HEALTH ON TIME Cardiac - Spring 2015

cardiac

HEALTH ON TIME

TM

SPRING 2015

it’s your move!

PHYSICAL ACTIVITY PROTECTS YOUR HEART AND REDUCES ADDITIONAL RISK FACTORS FOR CARDIOVASCULAR DISEASE K E E P T H E B E AT Your heart rate, aka your pulse, means the number of times your heart beats in one minute. An adult’s resting heart rate, which is measured when you’ve been sitting still for about 20 minutes, ranges between 60 to 100 beats per minute. Active people tend to have a lower resting heart rate. The heart muscle is not working as hard to maintain a steady beat, and that indicates good cardiovascular fitness.

A higher resting heart rate suggests it’s time to check in with your primary care physician and discuss expanding your exercise routine.

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our heart is a muscular organ at the center of your circulatory system, which consists of a network of blood vessels that includes arteries, veins, and capillaries. It’s the heart’s job to pump blood through these vessels, to and from all areas of your body. For a muscle that

Heart disease and stroke are two of the leading causes of death in the United States. But getting at least 150 minutes a week (2 1/2 hours) of moderate-intensity aerobic activity can help lower your risk for these diseases. is barely bigger than your fist, its task is no small matter. Each day, your heart beats roughly 100,000 times, pumping 1 to 7 gallons of blood a minute, and as much as 2,000 gallons a day. Over the course of the average lifetime, the heart will pump roughly 1 million barrels of blood.

It’s imperative that this process keeps moving, since your blood carries essential oxygen and nutrients to your organs and carries carbon dioxide (a waste product) to your lungs so you can breathe it out. A healthy heart pumps just the right amount of blood needed to keep the circulatory system in tip-top working order.

Like any muscle, the heart grows stronger, slightly larger, and more efficient with regular exercise. A healthier heart ultimately benefits your blood pressure, blood lipid levels, blood glucose levels, blood clotting factors, blood vessel health, and inflammation — all factors that are tightly linked to cardiovascular disease.

However, you can’t strap a 5-lb. weight to your ticker and do repetitive heart-lifts. The way to give your heart a good workout is by performing physical activities that require more oxygen than when you are sitting still or slowly strolling. In response to your body’s increased need for oxygen, your heart must pump harder and faster. It’s exercising!

If you remain committed to an exercise program, your resting heart rate should decrease.

new cardio center to open on GRU Health Sciences Campus

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RHealth’s Heart and Cardiovascular Services will open a new center on campus May 18. The Cardiovascular Center 15th Street is located at 937 15th Street, Augusta, Georgia, 30912 — the site of the former sports medicine center.

There are two ways to measure your heart rate: lace your index and third fingers on your neck to nP the side of your windpipe. lace two fingers between the bone and tendon nP over your wrist’s radial artery, located on the thumb side.

Once you feel your pulse, count the number of beats in 15 seconds and multiply this number by four to calculate your beats per minute.

That’s because your heart is now strong enough to pump more blood through your body with less effort and fewer beats. You’ve now successfully lessened the heart’s workload but without decreasing its performance.

For more information,

go to grhealth.org/cardio, or call 706-721-2426.

All three of GRHealth’s Heart & Cardiovascular Services’ locations are within close proximity to each other. From left to right: Cardiovascular Center Chafee Avenue, Cardiovascular Center 15th Street, and the medical center.

The center will house general cardiology, interventional cardiology, cardiac rehabilitation, and an outpatient echocardiography lab. All services will be available beginning May 18, except for cardiac rehabilitation, which will be available June 1.

The center will offer state-of-theart cardiac rehabilitation monitoring equipment and on-site cardiology diagnostic testing, in addition to convenient parking and close proximity to hospital-based services.

GRHealth’s Heart and Cardiovascular Services will continue to accept patients at its two other locations, which include the following with their corresponding services:

nC ardiovascular Center Chafee Avenue —

1003 Chafee Avenue: – Cardiothoracic surgery and vascular surgery pre- and post-operation appointments –Electrophysiology –Outpatient vascular lab nM edical center — 1120 15th Street: Inpatient procedures, including catheterization, echocardiography, electrophysiology, and surgery

For more information, visit grhealth.org/cardio.

GRU-016

Georgia Regents University 1120 15th St., AD 1114 Augusta, GA 30912

NONPROFIT U.S. POSTAGE PAID GEORGIA REGENTS UNIVERSITY

take action against

let’s get physical

heart disease

EXERCISE STRENGTHENS YOUR HEART AND IMPROVES BLOOD FLOW

BY DECREASING THE HEART’S WORKLOAD Your heart is a muscle, and, just like your glutes and abs, physical activity keeps it fit and strong, allowing this mighty muscle to do its job more efficiently. Physical exercise — particularly aerobic exercise that speeds up your heart rate — increases blood flow and blood volume in and out of the heart.

If the heart routinely receives increased blood volume, it adapts and slightly enlarges, which allows the heart to take in and pump out more blood per beat but with less effort. Research suggests that this benefit may reduce your risk for heart disease by nearly 50 percent. Studies further suggest that physical exercise helps to reduce the likelihood of developing major cardiovascular risk factors, such as high blood pressure, overweight/obesity, high LDL (bad) cholesterol, and diabetes.

Exercise is also a key element in cardiac rehab programs. A trained clinician works with the patient and primary health care provider to create a safe exercise routine that is well-suited to the patient’s fitness level, heart health, and physical limitations. With time and commitment, most cardiac rehab programs gradually increase the exercise program’s intensity and duration.

The good news is that it’s never too late to start exercising, and you don’t need to be an athlete.

According to the American Heart Association, a brisk walk counts. In fact, studies show that, for every hour spent walking briskly, life expectancy for some people may increase by two hours.

exercise your options

PUMP IT UP

aortic valve

pulmonary valve

Physical activity is not a one-size-fits-all story. How much and how often you get up and get going has a lot to do with personal preferences, time, age, general health, and always your physician’s input. With that in mind, the American Heart Association recommends a range of options to help to achieve overall cardiovascular health: At least 30 minutes of moderateintensity aerobic activity at least five days per week for a total of 150 minutes.

Examples of moderate-intensity activity include: n W alking briskly (3 miles per hour or faster, but not race-walking) n Water aerobics n B icycling slower than 10 miles per hour n Tennis (doubles) n Ballroom dancing n General gardening

mitral valve

tricuspid valve There are FOUR VALVES in the human heart, which ensure that blood only goes one way — either in or out of the heart’s four chambers. Regular heart-healthy workouts help to ensure that each valve has the strength to open all the way, allowing the right amount of blood to pass through a chamber and close tightly, so no blood leaks back into a chamber.

OR At least 25 minutes of vigorous aerobic activity at least three days per week for a total of 75 minutes. Following the same time frame, you can also try a combination of moderate- and vigorous-intensity aerobic activity.

Examples of vigorous activity include: n R ace walking, jogging, or running n S wimming laps n T ennis (singles) n A erobic dancing n B icycling 10 miles per hour or faster n J umping rope n H eavy gardening (continuous digging or hoeing) n H iking uphill or with a heavy backpack

oxygen-rich blood enters the heart from the lungs and goes out to the body

oxygen-poor blood enters the heart from the body and goes out to the lungs

To appreciate how exercise impacts the heart, start with the muscle’s primary function: to pump blood in and out of the lungs and through the body — and what a job! This small muscle beats on average about 100,000 times a day, 37 million beats per year, and 3 billion beats in an average lifetime.

Valves inside the heart open and close, which control how much blood is pumped into and out of the heart.

A physically fit heart does all this more efficiently. It helps to control blood pressure and improve blood flow to the small blood vessels surrounding your heart, which may prevent clogged arteries that can lead to heart attack. Evidence suggests that exercise helps your body to create more branches and connections between these small blood vessels, so, if an artery becomes narrowed or clogged, there are alternate routes for your blood to travel.

from heart attack to comeback Mel entered GRHealth’s Heart and Cardiovascular Services when he suffered from a heart attack in 1993. In 1997, he underwent stenting followed by triple-bypass surgery.

With the help of cardiac rehabilitation, he has been able to continue to live a physically active lifestyle full of walking and exercising at the gym, including practicing yoga. Since restoring his health and fitness, Mel has served as a patient advisor. Patient advisors meet routinely to discuss ways to improve the patient experience and shape the services provided at GRHealth.

make the move If a gym membership doesn’t fit your lifestyle, budget, or personal preferences, there are ample heart-smart activities to get the blood pumping.

Hot Dog! Skip shooing the pooch into your fenced-in back yard.

Instead, take your best friend for a brisk walk.

Child’s Play. Rather than sitting on a park bench and watching your little one play, take the tot for a buggy ride to explore the neighborhood.

Set Up Shop. When bad weather strikes, head to your favorite mall and window shop in a climatecontrolled environment as you briskly walk the mall’s perimeter.

Watch Out. Tune into your favorite TV show and walk or jog in place. Grab your resistance bands and knock out those muscle-strengthening activities.

Go the Distance. Rather than circling the parking lot for the closest spot, park as far as you can from the store’s front door.

Step It Up. Watch your heart rate climb when you take the stairs instead of the elevator.

Dream Big. If you’ve always wanted to take dancing lessons or learn to play tennis, do it!

AND Along with your moderate or high-intensity exercise routine, you should also include moderate- to high-intensity musclestrengthening activity at least two days per week for additional health benefits.

These activities increase skeletal muscle strength, power, endurance, and mass. Examples include: n P ush-ups n S it-ups n Lunges n S quats n L ifting weights n W orking with resistance bands

Keeping your heart fit — how much do you know?

1. T rue or False? A heart-healthy exercise plan requires 90 minutes every day.

2. A healthy resting heart rate is: A. Between 60 and 100 beats per minute.

B. Between 100 and 150 beats per minute.

C. Between 25 and 50 beats per minute.

IN ADDITION

6.5 percent

1. T o lower high blood pressure and high LDL cholesterol numbers, the American Heart Association recommends increasing physical activity to an average of 40 minutes of moderate- to vigorous-intensity aerobic activity three or four times per week.

2. R emember, if time is short, you can still achieve heart-healthy benefits if you divide your exercise time into two or three 10- to 15-minute segments a day.

Bottom line? There are no more excuses.

rue or False? You don’t have to train 3. T like a marathon runner to strengthen your heart.

of Americans meet the minimum physical guideline requirements.

rue or False? Only those who need 4. T to lose weight should worry about staying physically fit.

5. A pproximately what percentage of Americans exercise at least 30 minutes daily?

A. Less than 30 percent B. Less than 5 percent C. About 50 percent

On average, Americans sit

11 hours per day.

6. W here does “physical inactivity” fall on the list of risk factors for cardiovascular disease?

A. First B. Fifth C. Fourth 7. S taying physically active helps you: A. Strengthen your heart muscle.

B. Lower high blood pressure.

C. Lose weight.

D. All of the above

1. False: At least 30 minutes or three 10-minute sessions throughout the day does the job. 2. A. Between 60 and 100 beats per minute.

3. True 4. False. Anyone with a beating heart needs to stay active. 5. B. Less than 5 percent. 6. C. Fourth. Thirteen percent of global deaths due to cardiovascular risk factors are attributed to high blood pressure, followed by tobacco at 9 percent, diabetes at 9 percent, physical inactivity at 6 percent, and overweight/obesity at 5 percent. 7. D. All of the above, and all are regarded as essential goals to lower risk of heart disease.

YOUR PHYSICAL FITNESS AND HEART HEALTH TIMELINE

5–17 YEARS

18– 64 YEARS

Growing strong. Engage in at least 60 minutes of moderate- to vigorousintensity physical activity daily along with activities that strengthen muscles and bones at least three times per week.

On the Move. To strengthen your heart, you need at least 150 minutes of moderate-intensity physical activity throughout the week, or at least 75 minutes of vigorous-intensity physical activity throughout the week, or an equivalent combination of moderate- and vigorous-intensity activity. Remember those musclestrengthening activities two or more days a week.

65+ YEARS At Full Strength. For additional hearthealth benefits, increase your moderateintensity physical activity to 300 minutes per week.

Keep the Beat. For ultimate cardio health, aim for at least 150 minutes of moderateintensity physical activity throughout the week, or at least 75 minutes of vigorousintensity physical activity throughout the week, or an equivalent combination of moderate- and vigorousintensity activity.

BLOOD PRESSURE screening every 2 years starting at age 20 CHOLESTEROL screening every 4–6 years starting at age 20

screening every 3 years after age 50

It’s a myth that the older you are, the less physical activity you need. Keeping fit is important throughout life.

Regular physical activity increases older people’s ability to perform routine daily tasks and stay independent longer.

Source: National Institutes of Health

Read and watch other patient stories like Mel’s at grhealth.org/stories.

physician spotlight

Dr. James H. Wilkin Professor of Medicine

fellowships in internal medicine and cardiology at Letterman Army Medical Center in San Francisco.

Dr. Wilkin most recently served as adjunct professor of medicine at the University of Cincinnati, where he organized the inpatient consult service.

While there, he helped to arrange the relationship with Cincinnati Children’s Hospital

Medical Center, which resulted in the adult cardiology training program offering rotations at Cincinnati Children’s for adult congenital heart disease.

He spent almost 15 years serving in the U.S. Army and retired in 1989 as a colonel.

Dr. Wilkin is a fellow of the American College of Cardiology and a member of the American Heart Association.

Q&A As a senior with limited mobility, what are the best ways for me to stay active?

While it may be difficult for you to participate in vigorous exercise due to mobility limitations, that doesn’t mean that making smaller efforts to stay active won’t help you. It has recently been shown that even small increases in activity will have positive heart health benefits for seniors with limited mobility.

Activities like walking, gardening, or even housekeeping will all help to increase your heart health, including increasing your level of highdensity lipoprotein (HDL) cholesterol — also known as “good” cholesterol — which will reduce your risk of heart disease.

In fact, every extra minute you spend being active instead of staying sedentary will help to reduce your risk of heart disease. Researchers found that, for every 25–30 minutes you spend sedentary per day, your chance of a heart attack increases by 1 percent, so don’t postpone activities just because you can’t exercise vigorously.

Every step you can take is a step toward better heart health.

To make an appointment, call 706-721-2426.

heart rhythm center celebrates 10 years What are the best ways to warm up and cool down?

Warming up before Stay safe. The you exercise is effects of not important, warming up because it helps properly can lead to your body to serious injuries such as sprains, strains, get ready for swollen muscles, the workout and dislocations, derive greater and more. value from the workout. If you go directly from inactivity to vigorous exercise, you run the risk of injuring yourself.

One simple way to warm up and prepare for your exercise is to perform those same exercises but at a slower pace. This will help you to ease into your workout so your muscles are prepared when you begin to work out more vigorously. If you plan to stretch, make sure you do so after you warm up — otherwise you could injure yourself.

Cooling down after a workout is also important. To cool down properly, gradually slow your workout pace down, rather than stopping immediately when you’re done.

Going directly from exercising to stopping or sitting can cause dizziness, lightheadedness, or heart palpitations.

breaking news back to life

take a hike

A recent study performed on 58,818 patients at the Henry Ford Health System over the course of 18 years showed that people with good cardio health had a 50 percent reduction in their likelihood of dying early. The study examined heart health by looking at how efficiently oxygen was used by the patients’ bodies, as well as how efficiently blood was transported throughout patients’ bodies.

According to the study’s authors, this is the largest study of its kind ever performed. The study included low-, moderate-, and high-risk patients.

Patients in good cardiorespiratory health in all three patient populations saw the 50 percent reduction in likelihood of early death.

While moderate or vigorous exercise is important to staying in good health, it’s not the only way you can reduce your risk of heart issues. According to the American Heart Association, research has shown that just 30 minutes of walking per day can decrease the incidence of many heart issues.

Advantages of taking a walk every day include a reduced risk of coronary heart disease and stroke, improved blood pressure, improved blood sugar levels, and an improved blood lipid profile.

In addition, it will help your body in other ways, such as maintaining a healthy weight, enhancing your mental health, and reducing your risk of certain cancers.

W

hen Dr. Robert Sorrentino, Director of Arrhythmia Services, started GRHealth’s Heart Rhythm program 10 years ago, he had one goal: not to fail.

Following almost a 20-year career at Duke University Medical Center, where he honed his medical skills in its world-renowned heart rhythm program, Dr. Sorrentino came to Augusta to build a similar program. Like most people setting out on a mission, he had a plan — a five-year plan, to be precise.

However, unlike most, he completed it within just three years.

His early days at GRHealth consisted of frequently visiting the telemetry unit — the hospital’s central heart monitoring station, where technicians monitor heart rate and rhythm — scouring the hospital in search of patients with abnormal EKGs. He treated only a handful of patients per week.

Physicians now consult Dr. Sorrentino and his specialized team, who care for 20–30 patients per day. They evaluate and treat them with medication, catheter ablation techniques, and implanted heart rhythm devices.

Their high patient volume, paired with the well-trained, highly experienced physicians and lab staff, has led to excellent patient outcomes and cost-effectiveness.

Since Dr. Sorrentino’s initial goal, he and his team have continued to raise the quality of care and stay on the cutting edge of medicine. GRHealth’s Heart Rhythm program is now a significant driving force in the region and stands among other academic medical centers like Emory — and the origin of his career, Duke. Failure clearly wasn’t an option for Dr. Sorrentino and his team, who celebrated his 10 years with GRHealth in January, and his goal has shifted from not failing to not becoming complacent.

“We want to set the bar high in delivering excellent, state-of-the-art care for the area,” Dr. Sorrentino said. “As an academic medical center, we should be doing that.”

Be proactive about your heart health! Visit us online at grhealth.org/cardio.

Copyright © 2015 GLC, Skokie, IL 60077 U.S.A. This publication is not meant to replace professional medical advice or service. Personal health problems should be brought to the attention of appropriate medical professionals.

Dr. James H. Wilkin is a board-certified internal medicine physician and cardiologist who joined Georgia Regents University (GRU) with 40 years of experience in cardiology. Dr. Wilkin earned his medical degree from The Ohio State University in Columbus, Ohio. He completed an internship at Walter Reed Army Medical Center in Bethesda, Maryland, and