Heart Health 101

About 6.5 million Americans are living with heart disease. Heart disease is the leading cause of death for men and women of most racial and ethnic groups in the U.S.2 Lifestyle choices such as diet and exercise play a big role in who gets heart disease. But other health conditions play a role too. Heart disease is more common in people with certain long-term medical issues such as diabetes, psoriatic arthritis, or lupus.3-5 Plus, some cancer medications can damage your heart muscle.1 Why improve heart health? Improving your heart health can go a long way toward making you feel better and having more energy. In addition, many heart-healthy habits reduce the risk of other diseases, such as cancer and stroke. Looking and feeling better maybe a welcome outcome of maintaining a healthy weight and quitting smoking, 2 of the lifestyle changes that help your heart. Monitoring conditions and medications There are risk factors for heart disease that we can’t control. This includes certain genes, conditions we are born with, or infections we may get. The good news is that there are many areas where we do have control. Our daily habits have a major impact on our hearts. That means we have the power to improve our heart health with several different lifestyle choices. Even small changes can help. One way to keep your heart as healthy as possible is to manage your drugs and medical conditions. High blood pressure, high cholesterol, and diabetes pose major risks for heart disease and stroke. Keeping your blood pressure in a healthy range reduces strain on all of your blood vessels, your heart, and your kidneys.6 Likewise, controlling your blood sugar and your cholesterol is important for heart health. Monitoring these conditions, staying in touch with your doctor, and taking your drugs regularly are important for protecting your heart. This can be challenging, especially if you are feeling depressed or if you experience unpleasant side effects. Seeking social support and communicating with your healthcare team can help.7 Choose healthy food and drinks Eating plenty of fruits, vegetables, whole grains, nuts, beans, and other high-fiber foods contributes to heart health. Choosing healthy foods also helps you maintain your weight, which is another key factor in protecting your heart. Other ideas for making healthy food choices include:8 Limiting sweetened drinks, cured meats or lunch meats, processed foods, added sugars, full-fat milk and cheese, eggs, and tropical oils like palm and coconut. Avoiding trans fats and partially hydrogenated oils, which can be found in fried foods and commercially prepared baked goods. Choosing unsaturated oils, like olive oil and avocado oil. Reading labels to watch for hidden sodium, saturated fats, and added sugar. Cooking at home more often. Other helpful tips Walking, weight training, making it a point to get up and move throughout the day, and setting goals that motivate you to keep working harder can also be of help. Being physically active can provide a big boost. Even small amounts of physical activity can help your heart. This includes housekeeping and gardening. Experts recommend at least 150 minutes of moderate activity or 75 minutes of intense activity spread throughout the week.9 Quitting smoking is another extremely important action to take and the benefits are profound and happen quickly. Smoking is responsible for one-third of the deaths caused by heart disease. But within 1 year of quitting, your risk of heart disease and cancer goes down by half.10 Smoking is addictive, so it can be challenging to quit. But more than 1 million people successfully quit each year. The benefits improve more than your heart health, because quitting reduces the risk of cancer, makes it easier to be physically active, and protects your loved ones from the health risks of second-hand smoke.10 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] A deep vein thrombosis (DVT) is a blood clot, also called a thrombus. It can develop inside the deep veins of the body.1-2 These clots generally form in the lower leg or thigh but can form in other places.1 DVT can develop for many reasons and can go away on its own and be harmless. But if a part of the blood clot in a DVT breaks loose it can cause a serious problem.2 This is known as a pulmonary embolism (PE). It is caused by a blockage in one of the pulmonary arteries of the lungs that happens when a piece of the clot breaks away from the DVT and travels from the legs through the bloodstream to the lungs. DVT statistics A kind of venous thromboembolism (VTE), DVTs can develop in as many as 1 in 1,000 people and is a contributing cause of death for 60,000-100,000 people per year.1,3 It follows a heart attack and stroke as the third most common cause of death from cardiovascular disease.1 We don’t really know how often DVTs develop because the condition frequently goes undiagnosed. DVTs can cause pain or swelling, but also be present without any symptoms. When the symptoms are “silent”, there is often no treatment. 1 Who gets DVTs? Blood clots can be caused by immobility, medications, or conditions that affect the way blood clots including inherited conditions or an injury to veins or nearby tissue.2,4-5 Sitting still for a long time, whether at your desk all day, traveling in a car or airplane, or lying in a hospital bed can increase your risk for blood clots.2,4 They can also develop as a complication from surgery.1 DVTs can happen if the blood in a deep vein does not circulate or clot normally.4 The danger comes when part of a clot breaks loose as it can travel through the bloodstream and get stuck in the lungs. This can block blood flow, affect how the blood gets replenished with oxygen, and cause death.4 But DVT can be a largely preventable condition if people are educated about what to look for and how to lower their risk.3 DVT risk factors People commonly at risk for DVT include those with cancer, congestive heart failure, obstructive airway disease, who just had surgery, or those who smoke. Obesity, pregnancy, and age - people over 60 are also at increased risk of developing DVT.1 There are 3 main categories of DVT risk factors, called Virchow's Triad:1,3 Venous stasis – reduced blood flow due to extended bed rest, general anesthesia, surgery, stroke, or long-haul flights Vascular injury - damage to the blood vessel wall caused by trauma, surgery, IV drug abuse, or previous DVT Hypercoagulability – increased risk of clotting due to medical condition or genetics Diagnosing DVT Doctors use different tools to determine risk and diagnose a DVT.1 A physical exam and history (clinical), blood tests (biochemical), and imaging tests, most often ultrasound, are used to diagnose DVT.3 DVTs most often form below the knee in a deep or hidden area often with decreased blood flow.1,3 People with a DVT sometimes complain of pain or tenderness in the DVT area, especially when the foot is flexed. Others may experience swelling or redness. These are things your healthcare team will look for in examining you.1 The typical blood test used to indicate the presence of a DVT is called a D-dimer. It measures a protein that is a strong indicator of DVT but cannot identify the location of a clot. Ultrasound imaging is used to see deep into the veins and locate the specific clot. Treating DVT DVT can cause complications. The goal of DVT treatment is to prevent these complications; including pulmonary embolism, reducing the rate of death, and preventing or minimizing the risk of bleeding or developing post-thrombotic syndrome. Anticoagulation therapy, blood thinning, is the most common treatment for DVT.1,3 These are medicines that help to thin the blood, so it isn’t as sticky and doesn’t clot as easily. Other recommendations for managing DVT include getting up and walking, wearing compression stockings, and quitting smoking if you are a smoker.1 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] Atrial fibrillation (AFib) is a common heart rhythm disorder. AFib occurs when the upper chambers of the heart (the atria) beat very fast in a disorganized way. When this happens, the lower chambers of the heart (the ventricles) do not work correctly.1 Atrial fibrillation can cause symptoms like shortness of breath, fatigue, and palpitations. It also increases a person’s risk of stroke.1 Ablation is a minimally invasive surgery used to treat AFib. During an ablation, the surgeon burns or freezes some of the heart muscle tissue to scar it. These scars interrupt the heart’s electrical signals so that the heart beats correctly again.1-3 How does AFib affect the heart? There are four chambers of the heart, two on top (atria) and two on the bottom (ventricles).2 Each time the heart contracts, it receives a signal that begins in the upper right of the heart. With AFib, the signal doesn’t begin where it is supposed to. This prevents the atria from contracting normally and interferes with the way blood moves through the heart.2 The result is that the atria start to quiver, or fibrillate. This can prevent the heart from pumping enough blood out to nourish the body.2 How is AFib treated? There are 3 basic ways to treat AFib: Drugs, ablation, or shocking the heart back into rhythm. Research has shown that ablation is more effective than drug treatment in people with paroxysmal AFib (AFib that lasts less than 7 days) and persistent AFib (AFib that lasts a week or more).1 Different ablation techniques Ablation is a procedure that uses radiofrequency current (heat) or cryo energy (cold) to scar a small area of the heart by burning or freezing.1 Ablation destroys the tissue causing an abnormal electrical pathway and forms a scar.3 The scarred area cannot conduct electricity which prevents abnormal heart rhythms.3 During an ablation, catheters (thin hollow tubes) are inserted into a blood vessel in the groin and threaded up to the heart.2 Special tips on the end of the catheter produce energy that creates a scar. The specific area of tissue that is scarred depends on the structure of that person’s heart and the electrical changes present.1 Length and complications of ablation Ablation usually takes two to six hours. The doctor who performs the surgery is called an electrophysiologist. Electrophysiologists are cardiologists who specialize in treating heart rhythms.2-3 The procedure might cause slight discomfort. Most people spend a night in the hospital to be monitored after the procedure.2 Complications can occur during ablation.1 These tend to develop in patients who are older, female, very thin or very heavy, or who have another heart disease. These conditions can generally be managed but in some cases require emergency lifesaving treatment.1 What are the benefits of ablation? Ablation helps control symptoms and restores the normal electrical signals of the heart. The hope is that heart function, symptom relief, quality, and length of life improve. There is always the chance that AFib can recur after ablation. This can happen early, late, or very late after the surgery. Early is considered 1-3 months. Late occurs in the first two years. Very late happens after two years.1-2 Ablation procedures are performed more often today than years ago.1 Before, drugs were the first line of treatment, but in some patients, ablation can be considered before drug therapy.1 Success depends on selecting the right patients for the procedure. Researchers are trying to figure out who makes a good candidate for ablation. Currently, doctors believe that ablation remains the best choice for people who will achieve long-term heart rhythm control.1 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"] Coronary artery disease (CAD) is a medical term for the most common type of heart disease. It is the leading cause of death in the United States and around the world.1-3 CAD develops when fat and cholesterol deposits, called plaque, build up in the arteries. This makes the arteries more narrow and the blood vessel walls thicker and less flexible.3-4 What causes coronary artery disease? The buildup of plaque is called atherosclerosis or hardening of the arteries. Atherosclerosis usually develops over time; however, it can happen quickly and unexpectedly if a blood clot breaks away and blocks an artery.4 Atherosclerosis reduces the amount of blood flow so there are fewer nutrients and oxygen to sustain the body. Coronary artery disease is sometimes called ischemia, which means inadequate blood flow.5 When plaque builds up in arteries that supply blood to the heart, less blood reaches the heart muscle. This can trigger symptoms such as chest pain or pressure (angina). It can also play a role in high blood pressure. CAD can cause a heart attack if an artery becomes completely blocked and no blood can get through to feed the heart.3 CAD can lead to heart failure and heart rhythm problems called arrhythmias. If this happens, the heart is unable to pump blood the way that it should because the heart muscle gets weak.4 How is coronary artery disease diagnosed? Regular health checkups generally include an evaluation of your heart and your risk factors for heart disease. From the time you are young, your doctor may measure blood pressure, cholesterol, weight, and sometimes sugar levels. Children who are overweight, inactive, or have poor eating habits are at risk of developing CAD. A family history of heart disease or being a smoker also increases your risk.4 What you eat and your physical activity level in childhood can influence whether you develop plaque deposits. These can be seen early on in life.5-6 Doctors often recommend steps to achieve a healthy lifestyle to prevent or delay the onset of CAD.5 What are the risk factors for coronary artery disease? Coronary artery disease develops due to a mix of lifestyle changes, environment, and genetics.1 Some of these risks can be controlled such as diet and exercise. Risk factors that cannot be controlled include age, gender, race, and genetics. Post-menopausal women and men over age 45 have increased risk.3,5,6 The main risk factors for CAD include cholesterol levels, high blood pressure, family history, diabetes, obesity, and stress. Cholesterol is a type of fat in the blood. It is made up of low-density lipoprotein (LDL) or “bad cholesterol” and high-density lipoproteins (HDL), or “good cholesterol.” High levels of LDL and low levels of HDL can lead to CAD. Higher levels of HDL are thought to protect the heart because it carries cholesterol to the liver where it is removed from the body.6 What are the symptoms of coronary artery disease? As coronary arteries narrow from plaque buildup, the oxygen-rich blood supply to the heart decreases.6 In the beginning, you may not notice any symptoms. However, as CAD progresses, you may feel symptoms when you are active, and your heart is working harder. Symptoms may include chest pain, shortness of breath, and a heart attack. How is coronary artery disease treated? Many different kinds of drugs may be prescribed to treat CAD. The drugs your doctor prescribes will depend on whether you need to be treated for high cholesterol, high blood pressure, irregular heartbeat, or decreased blood flow. Surgery may be needed when blood vessels to the heart become blocked.8 Catheter-based techniques include angioplasty and stent placement. Other surgery includes coronary artery bypass graft (CABG) surgery.7 Can coronary artery disease be prevented? Like other kinds of heart disease, CAD may be prevented or delayed with diet and exercise and lifestyle changes.3 There are steps everyone can take to help lower their risk for most kinds of heart disease, including:7 Eating a heart-healthy diet Increasing physical activity to a minimum of 30 minutes a day Keeping any high blood pressure and diabetes under control Not smoking, or quit smoking Managing stress [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"],Coronary artery disease (CAD) is a leading cause of death around the world. Managing risk for CAD and understanding its signs and symptoms are important parts of a treatment plan. Prevention and treatment go hand in hand. Making lifestyle changes is the first step in treating CAD. Drugs or surgery may be needed.1,2 Healthy eating The basics of healthy living form the core concepts of treating CAD. Many of the benefits of a heart-healthy lifestyle impact one another.2-5 Eat a heart-healthy diet. There are many recommended diets such as the Mediterranean, keto, or DASH. But you can’t go wrong with these basic steps: More fruits and vegetables Whole grains, nuts, and legumes Reduce bad fats by not eating fried or processed foods Low-fat proteins like fish and poultry Limit intake of salt, sugar, red meat, alcohol and white starches Avoid or limit caffeine and alcohol Other lifestyle changes Get regular exercise. Leading an active lifestyle can help you live longer. Benefits may include:2,4 Improving blood pressure and cholesterol levels Weight control Better management of diabetes and other health conditions Don’t smoke. We already know smoking isn’t good for the lungs, but it can damage the blood vessels of the heart as well. Manage stress. Long-term stress contributes to several negative health effects, including coronary artery disease.2 Stress causes the body to release hormones that cause the heart to speed up. This creates a racing feeling and makes the heart work harder. Manage weight. Diet and exercise are key. Being overweight makes other risk factors for CAD worse.2,4 Manage blood pressure. Controlling blood pressure helps reduce hardening of the arteries which can narrow the channel for blood flow.2,4 Keep diabetes and cholesterol under control. High cholesterol levels in the blood can increase the risk of plaque formation. Together with blood sugar management you can help reduce the risk of complications for heart disease.2,4 Drugs to treat CAD There are many different kinds of drugs to treat coronary artery disease:2,3,5,6 Cholesterol medications - there are a range of cholesterol-lowering medications. Some common ones include statins, PCSK9 inhibitors, resins, and lipid-lowering therapies like niacin and fibrates. Aspirin - a daily aspirin or another blood thinner can reduce the ability of the blood to clot. This may help prevent buildup in the coronary arteries. Beta-blockers - these drugs slow the heart rate and reduce blood pressure which can lower the heart's demand for oxygen. Calcium channel blockers - these drugs can help improve symptoms of chest pain and are used in combination with or instead of beta-blockers. Ranolazine - prescribed to treat chest pain (angina), it improves blood flow to help the heart work more efficiently. Nitroglycerin - controls chest pain by temporarily widening the coronary arteries and reducing the heart's demand for blood. Nitroglycerin can quickly relieve pain or discomfort. ACE inhibitors - vasodilators work to lower blood pressure by widening blood vessels. This improves blood flow which makes it easier for the heart to work properly. These drugs also block the effects of harmful stress hormones. ARBs - Angiotensin II Receptor Blockers (ARBs) are an alternative for ACE inhibitors and offer similar benefits. Be sure to follow the instructions for each drug that you take. Do not stop taking any drug, even if you are feeling better.3,6 Report any sudden change in the way you feel to your healthcare team. Procedures to treat CAD There are different kinds of procedures available to treat more severe CAD.2,3,7 Cardiac catheterization is performed as a diagnostic tool to identify coronary blockages or to evaluate the pressures and cardiac output of the heart. A long thin catheter is inserted into an artery in the groin or arm which is threaded up through the arteries around the heart. Contrast or dye is injected, and x-rays are taken to see if there are blockages in the arteries.7 Catheterization is also used for certain procedures like coronary angioplasty or stenting if blockages are found. A stent is a wire mesh tube that is permanently placed in a blocked coronary artery. It is a minimally invasive procedure done by catheterization. The stent is placed on the end of the wire that is guided into the blocked coronary artery.7 When in place, a balloon inflates to press the stent open to widen the blocked artery. It is permanently positioned in the artery to reduce the chance of another blockage developing.1-2 Multiple stents can be placed in the same artery and in separate arteries. The goal is to relieve chest pain and improve blood flow to the heart. Coronary bypass graft surgery (CABG) is a common open-heart surgery that reroutes blood flow around a clogged artery. The procedure uses healthy arteries or veins taken from other parts of the body, called grafts.7 A surgeon sews them into the aorta and then into the coronary artery to bypass the blockage. This improves the supply of blood and oxygen to the heart. Bypass surgery reduces the risk of a heart attack and improves the ability to engage in physical activity.2 [lead_gen showIfLoggedIn="0" campaign="shortcode" source="site"]

Heart Health 101

How to Improve Heart Health

What Is Deep Vein Thrombosis (DVT)?

What is an Ablation for AFib?

Is AFib Genetic?

What Is Coronary Artery Disease (CAD)?

How is Coronary Artery Disease Treated?

What is AFib?

What is the Most Common Symptom of Peripheral Artery Disease?

What Are the Early Signs and Risk Factors of Coronary Artery Disease?

What Are the Symptoms of Deep Vein Thrombosis?

What Causes Peripheral Artery Disease?