HEART DISEASE PREVENTION

Todd A. Hoover, MD, DHt Your risk for a heart attack may be higher than you think. Heart Disease is the leading cause of death for both men and women in the United States.1 Currently, heart disease accounts for over 27% of all deaths, with one half of those deaths occurring in women. 2 Over 700,000 Americans will have their first heart attack this year and in 2010, the cost burden for heart disease exceeded 300 billion in direct health care costs and work time loss.3 Heart disease results from a lifelong narrowing of small arteries that supply the heart muscle with circulation and oxygen. As with all muscles, lack of oxygen leads to cramping of the muscle. Heart muscle cramping causes chest pain or arm/neck pain because the pain sensing nerves of the heart are not precise. Because the heart muscle cannot rest or stop moving, lack of oxygen may continue to increase leading to death of the cells. When heart muscle cells die, you are having a heart attack. Heart Attacks damage the heart in two ways: 1. Death of heart muscle cells 2. Injury of nerves that run through the muscle and control the rhythm of the heart. Because the heart is first, and foremost, a pump for circulation, any loss of pumping power can cause poor circulation of the blood. Progressive loss of pumping power results in Congestive Heart Failure, associated with shortness of breath, accumulation of fluid in the extremities, and decreasing function in the kidneys, which clear toxins from the body. If not reversed in the first hours of a heart attack, such damage to heart muscle and pumping ability is permanent. Damage to the nerves of the heart can cause any number of problems with the rhythmic control of heart pumping. These can be minor problems like skipped heartbeats, or more severe issues where the heart actually stops which is called cardiac arrest. Recognized risk factors for heart disease include: 4

Hereditary Factors (Unchangeable)

Family History of Heart Disease

Medical Problems (Treatable)

Prior Heart Disease High Blood Pressure
Diabetes Mellitus Elevated Cholesterol

Lifestyle Factors (Changeable)

Smoking High Fat Diet Obesity Lack of Exercise Alcohol Use

While some risk factors like a family history of heart disease or a prior heart attack cannot be changed, most of the risk factors for this disorder are under your control. Prevention of permanent loss of heart function is possible at nearly any stage of heart disease from the earliest signs to those who might be considering a cardiac bypass surgery. The 3 Stages of Prevention:

Early Detection

Lifestyle Changes

Disease Treatment

Early Detection If you are over the age of 20, you should be screened for heart disease risks including: Body Weight check Blood pressure check Blood cholesterol and triglyceride levels If you have a family history of heart disease, diabetes or high blood pressure, you should ask your doctor about additional testing: Fasting blood sugar Electrocardiogram Blood Homocysteine level Blood Cardio Sensitive C-Reactive Protein level Early warning signs of heart disease include: 1. Difficulty breathing with exertion 2. Chest pain (especially with exertion or after eating) 3. Unexplained pain in the neck, jaw, or arms, or chest pain that radiates to these areas 4. Chest pain associated with weakness, faintness, or trouble with breathing 5. Trouble with breathing while lying down One large survey showed that while over 90% of respondents knew that chest pain was associated with heart attacks, but only about a quarter knew all of the signs and that they should dial 9-1-1 when someone was having those symptoms.5 If you have any early warning signs, contact your doctor and go to the emergency room immediately to be checked. Lifestyle Changes If you have increased risk or signs of early heart disease, taking charge of lifestyle choices can make a huge impact on your future risk for a heart attack. Many clinicians across the country have witnessed patients who have reversed their risk for a heart attack by fully addressing their lifestyle associated risks. Begin by focusing on any factors that may be causing damage. Specifically:

1. If you smoke, stop as soon as possible. Smoking Cessation information is available here. 2. If you have heavy alcohol use or abuse alcohol, you should seek help to stop. 3. Reduction of your dietary fat intake can be done step by step. 4. Add an exercise program to your daily schedule. Make sure your choice of program is something you enjoy and designed to fit easily into your day Disease Treatment High blood pressure, diabetes mellitus, high cholesterol and obesity are the strongest risk factors for future heart attack (other than family history). Research has shown large reductions in heart disease through the close clinical management of these three disorders. These disorders reflect body-system wide problems that will respond best to a comprehensive wellness approach Follow this template to reduce your future risk for heart attack and permanent disability from heart disease. Holistic medicine practitioners to consider in addition to your Primary Care Provider include Acupuncturist, Yoga and other exercise therapists, Nutritionist, Herbalist, and an Integrative Physician.

References
1

Kochanek KD, Xu JQ, Murphy SL, Minino AM, Kung HC. Deaths: Preliminary Data for 2009. National Vital Statistics Reports.2011;59(4). Hyattsville, MD: National Center for Health Statistics.
2

Heron MP, Hoyert DL, Murphy SL, Xu JQ, Kochanek KD, Tejada-Vera B. Deaths: Final data for 2006

Statistics. 3 Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart Disease and Stroke Statistics2010 Update. A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee . Circulation. 2010;121:e1-e170.
4

[PDF2.3M]. National Vital Statistics Reports. 2009;57(14). Hyattsville, MD: National Center for Health

Chart derived from Information at Centers for Disease Control website on Heart Disease, subsection Heart Disease Risk Factors at http://www.cdc.gov/heartdisease/risk_factors.htm, last downloaded August 15, 2011
5

Centers for Disease Control and Prevention. Disparities in Adult Awareness of Heart Attack Warning Signs and Symptoms14 States, 2005. MMWR. 2008;57(7):175179.