Monday, October 1, 2012

Let's stop heart disease!

By Andrew P. Miller, M.D., FACC, FAHA, FASH
Cardiovascular Associates
3980 Colonnade Parkway
Birmingham, Alabama 35242
Office (205) 510-5000

From a study done across the world, 90% of your risk for a heart attack can be determined by a simple clinic visit and inventorying 6 common risk factors.
These are:

1.     Physical inactivity. Everyone should get 30 minutes of aerobic or symptom-limited activity 5 days a week or 150 minutes per week. If formal exercise is difficult, a pedometer can guage your activity level. The American Heart Association suggests 10,000 steps per day.

2.       Overweight/obesity. You should know where you stand with body mass index. This is your body weight divided by surface are of skin. The correct ratio is 25 or less. A body mass index over 30 qualifies as obese. It is predicted that in Alabama in 2030, 62% of our population will be obese. If you are in this category, a formal dietary intervention is worthwhile (such as weight watchers).

3.     Tobacco use. If you smoke or are around second-hand smoke then you are depleting your heart artery reserves and battering the artery walls with a risk factor that is most likely to take the young, productive members of this world from us. It is important to set a quit date. The number one indicator of whether you will quit is how many times you have tried. You must get smoking out of your environment. Then set a date that is at least 7 days away and not further than a month away and do your best. If you slip, you will have the experience of temporary success and it will be easier next time. Keep working on it.

4.         Hypertension. The ideal blood pressure is 115/75. For every 20 points on top and 10 points on bottom that you go up, your risk of stroke (and heart attack and death) is doubled. When you are over 50, it is the top number that is most important. So, when your blood pressure is 195 on top, your risk of stroke is 16-fold higher. The average number of pills it takes to control blood pressure in the US is 3.2. So, it might take some work, but simple medication for blood pressure might be the most important intervention we have to improve cardiovascular health in Alabama. You should have your blood pressure checked and get it controlled.

5.     High cholesterol. You should have yours tested and often treated with medications if it is high and you have other risk factors on this list or have had a prior heart attack or stroke.

6.     Diabetes. A fasting blood sugar can give you a good guage of your risk for it and diagnose it. Treating it is valuable for preventing heart attack, blindness, and the need for dialysis.

Each of these risk factors doubles or triples your risk for a heart attack. Unfortunately, together they are more potent at causing havoc, such that 3 wrong makes your risk 13-fold higher and 4 wrong makes your risk 42-fold higher.

It really takes a comprehensive strategy for inventorying and then controlling each of these risk factors to prevent heart disease and stroke, and keep you functionally able and independent for as long as possible.

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