April 9, 2009

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Cardiac Intervention Programs Reduce Future Heart Attack Risk

Carolyn Campbell

April 9, 2009

Joe Dalto was searching for a seat at the Deer Valley Amphitheatre when he suddenly collapsed. The 53-year-old Intermountain Healthcare quality consultant had no pulse or respiration. A bystander immediately started CPR while a volunteer ran to the first aid booth, returning with a defibrillator. When Dalto’s pulse returned, an ambulance rushed him to Intermountain Medical Center where he received three stints for blocked arteries. “The most significant struggle for me was fear that I could die at any minute,” Dalto recalls. Dr. Frank Yanowitz, medical director at LDS Hospital Health & Fitness Institute, says there is a tremendous emotional impact after having a heart attack, especially for those who were previously unaware they were at risk. “It is often a person’s first awareness that they are vulnerable and at risk to die suddenly.” Cardiovascular disease takes the lives of nearly 830,000 Americans annually, accounting for one of every three deaths, says Jennifer Merback, communications director for the Utah Division of the American Heart Association. In the urban United States, post-heart attack health management has improved due to rapid intervention; today, approximately 70 percent of heart attack sufferers survive the incident. “The focus after a heart attack is to avoid another one,” Yanowitz explains. “We identify factors in a person’s life, which, if changed, would decrease the likelihood that he or she will experience further complications.” He adds that changing those factors could also help protect someone who has never had a heart attack. Yanowitz explains that heart disease is a progressive illness that begins years before the moment when an artery suddenly closes off, causing damage to the heart muscle from lack of blood flow. Because there are multiple causes, doctors strive to identify each patient’s individual risk factors. There are genetic factors for individuals from families with a history of early heart attacks–below age 55 for men and 65 for women. Smoking, unhealthy diet, sedentary lifestyle and being overweight and/or obese, also increase heart attack risk, as well as high blood pressure and adult onset diabetes. Once a heart attack patient is discharged from the hospital, he or she follows a cardiac intervention program that includes medications to reduce cholesterol and control blood pressure. “Intervention is designed to restore both physical function and confidence along with promoting physical activity,” says Yanowitz. “The patient can return to physical conditioning under close supervision by the rehab staff.” Cardiac rehabilitation also provides education regarding diet, weight management, smoking cessation and improving cholesterol profile. “The patient is provided with information on his or her medications and is advised to continue taking the medications,” says Yanowitz. He adds that it is important for everyone—whether they have had a heart attack—to know their risk factors. “They need to know their history and whether their parents, siblings and even aunts and uncles have had coronary events, diabetes and high blood pressure,” says Yanowitz. Visit your doctor regularly to learn your cholesterol level, body mass index, fasting blood sugar level and blood pressure, advises Merback. “Cardiovascular disease and high blood pressure are silent diseases. It’s important that people who are not sick seek preventive checkups,” says Yanowitz. Exercise is a positive choice that can help lower heart disease risk. “Exercise reduces stress, helps control blood pressure and improves the ratio of good and bad cholesterol,” says Yanowitz. “People who exercise regularly have more energy, greater work efficiency and less fatigue.” Merback adds. “People with busy schedules can remember that 10 minutes of exercise here and there is as good for your heart as a continuous workout. A 10 minute walk in the morning and a 10 minute evening walk is as beneficial as walking twenty continuous minutes.” In addition to workout activities, Merback encourages physical activity throughout the day. “Park the car farther away from your office than usual,” she suggests. “Take the stairs instead of the elevator. Use your lunch hour to go for a quick walk. Do stretches at your desk.” Yanowitz says a heart-healthy diet is rich in fruits, vegetables and complex carbohydrates, such as grains and cereals. Merback adds the size of a healthy meat portion is about the size of a deck of cards. She also advises monitoring portion control when dining out. Look for heart-healthy entrees on the menu. Today, Dalto understands that “Staying alive is not a given. Now I give priority to my personal health. Everything else depends on that.”
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