Know the Fundamentals
In the game of life, it is important to know your level of risk for diseases such as CAD. The more risk factors you have, the greater your chance of developing Coronary Artery Disease (CAD). Some risk factors - age, gender and a family history of heart disease - are out of your control. Others you can change - smoking, diabetes, being overweight or obese, high cholesterol and physical inactivity.
Following are a few of the opponents you may be up against:
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Age - As you get older, your risk for CAD increases. In men, risk increases after age 45. In women, risk increases after age 55.
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Family History of Heart Disease - According to the American Heart Association, if one or both of your parents have heart disease, you are more likely to develop it yourself. In addition to your family history, your ethnicity can also mean you have inherited an increased risk. For example, African Americans have more severe high blood pressure than Caucasians and a higher risk for heart disease. Heart disease risk is also higher among Mexican Americans, American Indians, native Hawaiians and some Asian Americans. This is partly because these groups are more likely to have obesity and type 2 diabetes.
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High Total Blood Cholesterol - High cholesterol increases your chances of developing CAD. The higher your cholesterol level, the greater your risk for CAD. People who have total cholesterol levels greater than 200 mg/dL have an increased risk factor for CAD. Talk to your health care provider about how to lower your cholesterol level. Sometimes you can lower your cholesterol just by changing your lifestyle. Other times you may also need to take medication.
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Diabetes - Having diabetes makes it much more likely that you will develop CAD. Even people who carefully control their blood sugar are at greater risk. The risk is even greater for people who don't control their blood sugar. About three-fourths of people with diabetes die of some form of heart or blood vessel disease. If you have diabetes, work with your health care provider to keep it under control. Try to control any other risk factors you have.
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Overweight - Extra pounds, especially if most of them are around your waist, make it more likely that you will develop CAD. Excess weight makes your heart work harder and raises your blood pressure. It also raises your total cholesterol and triglyceride levels and lowers your HDL ("good") cholesterol levels. Extra weight can also make diabetes more likely to develop. Many obese and overweight people may have difficulty losing weight, but by losing even as few as 10 pounds, you can lower your heart disease risk. Talk to your health care provider about how to lose weight.
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Physical Inactivity - Regular, moderate exercise helps control cholesterol levels and blood pressure. It also helps prevent type 2 diabetes and obesity. The more vigorous your exercise, the greater the benefits, according to the American Heart Association. Be sure to check with your health care provider before starting an exercise program. Your provider can also help you decide which exercise is best for you.
Establish a Game Plan
When it comes to preventing heart disease, you can approach your health in the same way a coach plans for a game. The best offense is a good defense, so extend your defense with this proactive game plan.
Share your family heart history. Learn whether you have a family history of heart disease. If you do, share that information with your doctor so that he/she can assess your disease risk, recommend lifestyle changes to help prevent disease and/or prescribe laboratory or clinical tests to detect disease early.
Don't smoke. If you do smoke, quit. Talk to your health care provider if you need help with quitting.
Limit how much alcohol you drink. If you are a man, limit your alcohol to no more than two drinks a day or 14 a week. If you are a woman, limit your alcohol to no more than one drink a day or seven a week.
Exercise most days of the week. Aim for at least 30 minutes of moderate-intensity exercise each day. Be sure to check with your health care provider before starting an exercise program.
Eat a healthy diet.
This means limiting the amount of saturated fat and cholesterol you eat.
Control your blood pressure. Have your blood pressure tested. If you have high blood pressure, follow your health care provider's advice on how to lower it.
Know and Control your cholesterol levels. Have your cholesterol levels tested. If you have high cholesterol levels, follow your health care provider's advice on how to lower it.
Manage your weight. Lose weight if you need to.
Cardiac Testing
If you have several risk factors for CAD, your physician may recommend testing. Following are several tests that can be used to determine the condition of your heart:
Electrocardiogram (ECG or EKG) - The electrocardiogram is one of the most basic tests cardiologists use to gauge the health of your heart. This painless, noninvasive test analyzes your heart's electrical activity with the placement of electrode leads on your arms, legs and chest. The EKG yields a graphic record that looks like a series of waves representing each beat of your heart which can help your physician detect whether you are having or have had a heart attack, whether there are disturbances in your heart's rhythm or a thickening of your heart wall.
24-hour EKG (Holter monitoring) - You go about your daily activities while connected via electrode leads to a small, portable recorder that continuously monitors your heart's activity. Holter monitoring is often accompanied by a written diary of your activities over a 24-hour period.
Exercise Stress Test
- During a stress test, you exercise either on a treadmill or stationary bicycle while attached to the EKG machine via electrode leads. The test shows your physician how well your heart performs as more demands are made on it.
Pharmacologic Stress Test - For people who are unable to exercise, medications can be injected while the heart is being monitored by the EKG. These medications produce similar cardiovascular responses as during exercise.
Chest X-Ray - A chest X-ray may be taken to determine the size, contour and position of the heart. An X-ray can be useful in understanding some structural abnormalities or the presence of complications such as congestive heart failure. An X-ray can also guide placement of cardiac catheters, such as pacemakers and pulmonary artery catheters.
Blood Tests - You may be given blood tests that measure the presence of enzymes stored in the cells of your heart. When you experience a heart attack, damaged cells within your heart release enzymes into the blood stream.
Nuclear Scans - Small amounts of radioactive substances are injected into your body passing through the bloodstream and into the heart. A scanner indicates which areas of the heart are not getting sufficient oxygen. Nuclear scans are often used during an exercise stress test. This allows for comparison of resting and exercise images.
Echocardiogram (echo) - During an echo, the size of your heart and its chambers are measured using sound waves. Echos show your doctor whether your heart is pumping normally and whether your heart's valves are performing as they should. An echo may be used during exercise stress testing. Transesophageal
Echocardiogram (TEE) - A variation on the echocardiogram involves the threading of a small transducer through the mouth and into the esophagus. This technique provides clearer ultrasound images because the sound waves pass through less tissue.
Cardiac Catheterization (cardiac cath) - A cardiac cath or angiogram is a procedure that identifies possible problems with your heart or its arteries. During a cath, which takes between one and two hours, a thin plastic tube, called a catheter, is inserted into a blood vessel in your groin or arm. The catheter is guided up toward your heart. A special dye is injected into the catheter so that X-rays can show if you have any artery blockage or other heart problems.
(Rev.2/07/13).
