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Are we losing the battle in preventing heart disease?

February 03, 2020
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Yes, the statistics around heart disease in the United States are concerning. We talked with preventive cardiologist Dr. Quinn Pack of  Baystate Medical Center’s Heart & Vascular Program to learn more.

“In the past five years we have seen a reversal of a nearly half-century decline in heart disease and stroke, which was a major burden in the 1950s, but began to steadily decline until about 2015,” says Dr. Pack.

So, what happened?

While he considers smoking to be “enemy number one,” Dr. Pack’s other “five big ones” (risk factors) to control, include:

  • High cholesterol
  • Uncontrolled blood pressure problems
  • Physical inactivity
  • Obesity
  • Diabetes

Your lifestyle, age, family history, and pre-existing health conditions can increase your risk for heart disease. Nearly half of all Americans have at least 1 of 3 key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

“The more risk factors you have, the greater your chance of developing coronary artery disease. But, the good news is that 80% of heart disease is preventable. You can prevent or delay heart disease by beginning to turn your life around with healthy habits today,” Dr. Pack said.

While some risk factors for heart disease cannot be controlled, such as your age or family history, other factors can be managed to lessen your chances of developing heart disease.

Lifestyle Changes Make a Big Difference for Your Heart Health

February is American Heart Month, a special time to work closely with your primary care provider to lower your risk of heart disease. First, work on lifestyle changes. When those aren’t enough, your doctor may prescribe medicines to help control your risks.

So, where should you start?

Quit Smoking

“Smoking cessation may be hard, but is a more satisfying risk factor to treat because once you stop, unless you relapse, then that’s it - you’re done. That’s different than diet and physical activity which require effort every day of your life,” says Dr. Pack.

Also, within one month of quitting smoking, your risk for heart disease drops substantially. And, Dr. Pack noted that people will quadruple their chances of success if they talk with a coach and get approved smoking cessation medications from their doctor to help them quit smoking.

Among the methods to consider include calling 1-800-QUIT-NOW and visiting Smokefree.gov as well as medications such as varenicline, buproprion, an adequately dosed nicotine patch and gum.

Know the Risks of Vaping and Marijuana

Dr. Pack noted that when addressing the issue of smoking there are new factors to consider – vaping and marijuana.

“Last year there were tragic reports of death and lung disease linked to vaping. Several patients were hospitalized at Baystate, fortunately, none of them died,” said Dr. Pack.

“Scientists don’t have the answers yet, and may not for another 10 years, on how vaping might lead to lung and heart damage. As for e-cigarettes as a pathway to stop smoking and end your addiction to nicotine, I am not convinced that they are the solution,” he added.

E-cigarettes are not approved by the FDA as an aid to quit smoking and there is limited evidence that they are effective for helping smokers quit.

Dr. Pack agrees with the CDC’s position that “E-cigarettes have the potential to benefit smokers if used as a complete substitute for regular cigarettes and other smoked tobacco products.” He noted that for kids trying to get off of vaping, nicotine patches and gum should be a big help.

“I am not totally opposed to using e-cigarettes as an end solution to smoking cessation as long as you and your physician have exhausted all of the traditional methods to stop smoking,” he said.

As for smoking marijuana, Dr. Pack said that “there is a public perception that marijuana is harmless to your health despite evidence suggesting that the benefits are very limited, and the risks are substantial.”

He noted findings in an article published in Annals of Internal Medicine noted that 18% of respondents in a survey believed that being exposed to secondhand marijuana smoke is “somewhat or completely safe for adults.”

“I am much less worried about orals and edible cannabis products than I am about inhaling smoke from marijuana, which has been associated with heart attacks, pneumonia and stroke. I am also sure it will just be a matter of time before we discover that it is a causative factor in lung and other cancers,” said Dr. Pack.

Manage High Blood Pressure

While hypertension or high blood pressure is most often associated with the risk of stroke, it is also a major risk factor for heart disease and heart failure.

“We now have years of discovery behind us in high blood pressure and cholesterol. There are also medications today that are effective and have minimal side effects. So, there is no reason other than patient disengagement to not having your blood pressure or cholesterol under control,” said Dr. Pack, who noted patients should talk with their primary care doctor to learn if they fall under new guidelines for cholesterol lowering statins and hypertensive medications.

Get Active

Dr. Pack says exercise is essential to heart health.

“If you exercise every day for at least 30 minutes, just like taking a medication every day, you will have substantial benefits by lowering your risk of heart disease and lowering your blood pressure and cholesterol,” he said.

Dr. Pack considers obesity and being overweight as a major problem for your health.

“Weight is a major risk factor for high blood pressure, high cholesterol, and diabetes. It is also responsible for chronic obstructive sleep apnea, lower back pain, joint pain, and can lead to depression, a decrease in energy and some cancers. We also know that those who are obese are at a much higher risk to develop cardiovascular disease, especially heart failure and coronary heart disease,” said Dr. Pack.

“Fortunately, if you can lose even a little weight, it can have quite a positive effect on diabetes and prevent complications of diabetes such as blindness, kidney failure and neuropathy. It can be easily diagnosed and there are good medications available to control your blood sugars,” he added.

Learn More and Take Action

If you’re concerned about your health, talk to your primary care provider. They can help you take the right steps to reducing your risk of heart disease.

Learn more about the Baystate Heart & Vascular Program.