February is National Heart Month
Contrary to popular belief it is heart disease that kills most of us, not cancer. The pain associated with a heart attack is called angina. In men it is manifested as a heaviness or pressure in the chest, neck and jaw or left arm. Women many times experience only fatigue, shortness of breath, or a sense of doom. Men experience heart attacks at a younger age but are more likely to survive a heart attack because of their larger coronary arteries. We now have the tools and medications to largely prevent coronary artery disease.
Risk factors for heart disease:
Cigarette smoking, high blood pressure, high cholesterol, obesity, diabetes, family history of heart disease and inactivity all contribute to heart attack and stroke Mitigating these risk factors can help prevent cholesterol deposits in arteries and thereby prolong life and improve quality of life.
How to Prevent Heart Disease
See your doctor for a complete history and physical exam. Obtain blood tests for cholesterol and diabetes. Get your blood pressure checked. If high the first step is the DASH diet (Dietary Advances to Stop Hypertension). You can find this NIH website by putting DASH DIET in Google. This diet has been shown to lower blood pressure through the diuretic effect of more fruits and vegetables and less fat. If this does not work you doctor may wish to start a blood pressure medication with a goal of getting the blood pressure down to 120/80. Lowering you blood pressure will significantly reduce your risk of stroke and heart attack. In fact people with high blood pressure are 3 times more likely to die from a heart attack and 4 times more likely to die from a stroke. If you have diabetes or pre-diabetes you are more likely to have a heart attack and it is more likely to happen at a younger age. Weight loss alone can sometimes make the pre-diabetes or diabetes disappear. For weight loss especially with pre-diabetes or Type 2 diabetes, consider the following diets which tend to be low carb: Paleo diet, Miami Beach diet, or Protein and Produce diet. If reducing the carbs alone does not lower weight than you will need to start counting calories. Eat the Omega-3 fish twice a week (tuna, salmon, trout, herring, anchovies, halibut, or sardines). People eating higher amounts of these fish tend to have less heart disease. If considered safe by your doctor start exercising on a regular basis. Try to put in 10,000 steps per day.
Calculating your risk
The American Heart Association and American College of Cardiology have together put out a heart calculator which is available on the internet or can be downloaded to your phone as an app. Go to the App Store and download the ASCVD Suite. You will need to have your systolic blood pressure, the HDL cholesterol and the total cholesterol, and you must know if you are diabetic. Plugging these numbers in the app will give you your risk of having a heart attack in the next 10 years. If greater than 7.5% you are considered high risk for heart attack or stroke and need to be treated.
Taking it a step further
In my concierge practice of Internal Medicine I am very aggressive about preventing heart disease. Besides using the risk calculator, we will use a Doppler to obtain Ankle -Brachial indices to see if you have poor circulation to your feet. If positive this increases you risk for heart attack and stroke. We also may ask you to do an outpatient VASCULAR SCREEN which Christ Hospital will do for only $29. Depending on your particular health situation I may recommend a CT coronary Calcium Score at Proscan or a local hospital. This test costs $99 and reveals the amount of calcium in your coronary arteries. A high level of calcium indicates hardened cholesterol plaque which increases your risk for heart attack. If any one of these tests is abnormal it is recommended to take a cholesterol lowering medication.
If interested in this kind of prevention please contact us. My concierge practice allows enough time to spend on prevention of heart attack and stroke.
EXPERIENCE CONCIERGE MEDICINE AT ITS BEST WITH DAVID G. WILSON MD WHERE PREVENTION IS KEY. With concierge care at David G. Wilson, MD, we can keep you in the loop with vaccines and other important happenings for your health. Care with us is personalized, so that we keep you in mind with new medical developments. Contact us to set up an appointment (same or next day) at (513) 232-6900.
David G. Wilson MD, Board Certified Internal Medicine