Medical Minute
By Alan M. Blaker, MD, FACC, FACP
Heart disease can mean many different problems, such as blockages in the arteries, congestive heart failure, arrhythmias, and valvular disease. When most people think of heart disease, however, they are generally thinking about blockage buildup in the arteries of the heart. The best way to prevent this type of heart disease is by avoiding or treating those risk factors which we know can lead to artery disease. That would include the avoidance of tobacco and close follow up with treatment for hypertension, diabetes, elevated cholesterol, and triglycerides. Those individuals with a family history of early heart disease are at particularly increased risk and since we can't change our family history then it is most important to modify those other risk factors.
What are the warning signs for heart disease?
Warning signs for coronary artery disease would include symptoms such as tiring much easier than usual, the development of shortness of breath more than usual, or the more typical symptoms of chest pressure or chest tightness related to activity. It is interesting that women may have somewhat different symptoms than men as warning signs for heart disease. Signs in women tend to be more atypical and not the usual type of chest pressure or chest tightness that men more frequently have. Women may have more symptoms related to their neck, back, or shoulder. I think it is important to point out that although we frequently ask about chest pain, the symptoms associated with coronary artery disease are not typically a sharp, stabbing type pain but rather a dull pressure or tightness sometimes radiating to the arm, neck or back and associated with shortness of breath and sweating.
Why do nutrition and exercise play such a big part in the prevention of heart disease?
Nutrition and exercise play a large role in the prevention of heart disease predominately by lowering cholesterol and triglycerides to avoid the buildup of plaque in the arteries of the heart and reduce the opportunity for rupture of a plaque, which could lead to heart attack and death.
What are some tips in having a heart-healthy lifestyle?
A heart-healthy lifestyle would generally be considered to be regular exercise and a low fat, low cholesterol diet. For those over the age of 40, we usually recommend a daily dose of aspirin to help in the prevention of heart attack. Regular exercise should include a cardiovascular form of exercise such as walking, running or bicycle exercise approximately 30 minutes a day. It is important to maintain contact with your primary care physician for a follow up of your blood pressure, blood sugar, cholesterol, and triglyceride levels and to avoid the use of any type of tobacco. I would suggest less fatty foods such as chicken and fish in your diet rather than beef everyday. Also, avoid fried foods whenever possible. For those overweight, it would be helpful to begin a supervised weight loss program in combination with an exercise program.
If the warning signs are not obvious, how can you prevent future heart trouble?
In the Pee Dee area, heart disease and deaths related to heart disease or stroke are unfortunately very common. Over 43 percent of all deaths have been attributed to either heart disease or stroke. In South Carolina, more than one in four residents suffer from some form of heart disease. The best way to prevent future heart trouble is a heart healthy lifestyle with the avoidance of obesity in combination with regular cardiovascular exercise and a low fat low cholesterol diet. Aspirin has been shown to prevent heart attacks, taking 81 milligrams to 162 milligrams per day unless you are allergic to aspirin or have been told to avoid aspirin for other reasons. For those with diabetes, it is very important to maintain a normal blood sugar with regular follow up with by your primary care physician and control any elevated blood pressure problems with regular follow up for that as well. It is also important to seek medical attention at the earliest signs of heart disease such as chest discomfort, shortness of breath, or limited exercise tolerance.
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