|by Michelle Meadows
Sixty-two-year-old Jack Andre says having a heart attack in March 2003 was like getting hit in the head with a baseball bat. "It brought a lot of things to my attention that I never thought about before," he says. He was overweight, didn't exercise, and often ate high-fat foods. But he never connected his lifestyle to his heart.
"Six months before the heart attack, my doctor told me I had borderline high cholesterol and high blood pressure," says Andre, of Rockville, Md. "But I didn't think much of it."
That all changed after he experienced heart attack symptoms--extreme fatigue, dizziness, and back pain. Tests revealed that Andre had three clogged coronary arteries. "Now I walk every day at lunch, eat smaller portions, and I'm a food label reader," he says.
Bonnie Brown, 50, of Baltimore, says she also didn't change her life until she had a heart attack in 1997. "I used to smoke, ate cold-cut subs for breakfast, and had lots of fried foods, all the time, any time," Brown says. But her heart attack--which she initially mistook for a bad case of indigestion--led her to give up cigarettes, improve her diet, and sign up for weekly water aerobics and line dancing classes.
"There's nothing that motivates people like having a heart attack or bypass surgery," says Christopher Cates, M.D., director of vascular intervention at the Emory Heart Center in Atlanta. "I've found that people think that heart disease always happens to someone else, until it happens to them." Experts say that until Americans change their way of thinking from one of damage control to one of proactive prevention, heart disease will remain the No.1 killer of men and women in the United States.
"In many ways, I think we've become insulated by high-tech care," Cates says. "As physicians, we are partners in the health care of our patients, which means we need to educate them about their risk factors for heart disease. And they need to have some sense of ownership about what they can control. They can't simply look to their doctors or to the FDA or to Medicine, and say, 'Cure me, but I'm going to eat fatty foods, smoke, and be sedentary.'"
One of the reasons that some people may shrug off the possibility of developing heart disease is that it's a gradual, lifelong process that people can't see or feel. About the size of a fist, the heart muscle relies on oxygen and nutrients to continually pump blood through the circulatory system. In coronary artery disease, the most common type of heart disease, plaque builds up in the coronary arteries, the vessels that bring oxygen and nutrients to the heart muscle. As the walls of the arteries get clogged, the space through which blood flows narrows. This decreases or cuts off the supply of oxygen and nutrients, which can result in chest pain or a heart attack. Damage can result when the supply is cut off for more than a few minutes. It's called a heart attack when prolonged chest pain or symptoms (20 minutes or more) are associated with permanent damage to the heart muscle.
Every year, more than 1 million people have heart attacks, according to the National Heart, Lung, and Blood Institute (NHLBI). About 13 million Americans have coronary heart disease, and about half a million people die from it each year.
What's Your Risk Profile?
Risk factors for heart disease are typically labeled "uncontrollable" or "controllable." The main uncontrollable risk factors are age, gender, and a family history of heart disease, especially at an early age.
The risk of heart disease rises as people age, and men tend to develop it earlier. Specifically, men ages 45 and older are at increased risk of heart disease, while women 55 and older are at increased risk. A woman's natural hormones give some level of protection from heart disease before menopause.
"Heart disease presents in women an average of seven to 10 years later than in men," says Patrice Desvigne-Nickens, M.D., leader of cardiovascular medicine at the NHLBI. "But after menopause, women develop heart disease as often as men, and women who have a heart attack don't fare as well as men." Women are more likely than men to die from a heart attack.
Though heart disease is the leading cause of death for both men and women in this country, surveys have shown that many women don't know it, and that they are more worried about cancer, especially breast cancer. "We want women to know that heart disease is not a man's disease. Rather, heart disease is the leading cause of death for women, and heart disease is preventable and treatable," says Desvigne-Nickens.
The NHLBI defines having a family history of early heart disease this way: A father or brother who had heart disease before 55, or a mother or sister who had heart disease before 65. Be sure to tell your doctor if any of your family members have had heart disease. Andre says it was only after he had a heart attack that he learned that he had four uncles who had been diagnosed with coronary artery disease.
Even if you have uncontrollable risk factors for heart disease, it doesn't mean that you can't take steps to limit your risk. Researchers say that controllable risk factors--physical inactivity, smoking, overweight or obesity, high blood pressure, high blood cholesterol, and diabetes--are all major influences on the development and severity of heart disease.
According to Cynthia Tracy, M.D., chief of cardiology at Georgetown University Hospital in Washington, D.C., the best way to combat heart disease is to know the risk factors, "own" the risk factors that apply to you, and address the ones that are controllable. "I think many people can rattle off risk factors, but then they don't internalize them to say: 'That's a risk factor for me. I am at risk for heart disease. And now I'm going to do something about it,'" Tracy says.
For more information read Taking Charge of Your Health
Courtesy of the US Food and Drug Administration
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