Heart disease is the leading cause of death for both men and women in the United States. The updated statistics from the CDC continue to be sobering. Heart disease caused 840,768 deaths in 2018. Every 40 seconds, someone is having a heart attack. The only good news is that the death rate from heart disease has decreased by a third. Awareness of the problem and taking steps to decrease risk factors has proven to be very effective.
So what are some of the possible warning signs of heart disease? These may include chest pain, shortness of breath, jaw pain or even vague symptoms such as increasing fatigue, back pain and heartburn. As such, it is important to see your physician for your wellness exams in order to evaluate what your risks are and to help in determining if any of the above symptoms are serious in nature.
Common risk factors include older age, diabetes, high blood pressure and high cholesterol. Habits that negatively affect heart disease include unhealthy eating habits, smoking, excessive drinking and a lack of exercise. Family history especially increases risk if a father or brother was diagnosed with heart disease before the age of 55. Risk for women increases after the age of menopause. Other possible risks include sleep apnea, autoimmune diseases such as rheumatoid arthritis, and those who have an elevated homocysteine level.
It is essential to take an active role in your wellness approach so try to reduce your risks as much as possible. You cannot control family history or age but you can help in other ways. Optimize your nutrition by having a diet rich in vegetables, fruit, whole grains, fish and lean meats such as chicken and pork. Try to avoid foods that are processed or filled with sugar and corn syrup. Hydrate well, and limit caffeine and alcohol. Women of all ages and men above the age 65 should limit alcohol to 1 glass daily. Men under age 65 have a limit of 2 glasses. If you are a smoker, it’s time to stop. Although many smokers turn to electronic cigarettes (vaping) to help stop smoking cigarettes, the FDA advises avoidance of these products until more studies are available regarding their safety. Staying physically active with exercise is important so speak with your physician about the best fitness program and nutrition plan for you.
Other items that may need to be addressed include keeping your blood pressures under 130/80. Get your annual bloodwork done to evaluate for diabetes and see where your cholesterol levels are. If you have diabetes, work on getting the specialized diabetes lab tests to goal and include abdominal core exercises in your fitness program. The bad cholesterol, known as the LDL, should be less than 100 in the average person, and less than 70 in those with history of heart disease, strokes, vascular issues and diabetes. Often times, cholesterol medications are needed if these higher risk conditions are present.
Stress control is very important. Stress may influence cortisol levels and interrupt sleep, but it has also been known to raise blood pressures and sugar levels in those with hypertension and diabetes. It is important to address all stress issues. Please do not hesitate to discuss this with your physician and see if you would benefit from seeing a psychotherapist or starting medical therapy.
Aspirin use has been in some recent controversy. The risk for bleeding has been shown to be higher in average cardiac risk aspirin users and therefore has been advised not to be used unless recommended by your doctor. If you have had cardiac or vascular history or significant risk factors, this new study finding does not apply to you and aspirin is beneficial. Please do not stop aspirin or medical therapy on your own without speaking to your physician.
As an internist, I order many cardiac score CT scans to assess how much calcified plaque is in the coronary arteries. This is a very quick and non-invasive CT scan available to the public with a physician order. If this is abnormal or if cardiac symptoms are present, a cardiac pet scan or nuclear stress test may be ordered to see if there is plaque blocking blood flow in a cardiac artery. If so, a cardiac catheterization would be performed by a cardiologist to open this blockage in order to prevent a heart attack.
The best approach is to take an active role in your health. Please call your physician today to schedule your wellness visit and always seek help for new warning signs. Ask questions in order to understand what your lab tests show and if they are not optimal. Always address stress issues and discuss sleep problems with your doctor. My patients hear me repeat the following sentence quite often. Be proactive in your health and not just reactive. Prevention does save lives.
Dr. Sciavolino-Day is a concierge internist located in North Naples. More information may be obtained at www.drsciavolinoday.com.
