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Editorial

Do Your Part to Protect Your Heart


02/01/2005 - Heart disease is the leading cause of death for the men and women of Wyoming. Much of the heart disease we see among patients is 'garden-variety' atherosclerosis, where coronary arteries that feed the heart become diseased, inflamed and narrowed. This leads to heart attacks, sudden death and poor pumping function of the heart. The disease process seems to be largely related to our lifestyle and to some extent our environment and our genes. In looking at who gets heart disease, we have identified 'risk factors' that put a person at a higher chance for developing coronary artery disease.

The current risk factors for developing coronary artery disease include:

Coronary artery disease in your immediate family

High blood pressure (greater than 130-135/80-85)

High cholesterol [especially high LDL or bad cholesterol or low HDL (good cholesterol)]

Smoking or a history of smoking

Diabetes or borderline diabetes (called metabolic syndrome or insulin resistance)

Lack of physical activity

Obesity

Age, typically over age 65

Males tend to develop coronary artery disease before females, but both genders suffer the effects.

Obviously a person cannot control heredity, age or gender. However, many proactive and reactive things can be done to prevent or delay heart disease.

An exercise program is invaluable in preventing, or at least greatly reducing the chances of developing coronary artery disease. Hard work and staying active helps, but a daily dose (30 minutes or more) of walking, jogging, swimming, bicycling or something aerobic seems to be where the real benefit lies.

Smoking is devastating on the coronary arteries, not to mention the rest of you. This probably extends to second-hand smoke as well. There are many free resources available in Casper to help with quitting.

Over time, guidelines have become increasingly strict on cholesterol and blood pressure control. Many patients tell me that their cholesterol or blood pressure is'normal' when our current studies tell us they are at an increased risk for heart disease. Ironically, being 'normal' for blood pressure and cholesterol may mean that you are too high.

It is important to know where your blood pressure runs, and if elevated, work with your family doctor to reduce it with diet, exercise, life-style and medications. Treating elevated blood pressure is definitely an 'ounce of prevention'.

In addition, get your cholesterol checked at your doctor's office or through a community health program such as the Health Fair. You should be able to tell someone your HDL or LDL values as quickly as you can tell them your phone number. Keeping with the theme, cholesterol responds well to diet and exercise, as well as excellent cholesterol medications that you and your family doctor can discuss.

We see a gloomy future for preventing heart disease as obesity and diabetes are both being labeled as exploding epidemics. The disease is being seen earlier and more frequently and tends to run with other potent risk factors for heart disease. This alarming trend can be traced back to too many calories and not enough physical activity. Unfortunately, this trend can be seen in our young children and teenagers. As physicians, we now see heart attacks in people in their 30 's.

Over the past several years, doctors have recognized an emerging disease known as metabolic syndrome. The definition I like best is, "if your belly goes into the room before you do", although the formal definition recognizes blood values, blood sugar, belt size and your blood pressure. The disease can be thought of as a precursor to diabetes and is a risk factor for heart disease. Ask your family doctor about metabolic syndrome at your next visit.

The irony is that as we become more sophisticated in treating the outcome of coronary artery disease, we are failing at addressing the causes. Simple lifestyle changes such as a daily walk, not smoking, achieving a healthy weight and controlling excess blood pressure and cholesterol, will prevent many people from developing coronary heart disease.

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