Take Good Care of Your Heart

Take Good Care of Your Heart
by Pam Peitz

Amy was experiencing chest tightness and shortness of breath. She had similar symptoms years earlier and was diagnosed with bronchitis. Because she was 38 years old and considered herself healthy she was not too concerned but when the symptoms did not subside, she presented to the emergency department. She told the triage nurse that she thought she had bronchitis. After a brief check in process, she was sent to the waiting room. Once she was examined by the physician and he learned of Amy's history of cigarette smoking, and that her father had died of heart disease in his 40's, the physician ordered a 12 lead EKG. Amy was then hit with the bombshell, "You are having a heart attack".
Unfortunately, the above scenario is all too common. Heart disease is the number one killer of Americans. Many Americans minimize their risk of heart disease and believe it only happens to older people. Many women think of heart disease as a "man's" disease when in actuality, women have the same prevalence of heart disease as men.
The good news is that individuals can greatly reduce their risk of heart disease by making lifestyle modifications. Those characteristics or habits that increase the risk of heart disease are called risk factors. Risk factors can be divided into two categories: modifiable (those we can change) and non-modifiable (those we cannot change).
Non-modifiable risk factors include age, race and family history. Family history is particularly significant when premature heart disease is present. This would be defined as heart disease at age 55 or less in men and age 65 or less in women. Their children would be at much greater risk of developing heart disease at an early age. Diabetes is also a very significant risk factor for heart disease, so much so, that diabetics are often given the same treatment as those patients already diagnosed with heart disease.
Modifiable risk factors include smoking, high blood cholesterol, high blood pressure, obesity, high fat diet and sedentary lifestyle. Smoking cessation should be a priority for smokers as not only does smoking increase the risk of heart disease; it is associated with a multitude of illnesses including many cancers, stroke and chronic lung disease (emphysema). Individuals who have trouble quitting should talk to their doctor as new prescription medication is now available that has helped many persons kick the habit.
Having high blood cholesterol, particularly elevated levels of low density lipoprotein (LDL) is associated with higher rates of heart attack and stroke. Some individuals can reduce their cholesterol by eating a diet low in saturated fat, avoiding trans fat and eating plenty of fruits and vegetables. Losing weight and exercising will also improve cholesterol levels. When diet alone is not enough, many very effective prescription medications are available. These drugs, called statins, have been found to reduce the risk of heart attack and stroke.
High blood pressure is very common and is also a risk factor for heart attack and stroke. The ideal blood pressure is less than 130/80. Individuals should not resist when their physician recommends blood pressure medicine.
Obesity, high fat diet and sedentary lifestyle are all related as one can lead to another. Tremendous research now exists showing that exercise is directly related to mortality. Individuals who have a high exercise capacity reduce their risk of all causes of
death. Regular exercise, preferably 30 minutes most days of the week will not only increase exercise capacity but will also assist in weight loss. In some cases, exercise and weight loss can greatly improve blood pressure and cholesterol as well as reducing the risk of developing diabetes.
Individuals who have not been diagnosed with heart disease can achieve tremendous health benefits by making lifestyle changes such as engaging in regular brisk exercise, eating a heart healthy diet and not smoking. For those individuals who have heart disease, a monitored cardiac rehabilitation program prescribed by a physician is a very safe way to begin lifestyle changes. Amy, who we introduced at the onset of this article, completed a monitored exercise program, quit smoking and was able to return to her job.
The old saying, " An ounce of prevention is worth a pound of cure," certainly holds true for heart disease. For more information about heart disease, visit the American Heart Association web site at www.americanheart.org.

Pam Peitz, RN, MS, CHES is the Program Manager Cardiac Rehab and Congestive Heart Failure at Washington County Hospital in Hagerstown, MD.