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How’s Your Heart?

Maybe it’s the countless images of hearts everywhere I turn during this Valentine’s Day season, but it seems we should talk a little about protecting our hearts. If we were living in the U.S. in 1900, the top three causes of death would all be infectious diseases: flu and pneumonia (lumped together), tuberculosis, and gastrointestinal infections. And I probably wouldn’t be writing this article since the average life expectancy for men was 46 years old.

With the introduction of vaccinations, antibiotics, and overall better nutrition and sanitation, these infectious causes have retreated substantially. In their place, and reigning as the number one cause of death for many decades, is heart disease. It currently causes almost three out of every ten deaths.

One of the major forms of heart disease is coronary artery disease (CAD), in which the arteries supplying the muscle of the heart become blocked. When that happens, the oxygen- starved muscle generally hurts, causing a kind of chest pain we call angina. If the coronary artery is completely blocked, the part of the heart muscle it supplies dies. This is what’s going on in a heart attack (medically termed a myocardial [heart muscle] infarction [tissue death due to blocked blood supply]).

The stuff that blocks arteries is called plaque. Risk factors for plaque, and thus for heart attacks (as well as the strokes which happen by a similar process) are:

  • Smoking
  • High blood pressure
  • High cholesterol
  • Diabetes
  • Overweight
  • Physical inactivity
  • Having a family history of early heart disease
  • Increasing age

As you can see, several of these risk factors are manageable. One of the problems with prevention is that CAD is often a silent process until critical blockage occurs. Of course knowing the risk factors and working to combat lifestyle issues such as lack of exercise, overweight, smoking, and even diabetes is huge when it comes to prevention. In addition rather simple tests such as coronary calcium scores (a fairly inexpensive low dose cat scan picture of the arteries around the heart) can give further information about plaque on the coronary arteries. It’s not a perfect test, but it correlates pretty well with risk for future heart attacks or angina.

So as Valentine’s Day 2014 recedes into the past, as you ponder the status of your emotional heart, give your physical heart a little thought as well. If you have some reversible risk factors, go after them this year. And if you really don’t know the status of your cholesterol, blood sugar, or blood pressure, get them checked out. Also, see if your doctor recommends a coronary calcium score or other testing to further assess the status of your heart. All-in-all, it’s better to be aggressive with prevention now than with stents and bypasses later.

Andrew Smith, MD is board-certified in Family Medicine and practices at 1503 East Lamar Alexander Parkway, Maryville. Contact him at 982-0835

 

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