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ACE OF HEARTS from Overlake Hospital



By Ronnier J. Aviles
MD Overlake Hospital Medical Center-affiliated cardiologist

Many adults feel like they’re on a slippery slope that ends in heart disease. Their father had it. Their grandfather had it. Why bother? It’s inevitable, right? Wrong.

Coronary heart disease is a preventable disease in many patients. Prevention requires meeting specific treatment targets to address each patient’s risk factors. As I counsel my patients, I find that meeting these targets can be extremely challenging in today’s busy lifestyles. Although new medications and public health campaigns have led to significant reductions in cholesterol levels and smoking rates—two of the major risk factors for coronary heart disease—a recent study presented at the American Heart Association’s 2009 Scientific Sessions suggests any strides forward have been tempered by a rise in the rates of obesity in the U.S. population. According to the study’s lead investigator, the result is no net gains in reducing the overall risk profile for coronary heart disease during the past 20 years.

Researchers found there has been an increase in the number of people with optimal cholesterol levels and an increase in the number of people who never smoked. On the flip side, researchers also found:

  • An increase in average body mass index from 26.5 to 28.8 (25 is considered overweight).
  • A decrease in the number of people with optimal blood pressure, from 48 to 43 percent.
  • A decrease in the number of people with optimal fasting glucose, from 67 to 58 percent. (Blood pressure and glucose are both linked to obesity.)

The call to action for the medical community and patients is clear: focus on prevention of obesity through lifestyle changes and physical activity. Education is critical. I spend a lot of time listening and discussing each patient’s specific risk factor profile. Some risk factors include:

  • Age. Risk for coronary heart disease increases as you get older.
  • Gender. Men are at greater risk for heart attack than women, but heart attacks are still the No. 1 cause of death in women.
  • Heredity. Heart disease tends to run in families.
  • High cholesterol. As cholesterol rises, so does the risk for coronary heart disease. Optimal cholesterol level depends on the risk profile for each patient.
  • High blood pressure. High blood pressure makes the heart work harder and causes the heart to increase in size. When combined with other risk factors like obesity, smoking and high cholesterol, the risk for heart attack rises dramatically.
  • High blood sugar. Diabetes increases your risk for high cholesterol and high blood pressure.
The lifestyle changes that I typically recommend include:
  • Eating a heart-healthy diet. Focus on portion control and healthy food groups: lean protein, low fat dairy, whole grains, vegetables and fruits. Avoiding saturated fats also reduces heart attack risk.
  • Adding physical activity. Try to get 30 minutes of moderate aerobic exercise five days per week. Moderate strength training is also helpful.
  • Quitting smoking. Healthy people reduce their risk of heart disease by 50 percent one year after quitting smoking.
  • Maintaining a healthy weight. Excess weight, especially around the middle, can increase cholesterol, blood pressure and risk for diabetes.
  • Limiting alcohol consumption. Too much alcohol can increase your blood pressure and contributes to obesity and irregular heartbeat. The daily limit is no more than one drink for women and two for men.
Know your risk factors and know your specific targets for treatment. And if heart disease runs in your family—it’s time to break the cycle. Change the inevitable.


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