The Director of Mount Sinai Heart, Dr. Valentin Fuster is a cardiologist with four decades of experience. This column is first in a series for American Heart Month.
WHO’S AT RISK
The drugstores are brimming with heart-shaped chocolate boxes, but February is also American Heart Month — a good time for stepping back to assess what you can do to keep your heart healthy. “Cardiovascular disease is a term for diseases of the heart as well as of the arteries and veins that supply the organs with blood,” says Fuster. “Overall, cardiovascular disease is an acquired disease that results from factors like high blood pressure and cigarette smoking — which means that it’s also largely preventable.”
While genetics do play a role in every aspect of heart disease, the vast majority of cases are due to risk factors that respond to lifestyle modifications. “There are six fundamental risk factors: high blood pressure and obesity, cholesterol and diabetes, and being a smoker and being sedentary,” says Fuster. “We break these down into categories: mechanical, chemical, and behavioral risk factors.”
Three major shifts are happening in the way doctors think about heart health. “We’re trying to shift the emphasis from negative to positive, from preventing disease to promoting health — not only is treatment much more expensive, but promoting health helps people live longer and enjoy a better quality of life,” says Fuster. “The other things that are changing are a movement toward recognizing that the heart and the brain respond to the same risk factors, and an increasing use of the technologies of imaging and genetics to reduce cardiovascular disease.”
SIGNS AND SYMPTOMS
One of the reasons that cardiovascular disease can be so dangerous is that it can develop silently. “Often, there are no visible warning signs of the risk factors that contribute to cardiovascular disease,” says Fuster. “You don’t see high cholesterol, you don’t see high blood pressure — which is one of the reasons that we still recommend annual checkups. Because routine health screening can detect asymptomatic conditions like high blood pressure or cholesterol.”
For many people, the first red flag is a major cardiac event. “Some people have no symptoms until a heart attack, stroke, or cardiac arrest,” says Fuster. “These are the three most important events that can take place, and they can be fatal — which is one of the reasons that we want to identify patients at risk instead of waiting for symptoms.”
Some patients do experience symptoms . “Cardiovascular disease can affect your quality of life, causing shortness of breath and chest pain with exertion,” says Fuster. “Patients who have had a stroke can have one part of the body paralyzed or partially paralyzed.”
Identifying and treating the risk factors is a crucial first step toward promoting heart health. “The first thing we do is try to address the risk factors,” says Fuster. “This can entail lifestyle modifications and possibly medications.”
There are some basic principles of living a heart healthy lifestyle. “One thing everyone has to do is some moderate exercise, 3-5 days a week, 30 minutes a day,” says Fuster. “If you’re a smoker, you know exactly what you have to do: quit. I recommend leaving home with one cigarette less in your pocket and cutting back slowly over time.” He recommends a similar approach with weight loss, and advises patients to aim for one pound a week.
The good news is that treatments are available for just about everything that can go wrong with the heart. “If you have had a heart attack, we have drugs that can make the heart work better,” says Fuster. “If one of the valves of the heart is leaking, we have surgery for that.”
There’s no one-size-fits-all approach for heart health. “Every patient is different, and the patient has to know that his or her case is individual,” says Fuster. “When it comes to making lifestyle modifications, it’s a personal decision, and it’s not easy. It takes commitment to make these changes.”
Read the full article via February is American Heart Month – NY Daily News.