Health & Fitness

Heart Disease: What Are Your Risks?

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Heart disease kills nearly one in three Americans, but many of its causes are easily preventable. Learn how some simple habits can make a big difference.

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We hear about heart disease nearly every day, for good reason. It’s every bit as dangerous as serial killers and terrorists. Worse, we’re much more likely to encounter heart disease than any other threat.

The Centers for Disease Control and Prevention (CDC) report that about 610,000 Americans die annually because of heart disease, or about one in every four. And while men are most at risk statistically, women have swiftly caught up.
Coronary heart disease is the most common form, accounting for more than 370,000 deaths annually, while about 735,000 Americans suffer a heart attack each year.

High blood pressure, high LDL cholesterol and smoking are key contributors to heart disease, according to the CDC. About half of Americans, 49 percent, have at least one of these three risk factors, and there are others. Diabetes, obesity, poor diet, physical inactivity and excessive alcohol use are also powerful factors in the development of heart disease.

Diabetes and Heart Health

Diabetes is one of the most prevalent contributing factors in the development of heart disease. Left undiagnosed or unmanaged, diabetes erodes heart function and directly impacts other organs closely related to heart function. It’s nearly impossible to underestimate the adverse effects of diabetes.

“In general, individuals with diabetes have two to four times the risk of developing heart disease,” says Dr. Elsayed Mohamed, an interventional cardiologist at SwedishAmerican Heart Hospital, Rockford. “Diabetes is present in 30 to 40 percent of individuals with heart disease, compared to 9 percent in the general population.”

Mohamed adds that diabetes is typically associated with other established heart disease risk factors such as high blood pressure, high cholesterol and kidney disease.

“All together, they cause cholesterol plaque to accumulate inside the arteries,” Mohamed says. “Diabetes also can damage the kidneys, eyes and nerves.”

Diabetes is one of the most common factors he sees in heart patients because it promotes blockages in the coronary and peripheral arteries and causes stroke and congestive heart failure. A disturbing trend has occurred recently.

“As the incidence of childhood obesity increases, younger individuals are at a much higher risk of developing diabetes and heart disease,” Mohamed explains. “It is concerning. We were making headway in fighting heart disease but, with increasing diabetes and other cardiac risk factors associated with obesity, our progress will be set back. At this point, prevention becomes even more vital.”

Adopting a healthy lifestyle should start at a very early age, he says.

“Keeping an ideal weight, regularly exercising, not smoking, and properly managing diabetes and high blood pressure reduce the risk,” he points out.

When it comes to managing risk factors with medications, Mohamed emphasizes that consulting closely with doctors and a thorough assessment are the keys to success.

“Managing risk factors such as blood pressure are essential, especially when diabetes is also involved,” he says. “We must find the right regimen and regulate the patient closely. Medications will need to be tweaked and changed to meet the individual’s needs.”

The goal is to achieve the therapeutic targets that are proven in clinical trials to help ensure positive outcomes.
“If a heart attack is to occur, seeking immediate care is the key to preventing death or permanent heart damage,” Mohamed says.

A heart attack occurs when one of the arteries supplying the heart muscle is abruptly blocked. With immediate medical care, blood flow to the heart muscle can be restored before permanent damage occurs.

“If permanent damage occurs, the heart does not have the ability to rebuild itself,” Mohamed explains. “There is ongoing research examining whether stem cells can be used to regenerate new heart muscle.”

Mohamed concludes that diabetes is a strong risk factor for developing heart disease. The growing prevalence of obesity and diabetes will have a big impact on the burden of heart disease in society. Public health efforts aimed at reducing obesity and promoting a heart-healthy lifestyle are critical.

Kidney Disease and Heart Health

Kidney (renal) disease is another threat to heart health. The kidneys not only remove excess fluids from the body that can impair heart function, but also play a role in creating the red blood cells needed to carry oxygen through the body. Renal failure and its treatment are both hard on the heart.

Medications used to treat the heart can make kidney problems worse, says Meghan K. Hess, a nurse practitioner at Rockford Health System’s Heart and Vascular Center, Rockford.

“It depends on the heart disease’s progress,” Hess explains. “Diuretics are prescribed to eliminate fluid accumulation from the body that comes from the heart’s inability to pump properly. These have adverse effects on the kidneys, which must be closely watched.”

In some patients, it’s hard to say which came first, the renal failure or the congestive heart failure, since they often occur together. The influence on other health factors, such as high blood pressure, can impact the health of both organs. When a patient develops a blockage in coronary arteries that requires an angiogram, the contrast dye used to detect blockages is also detrimental to the kidneys, says Hess.

“We see many cases in which uncontrolled diabetes and high cholesterol levels affect both the heart and kidneys,” she says. “This too often begins with the base problem: undiagnosed or unmanaged diabetes, coupled with high blood pressure, which contributes to coronary artery disease and results in organ damage.”

Another connection between the kidneys and heart is less well known. The kidneys produce a hormone that stimulates the bone marrow to produce red blood cells. When they begin to fail, the patient develops anemia. Along with that condition, the heart doesn’t receive enough red blood cells to do its vital work of supplying oxygen throughout the body. This makes the heart work harder.

“The kidneys require a lot of blood flow,” Hess says. “Without it, the kidneys cannot do their work and the patient begins to retain fluid, which can lead to weight gain, abdominal distension, swollen legs and fatigue. When this happens, we have a patient who is really not feeling well at all.”

Hess emphasizes that prevention is always best. Unfortunately, primary preventative measures such as maintaining an ideal weight, exercising, managing blood pressure and diabetes, and restricting salt intake don’t happen or don’t happen enough to avoid damage.

“The A1C test measures the average blood glucose level over the past three months. Patients and their health providers work to keep that in range to reduce the risk of complications that can arise from diabetes,” Hess says. “We begin with dietary changes, then add medications, when diet is no longer enough. But with the kidneys and heart, too often there is no way to help one without hurting the other. For example, when a patient’s renal failure requires dialysis three times weekly, it’s a process that is hard on the heart.”

Properly balancing medications is not the only challenge. Dietary needs may conflict between heart and kidney treatment.

“Sodium is a huge factor in both cases,” Hess says. “Ideally, patients should not consume more than 2,000 mg of sodium daily. But too many are ingesting up to 3,000 mg or more. Patients tell us they don’t use table salt, but the sad truth is that there’s sodium in everything. Even those so-called ‘heart-healthy’ soups contain more sodium than is good. To get it right, people need to make everything from scratch, which is hard to do, when you’re feeling sick. And with poor appetites, patients often eat less than they should because it doesn’t seem to taste as good.”

While excessive fat in foods was once the major enemy nutritionists warned us about, their more recent hue and cry is to restrict high-glycemic, simple carbohydrates like refined sugar.

“High-glycemic carbohydrates can cause inflammation, which is especially detrimental to diabetic and heart disease patients,” Hess explains.

But the real balancing act begins when patients are prescribed blood thinners to help their hearts work easier and to reduce the risk of stroke because of the development of abnormal heart rhythm, says Hess.

“Now you have a patient with a diabetic diet, a heart disease diet, a kidney diet and restricted foods because they are taking blood thinners,” she says. “With blood thinners, patients are told not to eat green, leafy vegetables – exactly what they should be eating on a healthy diet plan. The best we can do sometimes is to tell them to eat restricted foods consistently so it is easier to maintain the blood thinner at a safe level.”

While the Heart and Vascular Center most often treats patients aged 60 to 90, it also sees heart disease patients as young as age 30 to 40.

“In this case, often the primary cause is family history and genetics,” Hess says. “You really can’t change that. And women are especially concerning because they present differently than men. Women need to be more aware of the ways a heart problem can present itself in order to have it treated as early as possible when it does occur.”

Lungs and Heart Health

Good lung function is also closely related to heart health and its impairment can spell trouble for the heart. The relationship of the heart and lungs during the exchange of oxygen is an interdependent one. The same habits and conditions that can harm lungs, especially smoking, can directly impact the heart.

When a person suffers from chronic obstructive pulmonary dysfunction (COPD), oxygen levels decline in the blood. That forces the heart to work harder to provide oxygen to the rest of the body. This can trigger chest pain in patients who have underlying coronary artery disease and can even provoke congestive heart failure.

This is why it’s so important for pulmonary patients to use inhalers and supplemental oxygen as prescribed, and to do everything possible to maintain both lung and heart health through good lifestyle choices.

Take the following basic advice from the CDC and your primary doctor:
• Lower your blood pressure and cholesterol to significantly reduce your risk of dying from heart disease.
• Follow your doctor’s instructions and take all of your medications consistently.
• Eat a healthy diet that is low in salt and saturated fats but loaded with fresh fruits and vegetables.
• Take a brisk 10-minute walk three times a day at least five days per week.
• Don’t smoke or abuse alcohol.

It doesn’t matter what your age is. The earlier you start treating your heart right, the better your chance of living a longer, healthier life.

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