs narrow or stiffen as a result of atherosclerosis, the blood and oxygen flow to the limbs can be diminished or even blocked. This can lead to numbness, tingling and pain in the legs and arms.
Keys to Reducing Risk
“There are several risk factors for heart disease. Some of the most common are also the ones we can impact with the decisions we make,” explains Dr. Sam Nassar, a cardiologist. “These common risk factors include high cholesterol, elevated blood pressure, diabetes, smoking, excessive alcohol consumption, obesity or being overweight, stress and a sedentary lifestyle.”
“If that sounds like an overwhelming list of things to worry about, it’s really not,” adds Dr. Andrew Hoover, a family medicine physician. “Most of these risk factors are interrelated and can be mitigated through an improved diet and increased exercise. In other words, when you focus on reducing one risk factor, you’ll probably also be reducing others.”
Here’s a look at some of these common risk factors and steps anyone can take to improve heart health:
Cholesterol is a waxy, naturally-occurring substance in our bloodstream. Our bodies need some cholesterol in order to help build healthy cells and aid in the digestive process. While our bodies produce all the cholesterol we need on their own, we also consume additional cholesterol through food, such as meat, dairy, eggs and foods containing trans-fats.
Cholesterol is transported through the bloodstream by what are known as lipoproteins. There are two types of lipoproteins, low-density (LDL) and high-density (HDL). LDL is often referred to as “bad cholesterol” and HDL as “good cholesterol.”
LDL cholesterol is bad for us because it contributes to the buildup of plaque in the arteries, which can lead to coronary artery disease, angina and heart attack. Keeping LDL levels in check is very important for heart health.
Conversely, the higher your HDL is, the better. The HDL lipoproteins transport cholesterol and fat through the blood and to the liver, so they can be eliminated from the body.
Triglycerides, a type of fat found in the blood, can also be harmful to cardiovascular health if they are too high.
A cholesterol screening, a simple blood test that measures cholesterol and triglyceride levels, will determine if your levels are in the normal range. Everyone should receive cholesterol screenings periodically:
- Children between the ages of 9-11
- Young adults between the ages of 17-21
- Adults every 4-6 years, if no history of heart disease
- Adults with a history of heart disease should visit with their physician about how often to be screened.
If your LDL levels are elevated, you can often bring them down by making dietary adjustments. Eating less saturated fat, the type of fat found in meat and dairy, can help improve cholesterol levels. Trans fats, also known as partially hydrogenated vegetable oil, are found in many processed baked goods, such as cookies and doughnuts, as well as some fried foods. Trans fats are considered to be the worst type of fat to consume, as they raise LDL cholesterol while reducing HDL levels. It’s recommended that people avoid consuming trans fats in all cases.
In addition to dietary adjustments, HDL levels can be elevated through regular exercise, which has numerous heart health benefits. If diet and exercise alone are insufficient to bring cholesterol levels into a healthy range, your physician may prescribe a medication known as a statin.
Blood Sugar in Check
Diabetes is a major risk factor for heart disease and causes other serious health problems. Diabetes is a disorder of the metabolism, meaning the body is not properly using the food it is consuming. Under normal circumstances, our liver breaks down carbohydrates into glucose, also known as blood sugar. The liver releases the glucose into the blood stream. Meanwhile, the pancreas, a gland located near the stomach, produces insulin, which is a hormone that helps the body’s cells absorb the sugar in the blood. Our cells then use the glucose for energy. If a person’s cells are unable to absorb enough glucose, blood sugar levels rise. This can lead to diabetes.
Your doctor can check your blood sugar level with a simple blood test, and there are several things that can be done to lower it if it’s too high. Some foods should be avoided or eaten only in moderation. This includes certain carbohydrates, such as white flour products like bread and pasta, as well as white rice. Sugary drinks, including soda and fruit drinks, can also cause blood sugar levels to spike. Getting regular exercise and remaining hydrated are important keys to keeping blood sugar levels in check.
All adults should have their blood sugar levels checked periodically:
- Men and women age 45 and older, every three years
- Men and women ages 19-44, if overweight or obese
- Women who have had gestational diabetes
Normal Blood Pressure
High blood pressure, also called hypertension, is often referred to as a “silent killer” – it usually produces no noticeable symptoms, but left untreated, can result in severe damage to the heart. A blood pressure reading measures the force of blood against the arteries. A blood pressure reading always includes two numbers:
- Systolic (upper number): when the heart beats
- Diastolic (lower number): when the heart is resting, in between beats
In 2017, the American College of Cardiology (ACC) and the American Heart Association issued updated guidelines intended to detect, manage and prevent elevated blood pressure levels, beginning at younger ages.
The updated blood pressure categories are:
- Normal: Less than 120/80 mm Hg;
- Elevated: Systolic between 120-129 and diastolic less than 80;
- Stage 1: Systolic between 130-139 or diastolic between 80-89;
- Stage 2: Systolic at least 140 or diastolic at least 90;
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120
Elevated blood pressure can damage the arteries over time. It also makes the heart work harder to pump blood, causing extra strain and possible damage to the heart. The root cause of high blood pressure is usually unknown and is a condition that often develops gradually with age. However, there are known risk factors that contribute to high blood pressure, including too much salt and too little potassium in a diet, as well as excessive alcohol consumption and tobacco use. As with cholesterol, if diet and exercise are insufficient to bring blood pressure into a normal range, your physician may prescribe medication.
All adults should have their blood pressure checked by a medical professional periodically:
- Men and women, age 18-39: every three to five years.
- Men and women, age 40 and older: every year.
Maintain a Healthy Weight
Maintaining a weight within a healthy, normal range is one of the most important things everyone can do for their overall health, including heart health. Being overweight can contribute to hypertension, elevated cholesterol and diabetes. Extra pounds on your frame will result in the heart working harder to pump blood throughout the body and causes strain on the joints, which in turn can make it more difficult to exercise.
“Keeping our weight within normal ranges is one of the most important things we can do to help lower blood pressure and protect our hearts,” says Dr. James Harvey, a primary care physician. “Losing weight may seem difficult, but the science behind it is very straight forward: if I burn more calories than I consume, I’ll lose weight. One pound is the equivalent of 3,500 calories. So, if I burn 3,500 calories more than I eat every week, I’ll lose one pound a week – and that’s a very steady and safe pace at which to lose weight.”
Healthy, Balanced Diet
“A healthy, balanced diet is a key component of heart health, while a poor diet is a key contributor to heart disease,” says Dr. Naresh Patel, a cardiologist. “Specifically, diet directly impacts cholesterol levels, blood pressure and blood sugar, three of the primary indicators for heart disease risk.”
When thinking about foods that comprise a heart-friendly diet, think about what to eat, what to avoid and what to only consume in moderation:
Good for you
Generally speaking, fresh fruits and vegetables, whole grains, unsalted nuts and lean meat and fish are heart-friendly foods that promote a healthy body weight and good overall health.
Additionally, drink plenty of water – at least 64 ounces per day.
Not good for you
Avoid any foods containing trans-fat. Remember, trans fats increase the bad, LDL cholesterol and reduce the good, HDL cholesterol.
It’s also best to avoid soft drinks and fruit punch; they are loaded with sugar and have no nutritional value. This is especially important for children, as sugary drinks are a major contributor to childhood obesity.
Only in moderation
A lot of the tasty foods we love tend to be high in sugar, salt, fat or all three. In general, consume these types of foods sparingly, if at all: fried foods, processed meats (such as hot dogs) and anything that is high in sugar and salt.
“For most people who are relatively healthy, minding your heart health doesn’t mean you can’t ever eat a cheeseburger or a plate of enchiladas,” says Dr. Mark Bernhardt, a primary care physician. “It does, however, mean those types of foods should be an occasional indulgence, not an everyday staple of your diet.”
“Sugar and salt can be especially tricky,” warns Dr. John Staniland, a primary care physician. “Foods that you would not think of as salty or sweet may well contain excessively high amounts of sodium and sugar. This includes foods such as bread, frozen dinners, sauces and packaged snacks. Read the nutrition labels carefully for an accurate assessment of how much salt and sugar you are really getting.”
Dr. Staniland adds: “If you are using salt, be sure to use rock sea salt, as this contains trace minerals in a natural balance that we are not getting anywhere else. Also, Iodine deficiency is all too common – discuss possible iodine supplementation with your doctor at your next visit.”
Adults older than 21 should only consume alcohol in moderation, if at all. That means a maximum of one drink for women and two for men in one day. Excessive alcohol consumption not only contributes to high blood pressure, it leads to weight gain, as well.
It’s Not Just What; It’s How Much
Too much of anything – even a good thing – isn’t good. That’s especially true of food. It’s quite possible to eat healthy foods but still consume too many calories, contributing to weight gain. Be mindful of serving sizes. A portion of meat should be four ounces, about the size of your palm. A serving of whole wheat pasta has some positive health benefits – but only if you keep in mind that a serving is one cup, dry.
“Our culture has super-sized everything we eat and drink,” says Dr. Raymond Blair, a family medicine physician. “We need to recognize that, adjust our thinking and not accept as normal or healthy the serving sizes that we see in restaurants. This is especially important for parents; it’s critical that we teach our children what an appropriate amount of food looks like.”
Read the labels to know how much a serving is and how many calories it contains – then use a measuring cup and a kitchen scale to make sure you and your family don’t prepare and consume excess food.
Don’t Sit Around
Exercise helps the heart in two important ways. Exercise such as walking, bicycling, running and swimming causes the heart rate to increase. As the heart beats faster to pump blood, the heart muscle is strengthened. When you hear someone talk about doing “cardio” exercise, that’s why: the heart is getting a workout.
The second way exercise helps, of course, is that it burns calories, helping achieve and maintain a healthy weight.
“Everyone should get at least 30 minutes of exercise a day, five or more days a week,” says Dr. Hoover. “It doesn’t have to be anything elaborate – a brisk walk is a great way to get started, burn some calories and give your heart some valuable exercise. You’ll feel better, also!”
IMPORTANT NOTE: Before beginning any exercise routine, visit with your physician first to ensure that exercise is safe for you. Exercising with an undetected, underlying health condition can result in serious injury, illness or death.
Stress probably does not get enough attention for the role it plays in our physical health, including heart health. “No matter your age or what you do for a living, everyone experiences stress. If stress is not managed correctly, it can negatively impact our overall health,” adds Dr. Hoover. “Stress can contribute to high blood pressure and other problems. In addition, some people try to cope with stress by turning to unhealthy habits, such as smoking or excessive drinking.”
“Getting adequate sleep each night will help manage stress,” advises Dr. Hoover. “Regular exercise is also an effective way to mitigate stress and clear the mind, especially any kind of outdoor activity.”
Smoking is one of the very worst things you can do to your heart. Smoking causes arteries to narrow and elevates blood pressure. It contributes to unhealthy cholesterol and triglyceride levels and can lead to diabetes. It also causes cancer and a host of other serious illnesses.
If you smoke, make an appointment to see your doctor and develop a plan to quit.
Take Care of Your Heart!
If you take care of your heart, it is more likely to take care of you for a long time to come. This February, take a look at what more you can be doing to keep your heart in tip-top shape. And if it has been a while since you’ve seen your health care provider or think you may be due for a cholesterol or blood sugar screening, get in touch with us and make an appointment today!
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