Heart Disease and Who's at Risk
For the past two years, COVID-19 has drastically changed the way Americans live, work and play. About 41% of us missed health care appointments, 37% of us gained weight and 8% didn’t pick up needed medications at least once during the pandemic. For many, there was a decline in activity and an increase in stress and unhealthy behaviors like drinking alcohol.
“The pandemic has created the perfect environment for a surge in heart disease,” says Dr. Yogesh Tejpal. The board-certified cardiologist with Premier Suburban Medical Group says, “February is the 57th anniversary of American Heart Month. Because of COVID-19, this month, with all its information, messaging and reminders, is more important than ever.”
Heart disease is still the leading cause of death worldwide for both men and women. About 50% of Americans have hypertension or high blood pressure, but only about 25% of them have it under control. “Heart disease isn’t just one thing,” says Dr. Tejpal. “Heart disease encompasses a variety of conditions which affect the heart.”
What is Heart Disease?
“These conditions include congenital heart disease and birth defects,” Dr. Tejpal continues. “A build-up of plaque - cholesterol, fats and other substances - block arteries and cause atherosclerosis. Arteriosclerosis happens when arteries harden and narrow, which reduces circulation of blood throughout the body. An irregular heartbeat, or a racing or “skipping” heart, could be arrhythmia, caused by problems with the electrical impulses in your heart. Atrial fibrillation is a type of arrhythmia, when your heart’s atria, the upper chambers, are out of sync with the ventricles, the lower chambers.”
Matthew Wilkins, licensed Physician Assistant working with Dr. Tejpal, says “Heart disease can also be an infection of the heart or a disease of the heart like cardiomyopathy. This enlarges the chambers of the heart, making it more difficult for the organ to pump, leading to heart failure. Heart disease also includes valve disease, when one or more of the valves within the heart fails to open or close properly, interfering with healthy blood flow.”
Who’s At Risk For Heart Disease
Dr. Tejpal explained that both genetic and lifestyle factors contribute to an elevated risk of heart disease. “Smoking and the use of tobacco products cause your body to create plaque, which o obstruct arteries. It also causes your arteries and veins to narrow, and blood to thicken, forming clots.”
While a glass of red wine can have benefits for those at risk of heart disease, thanks to antioxidants and its tendency to raise levels of “good” or HDL cholesterol, excessive drinking will raise the risk of heart disease, says Dr. Tejpal. “We see a strong link between excessive drinking and the development of cardiomyopathy. It also contributes to high blood pressure and heart failure.
“Diabetes is another significant risk factor,” says Nancy Melde, Nurse Practitioner and assistant to Dr. Tejpal. “High blood sugar damages your blood vessels. High blood pressure, another major risk factor, indicates your blood is pushing harder against the walls of your arteries, which damages them over time.”
Wilkins adds, “Overweight and obesity raises your cholesterol levels, which then increases the likelihood that you’ll develop atherosclerosis. It also causes high blood pressure, as your heart has to work harder to pump blood around your body. And like a dangerous loop, obesity raises your risk of diabetes, which in turn damages your blood vessels and heart.”
A family history of high blood pressure and heart disease will raise a patient’s risk, often regardless of their lifestyle choices. Having an autoimmune disease, such as rheumatoid arthritis, also raises the risk of heart disease.
Dr. Tejpal notes, “Many heart disease patients are in good physical condition, active and always at a healthy weight. They don’t smoke or drink to excess and they eat a healthy diet. That’s why regular screenings are so important.”
Women and Heart Disease
Even after years of celebrating Wear Red for Women Day, many women still believe heart disease is “a guy thing.”
“In reality, heart disease kills women at eight times the rate that breast cancer does,” says Melde. “There are significant factors that raise women’s risk. Many diseases that affect women, like endometriosis, gestational diabetes, preeclampsia, and polycystic ovary disease, will also increase the risk of coronary artery disease. After menopause, many women see an increase in hypertension due to declining estrogen levels.”
Women’s hearts are also different than men’s. It’s usually smaller overall, with thinner walls between the chambers. It pumps faster but moves about 10% less blood with each pulse. Many women don’t recognize their own risk factors, which Wilkins says becomes a risk factor in and of itself.
Tejpal says, “Women unfortunately are less inclined to recognize their symptoms when having a heart attack. They may ignore pain or discomfort in their shoulders or upper back, in their neck, jaw or abdomen. They may feel short of breath or just be incredibly tired. Even heartburn can be a symptom of heart attack in women. Because women often delay or put off care until they are at a real crisis point, they tend to stay longer in the hospital, recover more slowly and are more likely to die of heart disease.”
Screenings for Heart Disease
Getting regular screenings at your annual health and wellness review with your primary care doctor is the very best way to identify and manage any heart disease risk, says Dr. Tejpal. “One of the most effective screenings is a simple, non-invasive blood pressure reading. In fact, you should begin this screening in childhood, and then measure it about every two years after you turn 18. When you turn 40, you should have it measured yearly.”
Wilkins adds, “Every four to six years, get bloodwork done at your appointment. Your doctor should be looking at cholesterol levels by the time you turn 20, and especially if you have a family history of heart disease. Even if you have no symptoms, around the age of 45, your doctor should be screening for Type 2 diabetes as well, about every three years.”
When you do have a family history of heart disease, Melde notes that a calcium-score screening heart test, or a coronary calcium scan, is a good idea. “This test looks for calcium deposits in your coronary arteries, which raise your risk of a heart attack.”
Preventing Heart Disease
“The methods to prevent heart disease are the same methods to relieving and controlling it once diagnosed,” says Dr. Tejpal. “You will want to quit smoking immediately. Cut back on alcohol intake. Set a goal of achieving and maintaining a healthy weight by eating a diet heavy on vegetables, fruits, whole grains and lean proteins. Avoid fried foods, heavily processed foods like snacks and sugary drinks.”
“Make sure to take prescribed medications as directed,” says Melde. “This helps control your blood pressure, lower your cholesterol levels and control your blood sugar.”
Exercise and activity is also vital, says Wilkins. “Work your way up to 30 minutes of exercise five days a week, making sure you get to the point where it’s a little difficult to talk while moving.”
Heart disease isn’t just a stabbing pain in the chest. “Watch for symptoms that may present slowly,” says Dr. Tejpal. He says patients should seek emergency are when they have:
- Chest pain, pressure or a squeezing feeling that lasts for a few minutes, or worsens
- Shortness of breath
- Pain, numbness, tingling, coldness or cramping in the shoulders, neck, arms, legs or jaw
- Sweating, paleness, cool or clammy skin
- Weakness or fatigue
- Changes in heart beat; rapid, skipping or irregular
- Chest pain with nausea or vomiting, dizziness or fainting
- Swelling in hands, legs, ankles or feet
“Don’t wait if you experience these symptoms. Call an ambulance,” says Dr. Tejpal. “Your EMT or Emergency Department care providers will never think you’ve “wasted their time” if it turns out that everything is okay. Don’t hesitate.”
Dr. Tejpal says, “This February, read all you can about heart disease and do what you can to prevent it. Talk with your primary care doctor and make an appointment with a cardiologist when you have risk factors. With prevention, screening, and leading edge care, you should be able to prevent or control heart disease for a healthy, active life.”