Cardiovascular disease remains the largest cause of death in the United States. Every year in the U.S., 325,000 people suffer a sudden cardiac death. Unfortunately, for most people their demise is the first sign of heart trouble. I recall the many patients who were treated successfully due to advances in emergency cardiac care, but also remember far too many who did not survive due to their late presentation and or extent of disease.
When speaking to my patients, I emphasize prevention as the key to success. I also believe that early detection of heart disease and optimal risk factor modification to prevent cardiovascular events are crucial in preventing cardiac related deaths.
To reduce your risk of heart attack, I suggest engaging in regular moderate aerobic exercise for at least 30 minutes, five days a week, or for those in better health, vigorous workouts at least 20 minutes, three times a week. There are an abundant amount of outdoor walking and hiking areas in and around the Valley and local beach areas. Why not find a walking/biking/hiking buddy and make that a part of your lifestyle? You’ll be more likely to stick to consistent workouts if you carve them into your set schedule.
Following a healthy diet can also help you to maintain a normal body weight. Adopt a diet low in salt, saturated and trans fats, and high in unsaturated fats (fish, avocado, etc.) like the Mediterranean diet. And, be sure to stay away from processed foods and visit farmer’s markets for locally grown produce.
Most importantly, know and review your risk factors with a trusted physician. Your physician may recommend medications to control cholesterol, hypertension and diabetes. High-risk individuals should consider possibly taking a daily aspirin regime, but only under your physician’s care. Also, avoid hormone replacement unless you have severe menopausal symptoms and seek alternatives when possible.
In selected cases, it may be necessary to conduct non-invasive or even invasive tests to determine the nature and severity of the heart disease. Sometimes angioplasty/stenting or even bypass surgery may be needed if you have severe and symptomatic arterial blockage.
Common Risk Factors for Heart Disease
Age – Heart disease can occur at any age. However, four out of five people who die from coronary heart disease are aged 65 or older. The risk of stroke doubles with each decade after the age of 55. “Make 40 the new fifty and 50 the new sixty, remember to love life with your heart and live life through your heart!”
Gender – Men and women are equally at risk for heart disease, but women tend to get coronary artery disease an average of 10 years later than men. The risk for women increases as they approach menopause and continues to rise as they get older. Death rates from heart disease and stroke for women are twice as high as those for all forms of cancer.
Family History (Heredity) – Presence of heart disease in a parent or sibling, especially at a young age, increases your risk of developing heart disease.
Smoking – Smokers are twice as likely to suffer heart attacks as non-smokers, and they are more likely to die as a result. Smoking is also linked to increased risk of stroke. The nicotine and carbon monoxide in tobacco smoke damages the cardiovascular system. Passive smoking may also be a danger. 46 million Americans (25 million men and 21 million women) smoke. Women who smoke and take the oral contraceptive pill are at particularly high risk of heart disease and stroke.
Cholesterol – The higher the blood cholesterol level, the higher the risk of coronary heart disease, particularly if it is combined with any of the other risk factors. Diet is one cause of high cholesterol – High levels (over 100 mg/dl) of LDL (low-density lipoprotein), or “bad cholesterol”, are dangerous, and low levels (under 40 mg/dl in men and under 55 mg/dl in women) of HDL (high-density lipoprotein), or “good cholesterol”, increase the risk of heart disease and stroke. High levels (over 150 mg/dl) of triglycerides (another type of fat), in some, may also increase the risk of heart attack and stroke. Nearly 40 million Americans have high cholesterol levels.
High Blood Pressure – High blood pressure (over 140/90 mmHg and over 130/80 mmHg in diabetics) increases the risk of heart attack, stroke, aneurysm, and kidney damage. When combined with obesity, smoking, high cholesterol or diabetes, the risk increases several times. High blood pressure can be a problem in women who are pregnant or are taking high-dose types of oral contraceptive pill. 72 million Americans over age 20 have high blood pressure.
Physical Inactivity – Failure to exercise (walking or doing other moderate activities for at least 30 minutes five days a week or more vigorous workouts at least 20 minutes three times a week) can contribute to an increased risk of coronary heart disease as physical activity helps control weight, cholesterol levels, diabetes and, in some cases, can help lower blood pressure.
Obesity – People who are overweight are more likely to develop heart disease and stroke, even if they have none of the other risk factors. Excess weight causes extra strain on the heart; influences blood pressure, cholesterol and levels of other blood fats – including triglycerides; and increases the risk of developing diabetes. 66% of Americans over age 20 are obese.
Alcohol – Small amount of regular alcohol consumption (1/2 to 1 drink per day for women and 1-2 drinks per day for men) can reduce risk of heart disease. However, drinking an average of more than one drink a day for women or more than two drinks a day for men increases the risk of heart disease and stroke because of the effect on blood pressure, weight and levels of triglycerides – a type of fat carried in the blood. Binge drinking is particularly dangerous.
Drug Abuse – The use of certain drugs, particularly cocaine and amphetamines, has been linked to heart disease and stroke. Cocaine can cause abnormal heartbeat which can be fatal while heroin and opiates can cause lung failure. Injecting drugs can cause an infection of the heart or blood vessels.
Diabetes – The condition seriously increases the risk of developing cardiovascular disease, even if glucose levels are under control. More than 80% of diabetes sufferers die of some form of heart or blood vessel disease.
Previous Medical History – People who have had a previous heart attack or stroke are more likely than others to suffer further events.
Stress, Depression, Anger/Hostility – Stress, depression, and negative emotions have also been linked to an increased risk of heart disease.
Jahandar Saleh, MD, is an Interventional Cardiologist, Chairman of Department of Internal Medicine and Director of Cardiology Telemetry and Clinical Decision Units at Dignity Health Northridge Hospital.
For more information about how you can recognize heart attack symptoms and reduce your chance of heart disease, call (818) 678-4900.