January 26, 2016 at 4:09 am #24358
This is a question that comes up frequently on a day to day basis from my ‘healthier’ patients. Many patients make an appointment to see me because they are worried about their general cardiac health. All patients seem to have 1 of the following in common:
1. A strong family history of cardiac disease
2. A general worry that they have a current heart condition
I will address part 1 first. Is there reason to worry about yourself if you have family members with heart disease? Absolutely. From my experience, genetics play the most important role in heart disease. For example, I have had a patient who has smoked for 30 years, has a poor diet, lacks exercise, and does not take any doctor-prescribed preventative cardiac medicines (cholesterol, blood pressure, etc). They come to see me for chest pain and undergo a stress test. The stress test returns abnormal and then undergo a coronary angiogram. Their coronary arteries are clean as a whistle. This had baffled me for ages. However, this became more and more apparent in my daily practice. Over 90% of the time, they have older than normal parents or parents died of old age (90’s). This strongly hints that genetics of heart disease is a very important, if not the most important, role in heart disease.
As for the worrying patient concerned for heart disease, this is a valid point. Some studies suggest that patients who worry about a specific condition (hypochondriacs excluded!) tend to have reason. I can tell you that with certain tests cardiologist can perform, we can exclude significant heart disease with a relatively low value of error. However, there are patients who undergo extensive testing and they tend to “pass” them all and end up with severe cardiac disease that was not discovered through routine testing (tends to be <5% error).
In general, to have a healthy heart, you must follow simple rules. Remember the heart is a muscle.
1. You must exercise (aerobic exercise best).
2. You should eat right – low animal fat, high fiber
3. Stop tobacco products, including e-cigarettes (or vaping)
4. Take prescribed pills by your doctor that control certain medical comorbidities (diabetes, blood pressure, cholesterol)
5. Have your BMI in ideal range
6. Keep your doctor follow ups
Patients hear this daily from most of their doctors. Why are the above important? Exercising has proven to be a strong predictor of longevity (ability walk briskly for 15 minutes without being short of breath is ideal). Eating right assures sufficient nutrients the body including the heart. It also helps keeping your cholesterol as low as diet can keep it. Tobacco products are killers. They stimulate constant inflammation and create toxic environments for almost every organ in your body. Keeping appointments assures you do not run out of pills and allows for needed adjustments in blood pressure and to discuss potentially important symptoms.
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