|First the bad news. "Coronary heart disease is the leading cause of death
today in America for both men and women," said Dr. David Engle, a Brookfield
cardiologist. Now the good news. "Were improving," he said. "We have
recognized theres a problem."
cardiologist Dr. David Engle watches as Eugene Pohl performs a stress test. Regular
exercise and eating right are key factors to preventing heart disease.
"Between 1985 and 1995, the
death from heart attacks has declined by 28.7 percent. Thats a big improvement, due
in part to the advances in how we treat heart attacks. But the biggest thing thats
happened is people have recognized certain risk factors that make a heart attack more
likely and theyre changing their lifestyles to accommodate that."
So put down your cigarette and glass of
wine and dont pick up that piece of cheese.
Indeed, the American Heart Association has
identified six risk factors that contribute to heart disease and heart attacks. Work hard
at keeping these risk factors under control, cardiologists say, and you decrease your
chances for heart disease and/or a heart attack.
"(With the exception of genetics)
these are modifiable risk factors," said Dr. Sanjay Singh, a cardiologist at the
Waukesha Heart Institute in the Waukesha Moreland Medical Center. "We can treat
these. We can control them."
The Six Risk Factors
1. High blood pressure
This is also referred to as hypertension.
Know what your blood pressure is and understand what it means, said Engle. A normal blood
pressure should be equal to or less than 140/90. Anything above that needs to be monitored
by your doctor. Generally, if your blood pressure is 150/95 or higher, you will need
medication to reduce it.
Youve heard all the warnings. Smoking
and second-hand smoke is bad for you. "Women who smoke and use contraceptives
increase their risk of coronary heart disease 39 times," said Engle. "If a
spouse smokes, you have an increased risk for developing heart disease," he
continued. Cigar and pipe smokers are also at risk because, although theyre less
likely to inhale, theyre still getting second-hand smoke and making themselves prime
candidates for mouth or throat cancer. "Stop smoking, dont just cut down. We
have a number of things we can do to help, patches, gum, medication. The real thing is you
have to decide you want to quit, or it will never happen," Engle said.
The real incentive to quit smoking, he
added, is that youre back to normal in one to two years. In other words, you have a
second chance at being healthy, no matter how heavy a smoker you once were.
Diabetics are more susceptible to heart
disease and heart attack and need to be monitored closely by their physicians.
4. Extra weight or obesity
Exercise and eating right is
important for preventing heart problems. Engle advises exercising three times a week to
hold the weight youre at, or four times a week to lose weight. Warming up
before exercise and cooling down afterward is important.
Singh advised exercising four times a week
for at least 20 minutes each time, and he stressed it must be aerobic exercise. Walking
and stopping on a leisurely stroll through a park does not count, nor does standing around
waiting for your turn at a softball game. Exercise must be continuous brisk walking,
hiking, swimming, running, tennis, etc., Engle said.
It doesnt seem fair, but the older
you are, the longer you need to exercise. A 20-year-old might need to run only a mile in
ten or 15 minutes and be done. A 40-year old would do better to take a one-hour, three or
four-mile brisk walk.
Stay away from fatty foods, such as ice
cream, whole milk, fried foods, fast foods and meat. Engle said the American Heart
Association recommends limiting meat, poultry and fish intake to just six ounces a day.
Instead of making a steak the central item on your plate, make the vegetables and fruits
the central items on your plate, he said.
The doctors also suggest eating five
helpings of fruits and vegetables a day. Engle said some studies suggest taking Vitamin C
and E supplements lower the risk of heart attacks in those known to have coronary heart
disease. But dont take more than whats recommended on the bottle, he
5. High cholesterol
"Cholesterol is a substance the entire
body needs. Its a healthy thing. It forms cell membranes and hormones. But if
theres too much, its a big risk factor for heart disease," said Engle.
People should get their cholesterol checked every three to five years, starting in their
teens or early 20s, he said, and they should understand the difference between good and
HDL (high density lipoprotein) is good
cholesterol. The HDL is the vehicle that transports cholesterol away from arteries and to
the liver where it is passed out of the body.
LDL (low density lipoprotein) is bad
cholesterol. When a person has too much LDL cholesterol circulating in the blood, it can
slowly build up within the walls of the arteries feeding the heart. The plaque that forms
can clog the arteries.
If a persons mother or father had a
heart attack at age 65 or younger, that person has cause to be more concerned about having
a heart attack. There is even more of a concern if the father or mother had a heart attack
at an extremely young age, in his or her 20s or 30s. An extended family member, such as an
uncle or great aunt who suffered a heart attack at a young age does have some influence in
a persons chances for having a heart attack, but to a lesser extent, said Singh.
Whether or not a person is genetically inclined to heart disease and heart attacks, Singh
recommends annual physicals for everyone beginning in their late 20s.
Understanding heart attacks and heart
disease is an important part of trying to prevent them from happening. Heart disease
covers a wide range of heart problems and a heart attack is a specific form of heart
disease, explained Dr. Michael Cinquegrani, a faculty member at the Medical College of
Wisconsin, Division of Cardiovascular Medicine in Milwaukee.
Singh explained the four most
common types of heart disease:
Coronary Artery Disease
Coronary heart disease is a hardening of
the arteries, the most common form of heart disease which can lead to heart attacks. There
are three tubes that feed blood into the heart. Like hard water deposits in pipes, a
complex chemical substance called Atheroma deposits in these "pipes" leading to
the heart. Cholesterol is the most common of these chemicals. The tubes slowly narrow.
When one is completely clogged, it causes that part of the heart to die and that is a
If you think you may be having a heart
attack, check for these symptoms: Chest pain or pressure in the chest, shortness of
breath, irregular heart beats, sensation or discomfort in the stomach. A person might
think its indigestion, but really its the lower part of the heart having
In about eight percent of the cases, a
person has a "silent heart attack." That is, he or she felt no pain or
experienced no warning signs prior to the heart attack. This most commonly occurs with
diabetics who experienced nerve damage and therefore dont feel the pain or
To prevent a heart attack, you should
change and modify the risk factors mentioned. High blood pressure should be monitored and
can be controlled with drugs. Stop smoking. Eat the right foods and exercise.
Cardiomyopathy is a weakness of the heart
muscle, the second most common form of heart disease. In the majority of cases, the cause
is unknown, but some things that cause the weakness is years of excessive alcohol abuse or
heavy smoking; viral myocarditis, or inflammation of the heart muscle from a viral
infection (treatable); rheumatic myrocarditis, caused from a bacterial infection
(curable); Chagas Disease, due to an infection from parasites (curable); obesity
induced cardiomyopathy and diabetic cardiomyopathy.
Only the first cause of cardiomyopathy can
be prevented by avoiding alcohol and smoking.
Valvular Heart Disease
About one to two percent of the population
is born with congenital, aortic valve disease which results in two leaflets that make up
the aortic valve instead of three and is correctable with surgery. The valves can also
start malfunctioning due to rheumatic fever which is curable, or old age, senile valvular
heart disease. Unfortunately there is no cure for it.
Electrical problems in the heart
Electrical problems with the heart come
about because either the heart is beating too fast, which is called Tachycardia, or too
slow, which is Bradycardia.
Dr. Mickey Gadhoke, director of the
Arrhythmia Center at the Waukesha Heart Institute explained this further.
Electrical problems are very common, but
because of advances in the early 90s, they are completely curable. A slow heart beat
can be corrected by implanting a pacemaker. If the heart beats too fast following a heart
attack, it is called ventricular tachycardia and is usually life threatening, Gadhoke
said. It requires an implantable cardioverter defibrillator. If a person is born with too
fast a heart beat, this condition is called supraventricular tachycardia, and it can be
corrected with a procedure called radio frequency ablation which burns off the area
causing the problem. There is no cure for this ailment.
What about men versus women? Is one sex
more at risk than the other?
"It is a big fallacy to think men are
more susceptible," said Singh. "If you look at men and women up to age 40 and
50, incidents are higher in men than in women. After menopause, the risk in women starts
rising above the risk for men. At age 80, the risk becomes equal."
"Women are protected by their
hormones," said Cinquegrani. "However, as women age and go into menopause, they
begin increasing their risk for heart attack."
"Its not just a mens
disease," Engle summed up.