Being Smart about your Heart
By Lynn Swisher, MD, FACC
February is national Heart Month,
the goal of which is to draw attention to the prevalence of cardiovascular
disease in this country. By learning
more about the causes of heart disease, our personal risk factors for
developing it, and measures we can take to prevent it, we can have a positive
impact on the nation’s number one cause of death.
What are the risk factors for heart
In all honesty, we don’t yet know all of the risk factors for heart
disease; however, we have identified many of them including diabetes, high
blood pressure, high cholesterol, obesity, smoking, underlying inflammatory
disorders, and an early family history of heart disease.
The more risk factors you have, the
higher your risk for cardiovascular disease. However, if you identify your risk
factors at an early age and work with your doctor to modify or resolve them,
you can decrease or delay the risk of developing heart disease. By way of
example, studies show that when high blood pressure is treated, it does not
have the same ramifications for heart disease as untreated high blood pressure.
Studies also show that people with
known coronary disease who effectively lower their cholesterol have fewer
cardiac events than those who don’t lower their cholesterol.
What role does diabetes play in
developing heart disease?
The data show that diabetes is the
biggest single risk factor for heart disease due largely to the fact that
people with diabetes eventually develop blood vessel disease in both large and
small vessels. Diabetes is one of the very worst promoters of atherosclerosis
(plaque build-up in the arteries). On a positive note, research also shows that
if you are “pre-diabetic” you may be able to avoid getting diabetes with diet,
exercise, and weight control.
What is the link between obesity
and heart disease?
The obesity epidemic is going to
increase the prevalence of heart disease in this country. Pediatric
obesity will likely result in patients developing heart disease and diabetes at
an earlier age. Educating our children about healthy choices and setting
a good example are absolutely crucial to their long-term wellbeing. Moreover,
as adults, we can modify our own unhealthy habits to improve our quality of
life and extend our longevity. Being overweight is also associated metabolic
What is metabolic syndrome?
When an individual has slightly
raised values without any overt medical problems, they have metabolic syndrome.
This occurs when a person is moderately overweight and has slightly elevated
blood pressure, blood sugar, and cholesterol. Although no single indicator is
drastically out of line, everything is a little higher than it should be.
Studies show that with metabolic syndrome plaque is developing in the arteries
prematurely and this increases risks for heart attack and stroke. Metabolic
syndrome can be turned around with lifestyle changes in diet and activity, and
for some people medication may be indicated.
What is the role of inflammatory disease?
The impact of inflammatory disease
is more difficult to isolate. The inflammatory process can be set off by
infections and certain inflammatory disorders. There is significant research
being done on the relationship between inflammation and cardiovascular disease:
while there is a correlation between inflammation and an increased risk of
heart disease, at this point we don’t have a lot of answers.
New approaches to heart disease
Historically, coronary disease and
vascular disease have been treated as related, but separate, problems. However,
research suggests that heart problems develop from a systemic disease, and
future approaches to treatment may have us looking at more systemic solutions
rather than just treating the different components as we do today. There is no
question that the surest way to avoid cardiovascular disease is primary
Swisher is board certified in cardiovascular disease and is a Fellow of the
American College of Cardiology. She is a member of the medical staff of Cayuga
Medical Center and is in practice with Ithaca Cardiology Associates, where she
can be reached at (607) 272-0460. Dr. Swisher will talk about Lifestyles for a
Healthy Heart at the Get Heart Smart Health Fair.