Living Well January/February 2018

heart health

JANUARY/FEBRUARY 2018 A Publication of the

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contributors American Heart Association, Montana Greenshoot Media

People in Missoula and western Montana want to feel good, look good and live well. Available at more than 150 newsstand locations throughout the area, Western Montana Living Well is well suited to more than 23,000 readers monthly who want health tips on fitness, nutrition, family, wellness, therapy and beauty.

The opinions, beliefs and viewpoints expressed by the various authors and forum participants in this publication do not necessarily reflect the opinions, beliefs and viewpoints of the Missoulian or Lee Enterprises. The author of each article published in this publication owns his or her own words.

No part of the publication may be reprinted without permission. Š2018 Lee Enterprises, all rights reserved. Printed in the USA.

january/february 2018 VOL. 44

IN THIS ISSUE heart health ATRIAL FIBRILLATION

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ALSO IN THIS ISSUE

aNGINA

Page 5

BLOOD PRESSURE READINGS

Page 6

SODIUM

Page 8

LIFE AFTER HEART ATTACK Page 12 CHOLESTEROL Page 14

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Atrial Fibrillation

Atrial fibrillation is the most common type of arrhythmia, or irregular heartbeat. The term arrhythmia refers to your heart beating out of rhythm. An irregular heartbeat means your blood is not flowing properly.

Up to 6 million Americans experience atrial fibrillation, with the issue being more common for people over the age of 65, according to the Centers for Disease Control and Prevention.

Symptoms and Risk Factors Symptoms of AFib can vary for everyone and are sometimes so subtle that you may not even notice them. However, some people may experience several indicators, including shortness of breath, heart palpitations, fatigue or chest pain.

Having atrial fibrillation will heighten your risk of stroke and heart disease. The CDC reports strokes caused by AFib are more severe than strokes from other causes. AFib causes approximately 20 percent of strokes that occur when blood flow to the brain is blocked by clots or plaque.

A few of the common risk factors associated with AFib include high blood pressure, heavy alcohol use and diabetes.

Diagnosis If you think you may be suffering with atrial 4

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fibrillation, schedule an appointment with your doctor immediately. Based on your family history, a physical exam or a diagnostic test, your local professional can give you the tools and knowledge to manage this condition.

It is important to know your family’s medical history to allow your doctor to give you a proper assessment.

A history with heart disease, high blood pressure or diabetes may give you a greater risk of experiencing Afib.

Sometimes this condition can be discovered by listening to the rhythm of your heart and taking your pulse. In other cases, you may be required to go through an EKG. This is a painless test that focuses on your heart’s rhythm. This test usually only takes a few seconds, but you may be asked to wear a portable monitor so your doctor can analyze long-term data.

Treatment Most cases of AFib can be managed by prescription medication. It is important to continue using the medication even if the symptoms aren’t present, especially if these are your doctor’s orders. You may be prescribed blood thinners or heart rhythm controllers.

Severe cases may require installing a pacemaker. This device is used to send impulses to regulate your heart’s rhythm.

What is Angina?

While chest pain does not automatically mean a heart attack is lurking, it should never go ignored. If you are feeling pressure in your chest or pain in your neck or jaw, it may be angina.

This is a condition that occurs when your heart muscle is not getting enough oxygen-rich blood.

Angina is commonly a symptom of coronary heart disease, which is the most common type of heart disease among American adults. The National Institutes of Health estimate that nearly 7 million Americans suffer from angina.

Types of Angina There are four different types of angina that you may experience. Learn the different types and the severity of each one to educate yourself on the symptoms and treatment.

• Stable angina: The most common type, this occurs when your heart is working harder than necessary.

If you are suffering from this type of angina, you will likely be able to predict when it will occur and the severity of the pain.

This can usually be treated with medicine.

• Variant angina: This is a rare type of angina. It is caused by a spasm in the coronary artery. Pain caused by this type of angina usually will occur when you are resting. Medicine will typically not relieve the symptoms.

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• Unstable angina: This type of angina requires immediate emergency treatment. It is a sign that a heart attack may occur. Unstable angina does not follow a pattern and may be more painful than stable angina.

• Microvascular angina: This is the most severe and longest lasting type of angina. The pain will not be relieved by medicine. It also requires immediate treatment.

What Causes Angina?

Angina can be a sign that you have heart disease, according to the CDC. It is a good indicator that your arteries are experiencing a plaque build-up that is restricting blood flow.

It also might mean that you are experiencing blood clots. It is important to be analyzed by a heart specialist, as these clots and blockages may lead to heart attacks.

Some risk factors for angina include obesity, inactivity, high blood pressure and smoking.

Angina Treatments Treatment for angina is crucial for improving your heart health. The most common forms of angina can be treated with medicines such as aspirin or nitrates. Nitrates can widen your blood vessels, allowing blood to flow freely. Aspirin reduces the risk of blood clots.

Severe cases of angina may require surgery. Your doctor may choose to use a stent to relieve any obstructions.

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Understanding Blood Pressure Readings Greenshoot Media

What do your blood pressure numbers mean?

The only way to know (diagnose) if you have high blood pressure (HBP or hypertension) is to have your blood pressure tested. Understanding your blood pressure numbers is key to controlling high blood pressure.

Healthy and unhealthy blood pressure ranges Learn what’s considered normal, as recommended by the American Heart Association.

Blood pressure categories The five blood pressure ranges as recognized by the American Heart Association are: Normal blood pressure Congratulations on having blood pressure numbers that are within the normal (optimal) range of less than 120/80 mm Hg. Keep up the good work and stick with heart-healthy habits 6

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like following a balanced diet and getting regular exercise.

Elevated Elevated blood pressure is when readings are consistently ranging from 120-129 systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control it.

Hypertension Stage 1 Hypertension Stage 1 is when blood pressure is consistently ranging from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) such as heart

attack or stroke. You can learn more about your risk by using the Check. Change. Control.

Calculator™.

Hypertension Stage 2 Hypertension Stage 2 is when blood pressure is consistently ranging at levels of 140/90 mm Hg or higher. At this stage of high blood pressure, doctors are likely to prescribe a combination of blood pressure medications along with lifestyle changes.

Hypertensive crisis This is when high blood pressure requires medical attention.If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and test again. If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis. If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking, do not wait to see if your pressure Your blood pressure numbers and what they mean 117 over 76 millimeters of mercuryYour blood pressure is recorded as two numbers: Systolic blood pressure (the upper number) — indicates how much pressure your blood is exerting against your artery walls when the heart beats.

Diastolic blood pressure (the lower number)

Blood pressure category

— indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Which number is more important?

Typically, more attention is given to systolic blood pressure (the top number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term build-up of plaque and an increased incidence of cardiac and vascular disease.

However, elevated systolic or diastolic blood pressure alone may be used to make a diagnosis of high blood pressure. And, according to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

Why blood pressure is measured in mm Hg The abbreviation mm Hg means millimeters of mercury. Why mercury? Mercury was used in the first accurate pressure gauges and is still used as the standard unit of measurement for pressure in medicine.

Taking your pulse versus checking your blood pressure Your blood pressure and heart rate (pulse) are two separate measurements and indicators of health. Learn more about the difference between blood pressure and heart rate.

This content was last reviewed November 2017.

Systolic mm Hg (upper number)

diastolic mm g (lower number)

normal

less than 120

and

less than 80

elevated

120-129

and

less than 80

high blood presure

(hypertension) stage 1

130-139

or

80-89

high blood pressure

(hypertension) stage 2

140 or higher

or

90 or higher

higher than 180

and/or

hypertensive crisis

consult your wdoctor immediately

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Limit Sodium Intake

Sodium is a mineral your body requires to promote muscle function and send nerve impulses. Like anything else, sodium should be consumed in moderation.

Sodium is a major factor in bringing your blood pressure to dangerous levels, and high blood pressure is a major risk factor for heart disease.

While heart disease is likely to occur in a diet that is high in sodium, there are many other diseases it promotes. Sodium is linked to strokes, stomach cancer, 8

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kidney diseases and even osteoporosis. It is crucial to manage your sodium intake.

The Silent Killer High blood pressure is often referred to as “the silent killer.� Per the American Heart Association, approximately 77.9 million American adults suffer from high blood pressure. It also is the leading risk factor for death in American women, contributing to nearly five

times the number of annual deaths caused by breast cancer.

How does sodium increase your risk of high blood pressure? Extra sodium in your bloodstream pulls water into your vessels. This creates more blood to flow through the vessels, causing the pressure to increase.

Over time this high pressure can damage your blood vessels and even promote the growth of plaque that will block blood flow. This added pressure also causes stress to your heart by making it work harder to pump blood.

shaker during meals, there are many other foods that should be limited. The AHA has created a list deemed the “Salty Six,” which includes six foods that should be limited: • breads and rolls; • processed lunch meats; • pizza; • poultry; • canned soup; and • sandwiches.

Foods to Avoid The AHA recommends a daily limit of 1,500 milligrams of sodium each day. You may be surprised at some of the foods you should avoid if you plan to meet this recommended level.

Many Americans associate sodium with table salt.

While your diet may benefit from skipping the salt

Healthy Levels There can be great rewards to healthy levels of sodium in your diet. Sodium is the primary electrolyte needed to regulate blood pressure. Following the recommended dose of sodium will help keep your blood pressure from falling lower than it should be.

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Life after Heart Attack Overcoming a heart attack may seem like an overwhelming feat. While it will be a lifelong recovery, you can still live a long, healthy life. Diligently following your doctor’s orders will enhance your chances of success, so make sure you’re on the same page with your physician in regards to the next steps.

Your doctor can advise you on the most productive actions you can take depending on the damage caused to your heart. You also will be analyzed for the level of heart disease that is still present. According to the American Heart Association, heart attack survivors will likely need prescription medication for the lifetime. These medications will help reduce your risks of an additional attack.

Cardiac Rehabilitation Cardiac rehabilitation is a medically supervised program that focuses on improving your cardiovascular health. The AHA has listed the following three separate categories that are key during cardiac rehabilitation.

• Exercise and training: Physical activity will get your entire cardio system working. The experts at your rehab facility will teach you proper ways to promote heart health.

• Healthy heart education: educating yourself on which behaviors may put you at risk for a second attack.

• Stress counseling: With this exercise you will learn 12

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helpful tips on reducing stress, which is bad for your heart.

Dealing with Depression Surviving a heart attack will likely reveal many different emotions. According to the AHA, it is normal for this range of emotions to last from two to six months after a heart attack. Depression, anger and fear are just a few feelings you may experience.

If these types of emotions begin affecting your sleep or appetite, or even give you thoughts of suicide, it is best to get your doctor’s opinion. Your physician can give you the advice, referrals or medication you need to overcome depression.

Don’t deal with these emotions alone. A support system of friends or family also can be a great way to overcome depressive thoughts.

Balance Rest and Exercise Resting your body is an important part of recovery, but you also will need to keep physically active. In fact, most experts recommend a heart attack survivor to be more physically active than they were before the attack.

The key is to find your body’s limits. Exercise in short increments to test how much stress your body can handle. Don’t over exert yourself, and take naps throughout the day if you are feeling too tired.

Obesity and Heart Disease Per the Centers for Disease Control and Prevention, heart disease was the leading killer of Americans in 2016. One major contributor to heart disease is obesity. If you have been putting off losing those extra pounds, now is the time to commit to losing weight and improving your heart health.

Obesity describes anyone who is at least 20 percent over their ideal weight. This ideal weight is determined by BMI, or body mass index.

The American Heart Association reports nearly 70 percent of American adults are overweight or obese.

Determine Your BMI A person’s BMI is a calculated by dividing weight in kilograms by the square of height in meters. A body mass index does not directly measure a person’s body fat content. It is an easy-toperform calculation for screening weight categories such as underweight, normal, overweight or obese.

Determining your BMI is simple. The CDC offers a tool that calculates your BMI based on your height and weight. An individual with a BMI result of 30 or more is obese. If your is at or above 30, you might be at a higher risk for heart disease.

How Obesity Harms Your Heart Being obese can lead to serious diseases that will put you and your heart at risk. The

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National Institutes of Health has listed some of these common heart-related conditions to which obesity contributes.

• Coronary heart disease: CHD is a condition that causes plaque to build up in your arteries. Plaque may cause your arteries to narrow or become blocked, restricting blood flow to your heart muscle.

This could lead to heart failure.

• High blood pressure: Obesity causes your body to require more blood to supply your tissue with the proper amount of oxygen.

This causes your artery walls to be put under a dangerous amount of pressure that will harm your heart.

• Diabetes: Obesity is believed to change your body’s metabolism. This change causes tissue to release fat molecules into your blood and reduce your body’s responsiveness to insulin. Diabetes doubles your chances of experiencing heart disease.

Getting yourself out of the obese range as determined by your BMI will drastically reduce your risk for heart disease. A good place to start on this journey is to count calories and begin a regular physical regimen that challenges you to exercise daily.

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The Role of Cholesterol

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Greenshoot Media

A substantial risk for heart disease is high levels of bad cholesterol. With the help of your liver, your body creates all the cholesterol it needs to build tissue and assist in normal development. It is important to know that excess cholesterol is another way for your arteries to build dangerous plaque along their walls.

The American Heart Association reports that more than 100 million Americans have cholesterol levels that are higher than the total recommended level. High levels of cholesterol contribute to coronary heart disease, which is the United States’ top killer.

Good vs. Bad It is important to know the difference between good and bad cholesterol and how they affect one another.

LDL is commonly known as the bad type of cholesterol. It is a big contributor to building plaque and clogging arteries. Too much of this cholesterol can cause peripheral artery disease or atherosclerosis. To avoid too much intake of LDL, limit the amount of beef, herring and egg yolks in your diet.

HDL is often referred to as good cholesterol. This type will help remove LDL from your arteries. The AHA states that HDL can protect against heart attacks by sending LDL back to your liver to be processed out of

your body. HDL can be found in nuts, whole grains and beans.

Improve your Levels There are several ways you can lower your levels of dangerous cholesterol to reduce the risk of heart disease.

The National Institutes of Health has laid out some key components to focus on to get your levels on track.

• Change your diet. If you have discovered that your LDL levels are too high, a change in your diet is in order.

Cut out saturated fats, including cheese, skinned poultry and fatty beef.

• Weight matters. Being overweight or obese will raise your LDL levels as well as dangerous triglyceride levels.

• Be physically active. Regular exercise can lower LDL levels while raising HDL levels of cholesterol. Try to be physically active for at least 30 minutes a day.

Cholesterol-related Heart Disease Risk Cholesterol causes heart disease by building plaque in your artery walls. This buildup causes your arteries to become narrow and restrict blood flow to the rest of your body. This backup of blood flow will eventually lead to a heart attack.

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Heart Disease Facts Heart disease kills approximately 610,000 Americans each year. This makes it the leading cause of death in American men and women. The Centers for Disease Control and Prevention also reports that 735,000 Americans experience a heart attack every year.

Many of the risk factors associated with heart disease can be avoided by a change in lifestyle. Many cases of heart disease are caused by smoking, unhealthy eating or physical inactivity. Consider some of these startling facts as reported by the CDC to give yourself the motivation to change your life.

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American Heart Association Montana

• Nearly 47 percent of cardiac deaths happen away from a hospital.

• Forty-seven percent of Americans have one of the three risk factors of heart disease. These include high blood pressure, smoking and high cholesterol.

• A heart attack occurs every 42 seconds in America. A death caused by heart attack happens every minute.

• Due to health care, medicine and lost productivity, heart disease costs the U.S. nearly $207 billion each year.

• Heart disease is the leading cause of death of American men and women.

• Coronary heart disease is the most common heart disease and contributed to the death of 365,000 people in 2014.

• 32.6 percent, or 80 million adults, suffer from hypertension, a leading cause of heart disease.

• In 2015, 116,000 of the 750,000 Americans who experienced a heart attack died.

• In 2012, 160 million Americans were obese.

Obesity is another contributor to heart disease.

• 48 percent of AfricanAmerican women have some form of cardiovascular disease.

• In 2014, 19 percent of men who died of heart disease were smokers.

Heart Health Events American Heart Association Montana

1. Friday, February 23rd, 2018 Missoula Go Red For Women Luncheon 9:30am to 1:30pm DoubleTree by Hilton missoulagoredluncheon.heart.org

2. Saturday, February 24, 2018 15th Annual Heart Expo 7am to 12pm Providence St. Patrick Hospital Broadway Building Conference Center at 500 West Broadway Info: blood draws start at 7:00 am and lectures at 8:00 am Website: Montana.Providence.org/HeartExpo

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