Controlling Cardiovascular Disease During American Heart Month Cardiovascular Disease (CVD) is the leading cause of death for men and women. Dr. Mark Glazer, Assistant Professor of Cardiovascular Medicine, shares the facts about CVD including risk factors, signs and symptoms, small changes that can improve heart health, and resources for more information.
Marissa Wertheimer: Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast. I am Marissa Wertheimer with Health Plus. February marks National Heart Month, and I am here with Dr. Mark Glazer, Assistant Professor of Cardiovascular Medicine. Dr. Glazer is going to tell us a bit about the risk factors for cardiovascular disease, signs and symptoms, and what we can do to lower our risk of cardiovascular disease, but before we get started, will you please give us a picture of how common cardiovascular disease is? Dr. Mark Glazer: Sure Marissa. That is a great first question. I like to go up to people who I don’t know and ask them the following question: “What do you consider to be the greatest threat to your health?” Well, they stare at me like I am insane, and needless to say, I do not get invited to many parties. But after they pause and stumble around for a while, I rephrase the question, and I say, "Okay, let me put it this way. What do you consider to be the greatest threat to the health of American men and women?" And some people get the right answer. Many people though say things like overweight, eating badly, and not exercising. But it turns out that the answer to that question is cardiovascular disease. So, cardiovascular disease, it turns out, is the number one killer of American men and American women, and it has been the number one killer of men and women in America since 1900, except for one year. And I always ask people what year was it that it was not number one. And every now and then, somebody gets the right answer, but it turns out it was 1918 when the flu killed more Americans than cardiovascular disease. But other than 1918, cardiovascular disease is the greatest threat to the health of Americans, and yet, many Americans do not appreciate that. So, here are some numbers that might help them understand. Probably over 800,000 Americans will die this year from cardiovascular disease, that is 1 out of every 3 deaths will be from cardiovascular disease and that is more than cancer and lung disease combined. Now, you may ask me what does it mean: cardiovascular disease? What does that term include? So, the Heart Association includes the following four disease processes. Hypertension, coronary heart disease, heart failure, and stroke. So those four diseases make up cardiovascular disease which kills Americans greater than just about any other disease. Marissa Wertheimer: Wow, so it is very common. Thank you for giving us a better explanation of what cardiovascular disease is. Next, what are some of the risk factors for cardiovascular disease and are there certain populations that are at a higher risk for developing this disease? Dr. Mark Glazer: Yes. The standard risk factors that we look at include the following: One is genetic. Did your mother or father develop heart disease at an early age? There is nothing you can do about your genes, but if your parents or siblings developed heart disease at an early age, that puts you at increased risk. Another risk factor for cardiovascular disease is hypertension. Another is diabetes. Another one is an elevated cholesterol level, and the last one is cigarette smoking. All of us obviously are at risk being Americans, but the one population that I will point out that seems to be at higher risk than most is the African American population which has a much higher risk of hypertension for example. Almost 50% of African American men and women have hypertension, so that automatically raises a risk for the complication of cardiovascular disease. Marissa Wertheimer: So, in a moment, we will talk about some of the things that we can do to lower our risk of developing the disease, but before that, what are some signs or symptoms of cardiovascular disease? Dr. Mark Glazer: The classic symptom of coronary artery disease is a chest discomfort, not necessarily a pain but discomfort generally beneath the breast bone. Sometimes, it moves into the left arm, may move into the lower jaw, and it typically comes on with activity or emotional upset and goes away with rest or putting a nitroglycerine tablet on your tongue. That particular symptom is called angina, and it is a very common symptom of people who have coronary artery blockage. Now, it is well known that women have more unusual presentations for coronary disease. Their presenting symptoms may not be chest discomfort, although chest discomfort is still the most common symptom in women, but they may have shortness of breath, nausea, or chronic fatigue, so those kinds of symptoms, you should certainly think about a heart problem if you have those symptoms. Marissa Wertheimer: Please share with our listeners some small steps that we can take in our day-to-day lives to lower our risk of heart disease. Dr. Mark Glazer: Well, the first thing I would advise is be sure to go to your primary care physician and have him do a complete physical exam, take a full history, but in particular, get certain things done. Of course, he is going to check your blood pressure. He should also check a fasting blood sugar. He should also check a fasting lipid profile. So, those are the basics in terms of catching something like for example, diabetes which many people have but do not know about. A simple fasting blood sugar will pick that up and picking up an elevated cholesterol level which many Americans have and may not know about it and perhaps should be treated for it and may not realize that. So, that is the first thing that people need to do is get an appointment, go in fasting, and get the blood drawn. But in terms of modifying your risks, there are a couple of obvious things. Number one, if you are a smoker, do whatever you can possibly do to quit smoking. If that means you are smoking a pack a day, then decide that you are going to smoke 15 cigarettes a day and try that for a couple of weeks, and if you can get by with 15, then maybe set the goal at 10 cigarettes a day and see if you can figure out a way to get off cigarettes. Your primary care physician can also help you because there are certain medications that make it easier to quit smoking, so that is one thing you can do. If you are overweight or obese for that matter, and by the two-thirds of all adult Americans are either overweight or obese, it is a real epidemic and it is a real problem in the United States, and what is even worse than that is that between the ages of 2 and 18 one-third of all children and adolescents are overweight. So, if that is the case, then talk to your primary care physician about ways to lose weight, and of course, one of those ways is to begin a regular exercise program, and certainly, regular exercise is an important part of any kind of risk factor program that you might engage in. The next thing you can do is look at your eating habits. There are clearly ways to eat healthier. I am sure most people are aware of it. Things such as avoiding drinks that have sugar in them, drinking less alcohol, reducing your salt intake, eating more fruits and vegetables, less fried foods, eliminate fast food. If you could make some simple changes and you do not have to do them all, pick one or two that you think you can live with and start there, and if you can incorporate all of these things together, you will reduce your risk for developing cardiovascular disease. Marissa Wertheimer: Okay. Thank you so much that you shared with us some lifestyle modifications that we could all make that will help low our risks whether it is changing our eating habits, cutting out smoking, increasing our physical activity, or a combination of all of those will help significantly reduce our risks. Would you mind telling us some resources here at Vanderbilt and even within the Nashville community that can help listeners get more information on heart health and making some lifestyle changes? Dr. Mark Glazer: Well, the internet is a great way to get the resources and the information you need. You can Google Vanderbilt Heart or go to the following website vanderbilthealth.com/heart to find all the information you need about questions regarding cardiovascular disease, heart conditions and treatments, heart disease prevention tips, and advances in heart care. Again, your primary care physician is another good resource, and those would be the places that I would start in terms of finding out more. I would like to again say one more thing, and that is in terms of improving your risk. I gave a lot of suggestions, pick just one. Pick just one and start tomorrow in terms of seeing if you can modify one risk factor that you may have and stick with that for several months, and once you have modified that and you have changed your lifestyle, then think about picking a second. If you try to take on too much, you will fail, and you will never be able to reduce your risk. Marissa Wertheimer: Okay. Well, thank you so much again for that advice and for sharing your knowledge and expertise on cardiovascular disease. Thank you Dr. Glazer. Dr. Mark Glazer: Thank you Marissa. Marissa Wertheimer: Thanks for listening. Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. 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