Heart Health 2014

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H E A R T H E A LT H S P E C I A L A D V E R T I S I N G S E C T I O N

by Shari Held

A Heart-Healthy Lifestyle Take care of your ticker—and boost your overall well-being—by adopting smart habits

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f you’re in your 20s, developing lifestyle habits to keep your heart healthy is one of the best gifts you can give yourself—especially if heart problems are part of your family history. But it’s never too late to begin. It just takes some motivation.

“The main barrier to achieving a heart-healthy lifestyle is our environment,” says Max Lewis, M.D., a Witham family-medicine physician in Zionsville. “There’s a McDonald’s in every town and lots of opportunities to take it easy and not exercise.”

Here are some heart-healthy lifestyle basics from which everyone can benefit.

Eat right One of the best ways to eat heart-healthy is to follow a Mediterranean-style diet, incorporating lots of fresh fruits and vegetables, fish that are high in omega-3 fatty acids, whole grains, nuts, and olive oil in your diet. Moderate alcohol consumption is also touted as good for the heart, in that it may reduce one’s risk of a heart attack, according to the Mayo Clinic. Studies have also shown that oatmeal can lower cholesterol levels.

Lewis advises patients to limit their consumption of foods high in cholesterol and saturated fat, such as red meat, egg yolks, butter, ice cream, and other whole-fat dairy products. He also suggests decreasing salt intake.

“Overall, Americans eat eight to 10 grams of salt a day,” Lewis says. Even for those without high blood pressure, it’s better to take in less than four grams, he says.

The DASH (Dietary Approaches to Stopping Hypertension) Diet shares many similarities with a Mediterranean-style diet, and its high-fiber, low-to-moderate fat plan is one of many that can benefit patients with diabetes, people trying to lose weight, and those who want to prevent a heart attack and stroke.

“That’s one I recommend to my folks quite often because it’s a little easier to follow than others,” says J.D. Graham III, M.D., FACC, a cardiologist with Franciscan Physician Network Indiana Heart Physicians.

Maintaining a proper weight is vital for heart health.

“Obesity makes all the other risk factors worse,” says Michael Ball, M.D., FACC, a cardiologist with St. Vincent Medical Group. “It increases your risk for diabetes, your cholesterol

levels, and your blood pressure. As you lose weight, all those risk factors get better.”

And it doesn’t take much to reap big benefits.

“The unwritten rule for people on hypertensive medications is you can drop a medication for every 10 pounds you lose,” he says, adding that patients should always check with their doctor before stopping a medication.

While it’s best to get your nutrients from whole foods, Ball recommends fish oil and antioxidants to patients wanting to supplement their diet.

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Exercise more There’s no getting around it—your heart needs exercise to stay healthy. Graham recommends 30 to 60 minutes of cardio exercise five days per week.

Any type of movement is better than nothing at all.

“You can walk slow or do anything you want as long as you do it for 30 continuous minutes,” Ball says.

You’ll have to up the ante if you’re trying to drop pounds, though. Lewis says losing weight requires up to 300 minutes of exercise at a moderate or greater intensity per week. But you have to combine it with a healthy diet.

“To lose weight through exercise alone is tough,” he says.

Stress less The immediate effect stress has on the body is to elevate blood pressure.

“Long term, it raises your cholesterol level and increases your overall bloodsugar and blood-pressure levels,” Ball

says. He recommends exercise as the best stress reducer, but meditation or doing things that help you relax, such as reading a book, petting your cat, or listening to soothing music, can also do the trick.

If that doesn’t get you to schedule some downtime on your calendar, consider this.

“Some individuals can have a heart attack caused by stress alone,” Graham says. “It causes a reaction in the blood vessels that can lead to a heart attack even if they don’t have blockages.”

Don’t light up From a health standpoint, smoking is one of the worst things you can do.

“The chemicals constrict the blood vessels, and it also seems to increase the buildup of plaque in the arteries,” Graham says.

Know your numbers You not only have to know your health stats, you have to know what they

mean in terms of your individual heart health. Family history and known risks will impact your numbers, but eating healthy, exercising, and managing stress will help get them headed in the right direction.

Body mass index. Body mass index, or BMI, uses height and weight to get a reliable indicator of body fat.

“You want to try to be between 18.5 and 25 for your heart,” Lewis says. A BMI between 25 and 30 indicates you’re overweight and need to watch your diet and exercise more, while a BMI of more than 30 puts you in the obese category.

“At over 30, it might be time to think about a weight-loss medication to help you with your diet and exercise,” he adds.

Belviq, one of the newest Federal Drug Administration–approved weight-loss medications, helps patients feel full faster so they eat less. Bariatric surgery is an option if your BMI is over 40, even if you have no other risks, Lewis says. It’s something to consider if your BMI is greater

HEART HEALTH PROFILE

American Heart Association The American Heart Association’s Go Red For Women movement celebrates its 10th birthday in 2014, and there are still some very startling statistics about the No. 1 killer of women.

• Go Red Fact 1: Heart disease is the No. 1 killer of

women. o Cardiovascular diseases cause one in three women’s deaths each year, killing approximately one woman every minute. o Ninety percent of women have one or more risk factors for developing heart disease.

•

go red fact 2: Heart disease kills more women than all forms of cancer combined but is often undiagnosed. o One in 30 women dies from breast cancer each year.

One in three dies of cardiovascular disease. o Women comprise only 24 percent of participants in all heart-related studies.

• Go red fact 3: Cardiovascular disease kills more

women than men. o Since 1984, more women than men have died each year from heart disease and stroke.

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o The symptoms of heart disease can be different in women versus men and are often misunderstood— even by some physicians.

• Go red Fact 4: Heart disease affects all ethnicities.

o Of African-American women ages 20 and older, 48.9 percent have cardiovascular disease. Yet, only 20 percent believe they are at risk. o Hispanic women are likely to develop heart disease 10 years earlier than Caucasian women.

• Go red Fact 5: Women who are involved with the Go

Red movement live healthier lives. o Women who Go Red are more likely to make healthy choices: – Nearly 90 percent have made at least one healthy behavior change.

– More than one-third have lost weight.

– More than 50 percent have increased their exercise.

Find out more about fighting heart disease in women at goredforwomen.org.

“For 10 years, the American Heart Association and St.Vincent Heart Center of Indiana have been working together to fight heart disease through the Go Red For Women® movement.

Thousands of lives have been saved “For 10 years, nationwide, heart disease the Americanbut Heart Association and isSt.still Vincent Heart Center of Indiana the No. 1 killer of women. have been working together

fight heart disease through the It’stotime to shout louder, stand stronger Go Red For Women movement. and ofdemand change.

Thousands lives have been saved but heart disease It’issnationwide, time for all women to Go Red.” still the No. 1 killer of women. ®

Local Founding Sponsor stand stronger It’s time to shout louder, 2014 Go Red For Women Chair and demand change.

It’s time for all women to Go Red.” Chief Operating Officer

Darcy Burthay, RN, MSN

and Chief Nursing Officer Darcy Burthay, RN, Hospital MSN St.Vincent Indianapolis

Local Founding Sponsor

2014 Go Red For Women Chair Chief Operating Officer and Chief Nursing Officer St.Vincent Indianapolis Hospital

Visit IndyGoesRed.org to learn more.

Visit IndyGoesRed.org to learn more. ©2013, American Heart Association. Also known as the Heart Fund. TM Go Red trademark of AHA, Red Dress trademark of DHHS. ®National Wear Red Day is a registered trademark of HHS and AHA.

©2013, American Heart Association. Also known as the Heart Fund. TM Go Red trademark of AHA, Red Dress trademark of DHHS. ®National Wear Red Day is a registered trademark of HHS and AHA. 2014 Indy Gr Events + Volunteer ads 8.25x10.5.indd 2

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than 35 and you have diabetes or hypertension, he says.

Waist circumference. Another test is to measure your waist. Provided one’s BMI is at 25 or higher, the goal for men is a measurement of less than 40 inches, and for women, it’s less than 35 inches, according to the American Heart Association. Those who carry most of their fat around their waist instead of their hips are at a greater risk of heart disease and type 2 diabetes, reports the National Heart, Lung & Blood Institute.

Cholesterol. Your body needs cholesterol, but too much of it can lead to plaque buildup in the arteries, increasing the risk of coronary artery disease, heart attack, and stroke.

The American Heart Association and the American College of Cardiology recently released new cholesterol-treatment guidelines. The panel removed target numbers for levels of LDL, or “bad” cholesterol, and instead recommended that LDL be reduced by 50 percent or more, typically with statins. The guidelines also presented a new risk score to identify one’s

chance of a heart attack within 10 years.

Using this score, high-risk people are patients with known heart disease; diabetics; a patient who is told that his or her 10-year risk of a heart attack is 7.5 percent or more; and low-risk patients who have very high cholesterol The report emphasized healthy lifestyle choices to keep levels in check. Discuss with your doctor the best statin for you, should medication be suggested.

Blood pressure. According to the Centers for Disease Control and Prevention, 67 million American adults have high blood pressure. While many of those are taking medications to keep numbers in check, new guidelines published in December in the Journal of the American Medical Association suggest that some may not need a prescription after all.

According to the guidelines, those older than 60 may not need treatment for hypertension unless their systolic blood pressure (the top number) is 150 or above. Previously, the threshold was 140 or above. The diastolic goal should remain 90 or less. However, for those

younger than 60 and for those with diabetes or kidney disease, the goal remains 140 over 90.

Why the change? The committee found that there was not enough strong evidence for the targets that had previously guided treatment, and that there were risks that came with medications used to lower blood pressure.

But the new guidelines aren’t without controversy, as it’s thought that greater leniency may prevent some people from getting the medication they need.

Talk with your physician about the best way to control your blood pressure. There is a variety of medications available that can be selected based on existing risk factors. Lifestyle habits are also important, particularly not smoking, getting regular exercise, and eating a healthy diet.

Hemoglobin A1C. This blood test measures the concentration of sugar in the blood over an average of two to three months. A normal range is 4 to 5.7 percent, while the pre-diabetes range is 5.7 to 6.5 percent, and above 6.5 percent is a diagnosis of diabetes, Lewis says.

HEART HEALTH PROFILE

Community Heart and Vascular Hospital Community Heart and Vascular Hospital is one of the nation’s first all-digital hospitals providing coordinated care in a healing environment. Whether you or a loved one needs cardiovascular diagnostic testing, heart surgery, treatment for heart failure, support during recovery, or cardiopulmonary rehabilitation, the heart and vascular experts at Community are here to help.

Their patients rank them among the nation’s best in satisfaction with their care. With accredited, fully integrated heart and vascular programs available at all Community hospitals, they’re a recognized choice when it comes to matters of the heart.

Specialty areas of service: Fully integrated, comprehensive heart and vascular care. Community has one of the nation’s most integrated cardiovascular systems, linking together the primary-care physician, cardiologist, and surgeon for better health and wellness outcomes.

Electrophysiology: nationally recognized leaders of heart rhythm disorders, providing the most advanced treatments.

Cardiovascular genetic counseling center: the first program of its kind in Indiana, serving patients of all ages who may be at risk for a heritable cardiovascular condition.

Congestive heart failure: treatment of complex heart disease.

Structural heart disease: offering innovative procedures.

• • • • •

Innovations and technologies: Innovative therapies such as ventricular-assist devices.

Leaders in heart-valve repair and replacement, including new techniques, new devices, and less-invasive approaches.

Nationally recognized vascular surgeons providing comprehensive, minimally invasive thoracic and abdominal aortic therapy.

Advanced heart imaging using innovative applications of multidimensional imaging techniques.

Full spectrum of atrial fibrillation diagnostic and treatment services.

Access to leading clinical trials for new heart and vascular devices, and advanced minimally invasive surgical procedures.

• • • • • •

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If it has anything to do with your heart, it has everything to do with us. To learn more, call 800.777.7775 If it has anything to do with your heart, it has everything to do with us. To learn more, call 800.777.7775.

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Painting the Town Red find out how indy is showing its support for Go Red For Women Feb. 1–28: Buildings Go Red This month, several local buildings and landmarks, including Chase Tower, Monument Circle, and the Indiana Repertory Theatre, take on a rosy hue, joining other structures across the country in going red for the American Heart Association.

Feb. 4: The Red Dress Dash 8–9 a.m., Emmis Communications building, Monument Circle Throw on your favorite (or not-sofavorite) red dress over your winter clothing and dash around Monument Circle in support of women’s heart health. It doesn’t matter if you’re a man or woman—all support is needed to fight heart disease, the No. 1 killer of women. The first 50 participants to complete the dash will receive a goodie bag.

Afterward, check out the “heARTwork” of various Hoosiers on display inside the Emmis lobby.

Feb. 7: Wear Red Day Whether it’s a crimson dress, lipstick, tie, or shoes, plan to wear red this day, and encourage others to join you.

Feb. 7–14: Congenital Heart Defects Awareness Week Congenital heart defects, which include abnormalities in the heart’s structure, electrical system, and other deformities that affect the function of a baby’s heart, affect eight of every 1,000 births, according to the AHA. They’re one of the leading causes of death for infants less than one year of age, but thanks to years of research and medical advancements, many congenital heart defects can be fixed.

Feb. 8: Meet the Artist Fashion AWEARness 5:45–10 p.m., Central Library Go Red For Women is a community partner for this free philanthropic fashion show featuring designers and

models from around Indianapolis.

Feb. 14: Marion County Clerk’s Office Goes Red Couples being married by Marion County Clerk Beth White will have the opportunity to make a donation to the AHA as part of their wedding proceedings. Each couple will receive a special gift from the AHA. Feb. 21: Go Red For Women 10-Year Celebration 9 a.m. to 1 p.m., JW Marriott More than 1,000 attendees will gather at the JW Marriott for Indianapolis’s annual Go Red For Women Luncheon, presented by St. Vincent Heart Center of Indiana. This event includes educational breakout sessions, free health screenings, exhibits, a hearthealthy lunch, and a program, all to benefit the American Heart Association. Visit indygoesred.org for more information.

HEART HEALTH PROFILE

Marion County Health Department Heart disease is the second-leading cause of death in Marion County behind cancer. For women, heart disease can go undiagnosed until signs or symptoms are present. According to the Centers for Disease Control and Prevention, almost twothirds of women who die suddenly of coronary heart disease have no previous symptoms.

Women often experience the same symptoms as men, such as chest pain or discomfort. However, women are more likely to have other symptoms, including nausea, lightheadedness, and breaking out in a cold sweat, as well as shortness of breath and pain in the jaw, neck, back, or stomach.

One of the leading risk factors for developing heart disease is high blood pressure. It is critical for women to know their blood pressure and how to keep it in control. Even when taking medication, millions of Americans do not have control of their blood pressure.

One way to reduce high blood pressure is through proper nutrition, which includes lowering sodium intake. About 90 percent of Americans eat more sodium than recommended. Most of the sodium in our diet comes from processed foods and foods prepared in restaurants. It is possible to find foods that are lower in sodium, even when eating away from home. Cooking more at home is one of the most important ways to control how much sodium you consume.

Most importantly, take control of your health by not smoking, staying physically active, and maintaining a healthy diet. Also, schedule regular doctor visits to monitor any warning signs of cardiovascular disease.

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by Shari Held

Life After a Heart Incident Adopting and sticking to healthy habits must be part of the new normal

t

he experience is like you’re in a different country with people speaking a foreign language, using words and phrases that aren’t in your daily vocabulary, such as “myocardial infarction” or “ischemic stroke.”

That’s how Yazid Fadl, M.D., a cardiologist with IU Health, describes patients’ first impressions after experiencing a heart attack or stroke. And that’s just the beginning. Life as they once lived it will likely never be the same.

“You’re going to have to learn to adapt to this new environment,” Fadl says. “Your lifestyle has to change. But you get used to it, and then you function just fine in that new environment. It’s not necessarily a bad thing.”

Whether the condition is a heart attack or stroke, the same advice applies. Patients must take their prescribed medications, eat a healthy diet, exercise, maintain a normal weight, and control their risk factors.

The road to recovery

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steve meier conquered mount kilimanjaro just 10 months after his heart attack.

Community Heart and Vascular Hospital, he climbed to the summit of Mount Kilimanjaro.

“I told him to go for it,” says Dube, who has also climbed Kilimanjaro and knows firsthand the challenges it presents. “He trained and prepared for it gradually, and he did everything the right way. I felt very comfortable that he could do it.”

What motivated Meier? Having a concrete goal, training and sharing inspiring e-mails with the guys who would accompany him on his Kilimanjaro adventure, and paying his trainer at LA Fitness a month in advance so he wouldn’t be tempted to skip sessions.

photo courtesy steve meier

Even if they incorporate all those things into their lifestyle, patients may still face the real fear that they could have another heart attack or stroke.

“Once someone has had a heart attack, they have plaque, and plaque formation can occur in other areas,” says Sandeep Dube, M.D., FACC, a cardiologist with Community Physician Network.

Depression can occur, and some may worry about a recurrence and functional limitations. Exercise is typically one area of concern.

“A heart attack is an absolutely terrifying and life-changing event for almost everybody,” Dube says. “A cardiac-rehab program is great for people after a heart attack. Patients can exercise in a supportive environment where they feel comfortable they are under the supervision of exercise physiologists.”

He recommended rehab to Steve Meier, a patient who had a heart attack in November 2012 at the age of 49.

An avid backpacker who completed a solo 57-mile loop through the Smoky Mountains two months prior to his heart attack, Meier went far beyond just getting active. Less than a year after ending up at the cardiac catheterization lab at

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BestHeartCare.com

Indiana’s only 50 TOP Hospital for Heart Care.

“Dr. Go Red” Nancy Branyas, MD Cardiologist

St.Vincent Heart Center of Indiana has been named one of the 50 TOP Cardiovascular Hospitals in the nation—and the only one in Indiana.

The dedication to excellence behind that honor helps explain our commitment for the past 10 years as the local presenting sponsor of the American Heart Association’s Go Red for Women movement.

By leading the way in both cardiovascular care and women’s heart health awareness, we’re devoted to helping women continue to share their hearts with the ones they love for years to come.

Keeping your heart healthy is easier than you think.

Find out more at BestHeartCare.com.

Meier also credits the encouragement he received from Dube and other folks at Community for helping him attain his goal.

“Attitude is such a huge part of turning things around,” Meier says. “At 49, I just wasn’t willing to change my lifestyle in a way that meant doing less. I’ve got a long bucket list of things I want to accomplish and five children that keep me active.”

Next up for Meier is the Mount Everest base camp and Machu Picchu in Peru.

Dube uses Meier’s story to motivate his other patients.

“It tells them that they shouldn’t give up, that it’s possible to enjoy life and continue doing the things that keep them active and healthy,” he says.

Fadl has also seen patients turn their lives around after a heart attack. One of his patients had heart failure after suffering a heart attack and was a potential candidate for a future heart transplant. After surgery to repair his arteries, the patient religiously followed a regimen of cholesterol, blood-pressure, and heart-failure medicines and made appropriate lifestyle changes.

“This patient was highly motivated to do exactly what he was told to do because of the seriousness of his problem,” Fadl says. “Over the last three years, his heart strength has slowly improved and now it’s back to normal.”

The new normal

Working together with our physician partners and owners to provide The Best Heart Care in Indiana. Period.

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Shoveling snow is one activity cardiologists advise their patients to give up after a heart attack.

“We’ve found that extremes of heat or cold combined with a high level of exertion sometimes precipitates an event,” Dube says.

Smokers must also give up the habit.

After a heart attack, one of Fadl’s patients threw away her cigarettes for good.

“This is a woman who smoked for more years than most people are alive,” Fadl says. “And she broke that habit. It’s mind over matter. It can be done.”

Patients have to understand that they can’t go back to the way things were.

“They’ve got to follow the advice of their doctors and follow this new path that has been outlined for them,” Fadl says. “If they do that, there’s a good chance they’ll resume their functional life again.”

PUTTING OUR HEART WHERE YOUR HEALTH IS. At Kroger, we’re proud to play our part in raising awareness of heart health and helping individuals achieve a more heart-healthy lifestyle.

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She Has Heart

photo courtesy american heart association

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Darcy Burthay takes the lead as the 2014 Go Red For Women chairperson

ith a familial connection to heart disease and a long-running career in healthcare, Darcy Burthay is well suited for her role as chairwoman of the American Heart Association’s 2014 Go Red For Women campaign.

As chief operating officer and chief nursing officer of St. Vincent Indianapolis Hospital, Burthay oversees day-to-day operations and helps ensure that consistent nursing practices lead to quality patient outcomes.

Since last February, Burthay and the Go Red executive leadership team—in total 19 women from various industries— have helped land sponsors and worked with area businesses to promote heart health to their employees.

“It’s our job to be a catalyst and get everyone involved in the movement,” Burthay says.

Bringing sponsors on board helps the group reach its goal of raising $750,000, which helps the AHA continue its work in the community. As Burthay spreads the word about heart health, she hears stories from her peers—women her age who lead a healthy life, but still are affected by some form of heart disease. Those tales hit home for Burthay.

Shortly after taking the reins as chairwoman, she joined a gym and has lost 20 pounds so far.

“We start personalizing some of this and look at what we need to do to keep ourselves healthy,” she says.

Though heart disease is the No. 1 killer of women, so many still think of it as a “guy thing” darcy burthay and dismiss warning signs, Burthay points out.

“You tend to ignore those aches and pains,” she says. “I don’t think women, historically, listen to their bodies and respond the way they should.”

If just one woman leaves the Feb. 21 Go Red luncheon feeling inspired to live a healthier life, Burthay will consider the event, which typically attracts 1,000 guests, a success.

“I want to be sure women know that while this is about all of us, the difference we can make is with us individually.”

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