Coronary artery disease or heart disease is caused by atherosclerosis, a process which involves the accumulation of cholesterol plaques in the arteries that supply blood to the heart. These plaques can narrow the blood vessels and reduce blood and oxygen delivery to the heart, leading to symptoms like chest pain (ischemia). The plaques can also rupture and form a blood clot, blocking oxygen delivery and causing a myocardial infarction—a heart attack.
Posted in Health & Fitness
Tagged angiogram, angioplasty, bypass surgery, CABG, cardiac rehabilitation, exercise, GXT, heart attack, heart health, myocardial infarction, stress test
High blood pressure, or hypertension, has been in the news recently. Hypertension has long been known to be a major risk factor for heart disease and stroke, so diagnosing and treating high blood pressure has always been important. A new report has changed the blood pressure classifications to reflect research suggesting that what was previously considered “too high” is really too high. Given the new report, this is a good time to review the diagnosis, health effects, and treatment of high blood pressure. This is the topic of my Health & Fitness column in the Aiken Standard this week.
Hypertension is called the “silent killer” because it often has no symptoms but contributes to many heart attacks and strokes and is associated with type 2 diabetes, heart failure, and kidney disease. Since the risk of these conditions is related to the severity and how long your blood pressure has been high, blood pressure should be measured regularly.
The new guidelines lower the blood pressure at which more aggressive treatment is recommended for some patients who are at high risk for a heart attack or stroke. The guidelines also change the classifications of blood pressure, which may mean your doctor could start treatment sooner.
Know your numbers
Your blood pressure includes two numbers, both measured in millimeters of mercury (mmHg). The top number, systolic, is the pressure in your arteries while your heart is contracting and pumping blood. The bottom number is the diastolic pressure, which occurs between beats when the heart is relaxed. Both numbers are important.
According to the new guidelines, normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic. If your blood pressure is between 120–129 mmHg systolic and 80–89 mmHg diastolic, you have elevated blood pressure. Stage 1 hypertension is 130–139 mmHg systolic or 80–89 mmHg diastolic and stage 2 hypertension is a blood pressure 140/90 and higher.
What is now called elevated BP and stage 1 hypertension used to be called “prehypertension.” The new classification should draw attention to the fact that the blood pressure is too high and prompt doctors and patients to begin treatment.
Get it down
If your blood pressure is above normal you should take treatment seriously. Lifestyle changes including eating a healthy diet, regular physical activity, weight control, and quitting smoking are all effective and essential for lowering blood pressure.
There are also many effective (and affordable) medications that your doctor can prescribe to lower your blood pressure. Take them as directed and don’t forget that they are designed to work with healthy lifestyle habits.
Keep it down
The aim, of course, isn’t simply to reduce your blood pressure using medications. Your ultimate goal should be to keep your blood pressure low without relying on medications, all of which have at least some negative side effects.
The best way to maintain a normal blood pressure is through daily exercise, eating a healthy diet, losing weight if you are overweight, and quitting smoking. A good place to start is the DASH diet, which is high in fruits, vegetables, and fiber and low in sodium and added sugar. The DASH diet has been shown to modestly lower blood pressure and lead to weight loss.
Since blood pressure tends to increase with age, even if you have normal blood pressure now you should take steps to prevent high blood pressure in the future. Adopting a lifestyle that includes daily physical activity, healthy eating habits, managing stress, and not smoking is essential for preventing high blood pressure. Additionally, these same health habits will help you prevent most other chronic disease including diabetes, heart disease, and many cancers.
Posted in Health & Fitness
Tagged heart attack, high blood pressure, hypertension, stroke
Regular exercise is one of the most important things you can do for your health. A lower risk of weight gain, diabetes, heart disease, and some cancers are among a long list of positive health effects of exercise. Lesser known benefits include improved mental health, cognitive function, and greater feelings of wellbeing. Exercise is essential for development of children, maintaining health in adults, and can even reverse some of the effects of aging.
Despite these clear benefits, many people do not participate in regular exercise until they have a medical condition, like a heart attack or cancer, that motivates them to start. This is the topic of my Health & Fitness column in the Aiken Standard this week.
It is well-known that people who exercise have a lower risk of heart attack and improved survival if they do have one. While immediate treatment of a heart attack using medications and surgery is critical, the truth is that the long-term outcomes are largely based on what happens next. Traditionally, heart disease patients were told to rest and not stress their hearts, a belief that many still hold today. Now we know that exercise-based cardiac rehabilitation programs are key to improving heart health and preventing future complications.
Most cardiac rehabilitation programs include several phases that include monitored exercise, education about nutrition, weight control, stress management, proper medication use, and psychosocial wellbeing. The benefits of cardiac rehabilitation are well-established through research and practice. In fact, many patients credit cardiac rehabilitation with saving their lives, even if they had bypass surgery. Despite this, less than a third of patients who are eligible for cardiac rehabilitation actually attend a program.
Exercise is also known to reduce the risk of developing certain types of cancer, including breast, colon, bladder, lung, kidney, and endometrial cancers. This is due to the fact that exercise causes changes at the cellular and hormonal level that result in reduced inflammation and improved immune system function. Regular physical activity can also improve survival and reduce the risk of recurrence of cancer.
In addition to helping reduce the risk of cancer development and recurrence, regular exercise can help you handle cancer treatment better. To be sure, cancer treatment can lead to extreme physical consequences including loss of weight, muscle mass, strength, and endurance. At least some of this is due to more time resting and less time being active, the effects of which occur within days and get worse over time.
The fitter you are when you begin treatment, the fitter you will be at the end because you have “saved” more strength and endurance in your fitness bank. You simply have more you can lose before you get to a point at which you can’t complete your normal activities. And post-cancer exercise programs are becoming more common as a way to help women recover from cancer treatment and rebuild strength, endurance, and feelings of wellbeing.
Another benefit of cardiac rehabilitation and cancer exercise programs is the support from other heart attack and cancer survivors. Combined with support from medical professionals, family, and friends, these groups become an essential resource for information, comfort, and encouragement.
If you or someone you know has had a heart attack, heart surgery, or a cancer diagnosis, encourage them to ask their doctor about an appropriate exercise program—it is likely to be the best way to improve quality of life. In our area, there is a cardiac rehabilitation program based at the USC Aiken Wellness Center as well as at several hospitals in Augusta. There is also an exercise program for cancer survivors called Livestrong at the YMCAs in Aiken, North Augusta, and Augusta.
Nutrition, exercise, and health information can be confusing. But it doesn't have to be that way. What can I help you with? drbrianparr@gmail.com | http://twitter.com/drbrianparr
Posted in Health & Fitness
Tagged cancer, cardiac rehabilitation, exercise, heart attack, heart disease, Livestrong
I have been writing recently about heart disease, how it is diagnosed, and what you and your doctor can do to treat it. In order for your doctor to start treating you for heart disease risk factors such as high blood pressure, high cholesterol, or diabetes you need to be diagnosed with one of these conditions. This requires proactively seeing your physician for screening before you start experiencing the consequences of these conditions.
But most people don’t visit their doctor until they have symptoms, and many wait until a more serious event (a heart attack, for example) occurs to seek medical attention. By this time, the disease process has progressed and managing it becomes the goal. It is possible to prevent both the conditions that lead to heart disease as well as reduce the risk that you may have a heart attack or stroke.
Your risk of heart disease is largely determined by health-related attributes and behaviors called risk factors. Some of these risk factors cannot be changed, including age, sex, and family history. Other risk factors are modifiable, meaning you can change them to reduce your risk. These modifiable risk factors include smoking, high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity.
While there are medications that can lower blood pressure and cholesterol and treat diabetes, these modifiable risk factors are best addressed by lifestyle changes. Adopting healthy habits has the potential to have a bigger effect on heart attack risk than medical management. There are three important health behaviors that, together and separately, have a powerful effect on reducing heart attack risk:
Stop smoking. There is no way around this one. Quit! Ask your doctor about prescription medications that can make quitting easier. Nicotine replacement therapy in the form of patches, gum, and lozenges can help manage cravings and are available over the counter. Ultimately, though, quitting smoking is a behavior change that takes motivation, willpower, and time. But it is worth it—your risk of heart attack can drop 50–70% within five years of quitting.
Be active everyday. The importance of physical inactivity as a risk factor for heart disease is often overlooked. But make no mistake, being active on a regular basis is one of the most important things you can do to improve your heart health. Whether you have other risk factors or not, physical activity can reduce your chance of having a heart attack. And if you do have a heart attack, your active lifestyle improves your chances of survival and returning to a normal lifestyle.
The benefits of exercise are well-established and impact heart disease risk in a multitude of ways. Physical activity helps with weight control, lowers blood pressure, improves blood lipids, and prevents and treats diabetes. Think of this as a great health “deal.” By modifying one risk factor—inactivity—you can also promote beneficial changes in four others—obesity, hypertension, high cholesterol, and diabetes. There is no other treatment, drugs included, that can have such a broad impact on heart disease risk!
Improve your diet. If you are like most Americans, your diet is too high in saturated fat, salt, and added sugar and lacking adequate whole grains, fruits and vegetables, and fiber. This type of diet is associated with obesity, high blood pressure, high cholesterol, and diabetes. All of these conditions are risk factors for heart disease, so you may literally be eating your way to a heart attack.
It turns out that adopting a healthier eating pattern is important in reducing your risk of heart disease. Saturated fat intake can lead to abnormal blood lipids and high salt intake is linked to high blood pressure. While eating sugar doesn’t cause diabetes, the type of diet described above is associated with weight gain and diabetes. Just like with physical activity, a healthy diet can lead to improvements in several other risk factors.
The potential impact of these three health behaviors is great. Even modest changes in diet and activity can lead to improvements in risk factors and reduced heart attack risk. More intensive lifestyle modification can produce even greater benefits. In one famous study, daily exercise, a low-fat vegetarian diet, and stress management actually caused regression of heart disease, meaning that the blockages in the coronary arteries were smaller following treatment. While you may not follow such a strict program, becoming more active, eating a healthier diet, and quitting smoking can go a long way to improving your heart health.
Posted in Health & Fitness explainer
Tagged exercise, healthy eating, healthy-living, heart attack, heart disease, heart month, prevention, stroke
As Heart Month draws to a close, it’s worth understanding a bit more about the tools your doctor may use to diagnose and treat heart disease or a heart attack. And, equally important, what you can (and should) do if you have a heart attack help prevent it from happening again.
Coronary artery disease or heart disease is caused by atherosclerosis, a process which involves the accumulation of cholesterol plaques in the arteries that supply blood to the heart. These plaques can narrow the blood vessels and reduce blood and oxygen delivery to the heart, leading to symptoms like chest pain (ischemia). The plaques can also rupture and form a blood clot, blocking oxygen delivery and causing a myocardial infarction—a heart attack.
If you experience symptoms such as chest pain or have a high risk of heart disease due to family history and other risk factors, your doctor may recommend a diagnostic test. In a graded exercise test (GXT), or “stress” test, a person exercises, typically walking on a treadmill, at increasing speed and grade while heart rate, blood pressure, and heart rhythm are monitored by a doctor or exercise physiologist.
Changes in these variables, as well as the person’s exercise capacity, can be signs of ischemia and heart function. Often, a GXT is combined with another diagnostic technique such as nuclear imaging, which shows areas of the heart that do not receive enough blood flow, or an echocardiogram that uses ultrasound to show the heart beating and ejecting blood.
Based on the GXT results a cardiologist may recommend an angiogram, in which a catheter is inserted into an artery and threaded into the coronary arteries, dye is injected, and the coronary arteries are viewed through X-ray imaging. This allows cardiologists to actually see the extent of the narrowing in the coronary arteries.
You can been diagnosed with heart disease based on the results of an angiogram or if you had a heart attack. During the angiogram a cardiologist can perform an angioplasty in which a balloon catheter is inflated to open narrowed arteries. A mesh stent may also be placed to help keep the vessel open for longer. In other cases coronary artery bypass surgery may be indicated. Considered open heart surgery, this procedure actually bypasses narrowed sections of coronary arteries using another vessel, typically a leg vein. Both angioplasty and bypass surgery can restore adequate blood flow to the heart and treat ischemia and heart attacks.
Many people consider the treatment complete after the heart attack has ended and the angioplasty or bypass surgery is complete. The truth is that the long-term outcomes are largely based on what happens next. Traditionally, heart disease patients were told to rest and not stress their hearts, a belief that many still hold today. But exercise-based cardiac rehabilitation programs are key to improving heart health and preventing future complications.
Most cardiac rehabilitation programs include several phases. Phase I programs start in the hospital and focus on getting out of bed and performing self-care activities and some walking. Phase II cardiac rehab involves closely-monitored exercise, usually for 12 weeks following a heart attack or surgery. Phase III involves longer exercise sessions with greater independence and transitions into Phase IV, a lifelong exercise program. Education about exercise, nutrition, weight control, stress management, proper medication use, and psychosocial wellbeing are essential in all phases of cardiac rehabilitation.
The benefits of cardiac rehabilitation are well-established through research and practice. In fact, many patients credit cardiac rehabilitation with saving their lives, even if they had bypass surgery. Despite this, less than a third of patients who are eligible for cardiac rehabilitation actually attend a program.
If you or someone you know has had a heart attack or surgery, encourage them to ask their doctor about cardiac rehabilitation—it is likely to be the best way to improve quality of life and avoid future heart problems.
Posted in Health & Fitness explainer
Tagged angina, bypass surgery, CABG, cardiac rehab, GXT, heart attack, heart disease, myocardial infarction, stent, stress test
February is American Heart Month, an ideal time to assess your risk of heart disease and take steps to improve your health. When it comes to heart disease, there are several numbers, including your blood pressure, cholesterol, and glucose, you (or your doctor) may be monitoring. But there is another set of numbers that are equally important for preventing and treating heart disease that you may not be familiar with: 0, 5, 10, 25, and 30.
What these numbers mean and why they are so important is the topic of my Health & Fitness column in the Aiken Standard this week.
0 is for no smoking. Cigarette smoking more than doubles your risk of heart disease and stroke, is by far the leading cause of lung cancer and other lung diseases, and is responsible for over 400,000 deaths per year. If you smoke, quitting now is one of the most important things you can do to improve your health. Nicotine replacement therapy in the form of gum, lozenges, and patches as well as prescription medications can help, but quitting really does require serious dedication. It’s well worth the effort and some benefits of quitting can be realized almost immediately.
5 is for eating five fruits and vegetables each day. A healthy diet is one important aspect of good health. While there is no one single measure of a healthy diet, adequate fruit and vegetable consumption is widely considered to be essential for good health. Fruits and vegetables contain vitamins, minerals, and fiber and most are low in calories. At a minimum, you should eat five servings per day with an emphasis of fresh fruits and vegetables. Your real goal should be to include fruits and vegetables in all meals and snacks, but five servings per day is a good start.
10 is for 10,000 steps per day. Regular physical activity is essential for good health. Almost any activity counts, and a good goal is to be as active as possible throughout the day. You can track your physical activity using a pedometer (step counter) or an app on your phone. A target of 10,000 steps per day is a commonly cited goal, but you should try to take as many steps as possible. You can do this by minimizing the time you spend sitting, taking the stairs instead of the elevator, and walking instead of driving when possible. More steps are better, even if you don’t get to 10,000.
25 is for maintaining a healthy body weight, or a body mass index (BMI) of less than 25. The BMI is a measure of weight relative to height. A BMI of 18–25 is considered healthy, 25–29 is considered overweight, and 30 and higher is considered obese. The risk of health problems like diabetes, heart disease, and some cancers goes up with BMI, so maintaining a healthy body weight is good for your health. If you are overweight you should lose weight, even if you don’t achieve a BMI of less than 25.
30 is for 30 minutes of exercise per day. In addition to being as active as possible throughout the day, you should dedicate a minimum of 30 minutes for exercise or other activity. Considerable research shows that as little as 30 minutes of moderate to vigorous activity leads to improved fitness and health with greater benefits coming from longer duration or higher intensity activity. This can include exercise—a brisk walk or jog, lifting weights, or other aerobic exercise—as well as other activities like housework and yard work. Your goal should be to sit as little as possible, move as much as possible, and make time each day to be active.
Posted in Health & Fitness
Tagged diabetes, diet, exercise, fitness column, heart attack, heart disease, heart month, high blood pressure, nutrition, obesity, physical activity
February is American Heart Month, a time to raise awareness about heart disease, the leading cause of death among adults in the United States. Heart disease, sometimes called coronary heart disease or coronary artery disease, is responsible for nearly 375,000 deaths each year, mostly from heart attacks. Over 13 million adults have been diagnosed with heart disease and, if other cardiovascular diseases like high blood pressure, heart failure, and stroke are included, that number jumps to 80 million. (more statistics are available from the American Heart Association)
The process that leads to heart disease is called atherosclerosis and is characterized by the accumulation of cholesterol-containing plaques in the coronary arteries, the vessels that supply blood to the heart. These plaques narrow the vessels and reduce the amount blood delivered to the heart. The heart requires a constant supply of oxygen to beat and any narrowing in the vessels reduces blood flow and interferes with normal heart function. A decrease in oxygen delivery can cause chest pain (angina pectoris), especially during activity or exertion. It is usually relieved with rest, but can limit normal activities. A complete blockage in blood flow causes a heart attack, also called a myocardial infarction or MI, in which the heart muscle is damaged, sometimes permanently. Many MIs lead to death because dangerous arrhythmias—abnormal heart rhythms—develop that lead to cardiac arrest.
The traditional view of heart disease holds that the cholesterol plaques progressively narrow the arteries until they close completely, a process similar to a blockage in a pipe in your house. It turns out that the process of atherosclerosis is more complex. In fact, most heart attacks occur because of vessels that are around 50% blocked.
Current evidence shows that inflammation plays an important role in the accumulation of plaque in the vessel walls. Additionally, inflammation plays a role in making the plaques unstable and prone to rupture, resulting in a blood clot in the artery which completely blocks the flow of blood leading to a heart attack. This makes more sense if you think of the inside of a blood vessel like your skin. A cut on your finger results in inflammation and the formation of a blood clot which stops blood flow. A similar process occurs inside the coronary arteries to lead to an MI.
The process that occurs in coronary arteries also takes place in other vessels. A blood clot that forms in a vessel in the brain can cause a stroke, sometimes called a “brain attack” because the process is similar to a heart attack. Narrowed vessels that reduce blood flow to the brain can cause a reversible condition called a transient ischemic attack (TIA) or mini-stroke. Narrowed arteries in the legs can cause muscle pain during exercise or activity.
Atherosclerosis is a process that starts when we are young and progresses as we age. It generally doesn’t cause symptoms like chest pain until the arteries are at least 70% narrowed, so most people are unaware that it is happening. The process is accelerated by conditions like obesity, diabetes, high cholesterol, and high blood pressure as well as risk factors like a high fat diet, lack of exercise, and smoking.
Genetics play a role, too, but since you can’t change your genes, the emphasis is placed on factors that you can control. It turns out that making lifestyle changes can greatly reduce your risk of heart attack, and may even reverse the process that causes heart disease.
I will continue to celebrate Heart Month with more information about how to assess your risk for heart disease and what you can do to prevent and treat heart disease.
Posted in Health & Fitness explainer
Tagged atherosclerosis, heart attack, heart disease, heart month, stroke
Today is World Heart Day, with a focus on encouraging all of us to make heart-healthy choices to reduce cardiovascular disease risk. I thought that sharing some information about the heart, how it works, and how to keep it healthy would be an appropriate way to celebrate. This is also the topic of my Health & Fitness column in the Aiken Standard this week.
Your heart started beating months before you were born and will continue to beat every second or so…until it stops, signaling the end of your life. During your lifetime, your heart will probably beat more than two billion times, or about 100,000 times per day. (more interesting heart facts here)
The major function of the heart is to pump blood to all of your tissues through the arteries and back again through the veins. The heart has four chambers: the left and right atria that receive blood from the veins and the left and right ventricles that pump blood into the arteries. The right ventricle pumps blood to the lungs to pick up oxygen and the left ventricle pumps oxygenated blood out to the rest of the body.
The activity of your heart will vary throughout the day. At rest your heart rate is low, typically around 70 beats per minute. Some athletes have resting heart rates that are much lower, owing to their bigger, stronger hearts.
But when you are active your heart beats faster and more forcefully to eject more blood to the working muscles. During intense exercise, a young person’s heart rate can go above 200 beats per minute and the amount of blood pumped can be five times higher than at rest!
The heart is made up mostly of muscle that functions similarly to the skeletal muscles you use to move your body. But cardiac muscle is different in that it can spontaneously contract when stimulated by a specialized area of the heart called the SA node or pacemaker. And unlike skeletal muscle, the heart is remarkably fatigue-resistant, meaning that it can contract repeatedly without needing a break.
In order to beat continuously, the heart needs a steady supply of oxygen which is delivered through coronary arteries, not from the blood inside the chambers of the heart. Normally, plenty of oxygenated blood gets through. But if the coronary arteries become narrowed through atherosclerosis, the accumulation of plaque in the vessels, blood supply can be limited.
This can lead to reversible symptoms like angina pectoris (chest pain), especially during exertion. If a clot forms in the narrowed vessel, blood flow can be blocked completely causing a myocardial infarction (heart attack). Heart disease can be managed using medications, angioplasty, or bypass surgery, but the best approach is to prevent the problem from occurring in the first place.
Taking care of your heart is one of the most important things you can do for your health. Like other muscles, regular exercise can make your heart larger and stronger to pump blood more effectively. Exercise also lowers your blood pressure and can help reduce your blood cholesterol, further reducing the risk of heart disease.
A diet that is low in salt and unhealthy fats, like trans fats, can help lower blood pressure and cholesterol, slowing the process of atherosclerosis and preventing heart failure, a condition in which the heart muscle becomes weak. Maintaining a healthy body weight and controlling blood glucose are also keys to a healthy heart.
More than anything, though, your heart likes to be active. So celebrate World Heart Day by taking your heart for a walk!
The American diet is frequently blamed for the poor health of Americans and, increasingly, other countries. The quest for the healthiest way to eat can literally take people around the world to find the right foods eat.
Unfortunately, diets and supplements that include these “super foods” are rarely the answer to good health on their own. It turns out that the key getting the optimal health benefits from your diet isn’t the food itself—it’s exercise!
This is the topic of my Health & Fitness column in the Aiken Standard this week. It’s not to say that what you eat isn’t important (it is!). The point is that healthy eating will only get you part of the way to the goal of good health.
For decades scientists have tried to isolate the types of foods or individual nutrients that lead to good health by studying what healthy and unhealthy people eat around the world. In some studies eating more of a certain nutrient or food, like saturated fat or red meat, was associated with a higher risk of heart disease and people who ate more fish had better heart health.
This is how we arrived at the common guidelines that encourage us to eat more fish and less red meat. The assumption was that the saturated fat in red meat was the cause of more heart attacks in Americans while the beneficial oils in fish protected the Japanese from heart disease.
But these studies, or at least the interpretation of these studies, didn’t take into account the fact that the populations that had the higher heart attack risk were also less active than their healthier counterparts. Perhaps it was the physical activity that made the difference in health.
A good example of this is the popular Mediterranean diet, which is often touted as the healthiest diet in the world. It’s true that people in the Mediterranean region historically tended to have a lower risk of heart disease. This was thought to be due to their diet which emphasizes healthy fats from olive oil along with vegetables, whole grains, seafood instead of red meat, and red wine in moderation.
Unfortunately, eating more olive oil or drinking more red wine, both recommendations based on the Mediterranean diet, won’t necessarily make you any healthier. This is because health benefits are due to a complex interaction of what we eat and other lifestyle factors, including activity. And people in the Mediterranean region move a lot more than we do, a key to realizing the benefits of the local diet.
Another example is the Ornish diet, a low-fat, semi-vegetarian diet that has been credited with improving blood lipids and even reversing the process that clogs arteries in heart disease. This is part of the reason for the recommendation to avoid foods high in saturated fat and cholesterol and eat more vegetables. It’s true that this diet has been shown to improve heart health, but the subjects in the studies also exercised regularly. Achieving the full benefits of this diet requires exercise, too.
Even the typical American diet won’t necessarily be unhealthy when combined with enough exercise. The Olympic swimmer Michael Phelps famously revealed what he ate on a typically day. The amount and type of foods he consumed were not what you would expect from someone so fit and healthy! Without the hours of training he engaged in each day that diet would almost certainly have resulted in obesity and poor health.
So, as you work toward improving your diet, don’t forget about the importance of daily exercise or other activity in maximizing the health benefits. And when people ask your secret, you can tell them that the real key to a healthy diet is exercise.
Posted in Health & Fitness
Tagged aiken standard, American diet, calories, diet, exercise, fitness column, food, gaining weight, health, healthy choices, healthy eating, healthy-living, heart attack, heart disease, Mediterranean diet, nutrition, obesity, Ornish diet, physical activity, supplements, weight loss
February is Heart Month, an ideal time to assess your risk of heart disease and take steps to improve your health. This is important because heart disease, sometimes called coronary artery disease, is the leading cause of death among adults in the United States. It is responsible for nearly 600,000 deaths each year, mostly from heart attacks. Millions more are at increased risk because of certain biological and behavioral risk factors.
Identifying your personal risk for heart disease and making efforts to improve your heart health is the topic of my Health & Fitness column in the Aiken Standard this week.
Some of these risk factors cannot be changed, such as age, sex, and family history, while others can be altered to reduce risk. These modifiable risk factors include smoking, high blood pressure, high cholesterol, diabetes, obesity, and physical inactivity. While your doctor can play an important role in treating these conditions, there is much you can do on your own to improve your heart health.
The first step is to get a good assessment of your heart health. If you haven’t done so recently, you should see your doctor to have your risk factors evaluated. This includes tests for blood glucose and blood lipids (including total, LDL, and HDL cholesterol and triglycerides), measurement of your blood pressure and body weight, and an assessment of other health factors such as your family history, whether you smoke, and your level of physical activity.
The next step is to treat the risk factors that you have. Depending on the severity and your own personal health history your doctor may prescribe medications to lower your blood pressure, blood glucose, or blood lipids. These medications are most effective when combined with lifestyle changes including good nutrition, exercise, and weight loss. In some cases, poor diet and lack of activity can counteract the beneficial effects of these drugs. Furthermore, these healthy habits may help you reduce the dosage, and limiting the side effects, or stop taking the medications altogether.
The other risk factors—obesity, inactivity, and smoking—really must be treated through lifestyle management. While there are medications that can help with smoking cessation and weight loss, being successful requires making lasting behavior changes. These habits can be difficult to change, and many people have tried before without success. Keep in mind, though, that everyone who is successful at quitting smoking, losing weight, or sticking to an exercise program has experienced his or her share of difficulty. The difference is that those people kept trying until they were successful. You can be successful, too.
Even small changes can have a big impact. Take exercise, for example. The benefits of as little as 30 minutes of physical activity per day are well established and impact heart disease risk in a multitude of ways. Physical activity helps with weight control, lowers blood pressure, improves blood lipids, and prevents and treats diabetes. Think of this as a great health “deal.” By modifying one risk factor—inactivity—you can also promote beneficial changes in four others—obesity, hypertension, high cholesterol, and diabetes. There is no other treatment, drugs included, which can have such a broad impact on reducing heart disease risk!
Of course, there are steps you can take beyond becoming more physically active to reduce your risk of heart disease. The list of beneficial changes you can make to improve your heart health is long, but keep in mind that even small changes can add up to a big benefit.
Knowing which risk factors are most concerning can help you and your doctor make effective treatment decisions. Quitting smoking, increasing your physical activity (and reducing sedentary time), and eating a healthier diet can lead to improvements in heart disease risk factors and reduced heart attack risk. The best news is that these same changes can also reduce your risk of other serious health problems including many types of cancer, stroke, and lung disease.
Dr Parr Says... 