Steven Bruhl, MD, Chief Medical Officer for Mercy Health – Tiffin Hospital, observes that awareness of heart disease among the population today is substantially better than it used to be. He also notes that most people nowadays recognize the link between high blood pressure and cardiovascular disease and are, therefore, becoming less reluctant to take blood-pressure-lowering medications when appropriate. Even more encouraging is that mortality from these conditions has fallen thanks to increasing awareness and advances in treatment.
That’s the good news. The not-so-good news is that, despite these positive trends, heart disease remains the number-one killer for both men and women.
Nonetheless, there are steps we can all take to avoid becoming another heart-disease statistic. Dr. Bruhl recommends the following:
Know the risk factors
“When it comes to heart-disease risk factors, age is one of the biggest, and that’s something we all have to face. Another major risk factor we can’t control is family history, which is especially significant if your father, mother, brother, or sister had early-onset heart disease, meaning before age 50 in men and before age 60 in women. However, we do have the ability to lower our risk through proactive measures such as eating a healthy diet, leading an active lifestyle, avoiding smoking, and getting regular heart-health screenings,” he explains.
With respect to this last point, getting routine blood-pressure screenings is critical. High blood pressure affects the entire cardiovascular system, placing excessive stress on the blood vessels, which causes small “fractures” to develop in the vessel walls. Cholesterol then can accumulate in these fractures and cause atherosclerosis, which affects not only the heart but all the organs, including the brain (stroke risk) and kidneys. “In fact, atherosclerosis is the second leading cause of kidney failure, the first being diabetes,” Dr. Bruhl adds.
Know the symptoms
When high blood pressure is setting the stage for atherosclerosis, unfortunately there are no obvious signs or symptoms. That’s why this condition is commonly known as a “silent killer”—and why regular blood-pressure and other heart-health screenings are so important.
If the disease progresses to the point of actually causing a heart attack, recognizing the symptoms can be a matter of life and death.
The challenge here lies in the fact that not all heart-attack victims have the same set of symptoms. “The ‘Hollywood’ version of a heart attack—crushing chest pain, pain radiating down the left arm, pain in the jaw, etcetera—is a common presentation of heart attack, but some patients experience different symptoms. For example, it’s shocking how often patients having a heart attack are in denial because their primary symptom is chest pressure instead of chest pain, which for some reason is not the same in their mind. I like to say that the number-one killer in the country is heartburn because people having a heart attack very commonly mistake it for heartburn,” he says.
Dr. Bruhl also emphasizes that women having a heart attack are more likely than men to experience gastrointestinal symptoms, such as nausea and vomiting, rather than the “typical” chest pain or pressure. “For example, about 15 years ago, a woman came into the ER throwing up, and everyone thought she had the flu or some other stomach bug—until we did an EKG and saw that she was having a major heart attack,” he recalls. “You don’t have to go to the ER every time you have an episode of vomiting, but it’s important to be aware that GI symptoms can signal a heart attack, especially in women.”
By the time patients wind up in a cardiologist’s office, their cardiovascular health has typically been declining for a long time and/or a heart attack or other cardiac event has already occurred. Dr. Bruhl’s best advice when it comes to maintaining a healthy heart is not to wait until a problem arises, but to take a proactive stance by eating properly, exercising, avoiding or quitting smoking, knowing your risk factors, and seeing your primary care physician for heart-health screenings on a routine basis. And if you do experience symptoms of a heart attack, get medical help immediately. ❦