Silent Assassin: Heart Attack Risk Factors

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Q. Glen,How do I know if I am at high risk for a heart attack? And if I feel alright how can I tell?



A.Here is a article I read that best explains it!


There's a killer on the loose. In fact, the most deadly, dangerous killer of our time. Quietly stalking his prey, waiting until his victim is weak and vulnerable, and then, striking without warning with heartbreaking efficiency.

More deadly than Gacy, Dahmer, Berkowitz, Bundy and the BTK killer combined -- heart disease is the leading killer of men and women in the United States. Be afraid, be very afraid.
According to Dr. Curtis Mark Rimmerman, cardiologist, echocardiographer, medical director for Cleveland Clinic Westlake and author of Heart Attack: A Cleveland Clinic Guide, just because you don’t have any symptoms, doesn’t mean you’re not at risk for heart disease.
"Thirty to 40 percent of people with significant obstructive coronary artery disease -- plaque buildup on the inside of heart artery walls, which reduces blood flow -- have no symptoms at all until their first heart attack," explains Dr. Rimmerman.
So how can people protect themselves? By recognizing and managing the risk factors associated with heart disease, according to Dr. Rimmerman.

“The main way we gauge the likelihood of heart disease and heart attack is by taking an inventory of risk factors."

There are two types of risk factors that affect the heart and heart disease: modifiable risk factors, those that can be controlled by lifestyle and behavioral changes, and those that cannot, or nonmodifiable risk factors, says Dr. Rimmerman.
Nonmodifiable Risk Factors
Getting on in years: “Over 83 percent of people who die of coronary heart disease are 65 or older. At older ages, women who have heart attacks are more likely than men are to die from them within a few weeks,” Dr. Rimmerman writes.
Just being a man: Men have a greater risk of heart attacks than women, and they tend to have attacks earlier in life, according to Dr. Rimmerman.
Family tradition: “Genes are the No. 1 risk factor for coronary artery disease,” he explains. “Children of parents with heart disease are more likely to develop it themselves.



Higher heart disease risks are more common in African Americans, Mexican Americans, American Indians, native Hawaiians and some Asian Americans -- partly due to higher rates of obesity and diabetes. “And most people with a strong family history of heart disease have one or more other risk factors," he said.
Modifiable Risk Factors
Smoking gun: “Smokers’ risk of developing coronary heart disease is two to four times greater than that of nonsmokers,” he said.
Dr. Rimmerman explains that smoking is a powerful independent risk factor for sudden cardiac death in those with coronary heart disease. It also greatly increases the risk of developing coronary heart disease in the first place.
“It’s never too late to stop smoking. Over time, depending on the age at which you quit, your cardiac risk begins to reach that of a nonsmoker.”
Obesity and overweight: “People who have excess body fat -- especially if most of it is at the waist -- are more likely to develop heart disease and stroke, even if they have no other risk factors,” according to Dr. Rimmerman.
Excess weight increases the heart’s work; raises blood pressure, blood cholesterol and triglyceride levels; increases the likelihood of diabetes and lowers the levels of HDL (“good”) cholesterol.
While losing weight is often very difficult, according to Dr. Rimmerman, “losing even as few as 10 pounds can lower your heart disease risk.”
Diabetes: Even if blood sugar levels are controlled, diabetes increases the chances of heart disease and stroke, but if blood sugar is not controlled, the risks become even greater.
“About three-quarters of people with diabetes die of some form of heart or blood vessel disease,” says Dr. Rimmerman. “If you have diabetes, it’s extremely important to work with your health-care provider to manage it and control any other risk factors you can.”
High blood cholesterol: “As blood cholesterol rises, so does risk of coronary heart disease,” Dr. Rimmerman says.
Combined with other risk factors such as smoking and high blood pressure, the risk increases exponentially. Cholesterol can be affected by age, sex, heredity and diet.
High blood pressure: "High blood pressure increases the heart’s workload, causing the heart to thicken and become stiffer,” Rimmerman says. It also increases a person’s risk of stroke, heart attack, kidney failure and congestive heart failure -- and when teamed with other risk factors such as obesity, diabetes or smoking, it becomes a very risky combination for strokes and heart attacks.
Physical challenge: A sedentary lifestyle is a risk factor that contributes to all other risk factors. Dr. Rimmerman recommends regular, moderate-to-vigorous physical activity to help prevent heart and blood-vessel disease.



“Exercise can help control blood cholesterol, diabetes and obesity, as well as help lower blood pressure in some people,” he says.
Now you’re armed with the knowledge necessary to recognize the risk factors of this silent slayer. You can learn more about the risks and controlling heart disease in Dr. Rimmerman's book Heart Attack: A Cleveland Clinic Guide. And to get your diet, weight and exercise back on track. Don’t be another victim.
Resource: Dr. Curtis Mark Rimmerman, Cardiologist.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You Great Health!

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Do You Know Heart Attack Signs?

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Q. Glen, What are the signs that you are having a heart attack?

A. We've all seen the Hollywood movie where the character clutches his or her chest in agony and drops to the ground. While this is our vision of a heart attack, the reality may be very different.

While some heart attacks are sudden and intensely painful, most start slowly, with mild pain or discomfort that lasts just a few minutes. As a result, people often wait hours to seek help, a delay that can be lethal. Some new research shows that many heart-attack victims don't experience chest pain or anything like the classic "Hollywood" heart attack.

One study showed that for as many as a third of sufferers, sudden excessive sweating is the symptom most likely to send them to the doctor. One reason excessive sweating might send a person to the doctor is that it's not as easily explained away as shortness of breath, nausea, chest pain and fatigue, which can be attributed to overdoing things, a bad night's sleep, a flu bug or any number of things.

WHAT'S A HEART ATTACK?
What exactly is a heart attack? When one of the arteries that supplies blood to a portion of the heart is blocked, this can cause injury to that part of the heart muscle. Irreversible injury to the heart muscle usually occurs if medical help is not received promptly. Unfortunately, it is common for people to dismiss heart-attack symptoms. Aside from the excess sweating, some of the more common signs of a heart attack include:

Pain spreading to the shoulders, neck or arms. The pain can be mild or intense. The pain may feel like a heavy weight, tightness or burning; it can be located in the chest, upper abdomen, neck or jaw.

Paleness.

Anxiety, nervousness or sweaty skin.

Increased or irregular heartbeat.

Feeling of impending doom.

Chest discomfort, with lightheadedness, fainting, sweating, nausea and shortness of breath.

As with men, women's most common heart-attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Not all of these signs occur in every heart attack. Sometimes they may go away and come back. If some occur, it's important that you get help. Call 911. If you are near someone and they go into cardiopulmonary arrest (they aren't breathing and have no pulse), start CPR right away if you know how.

So heart attacks can show themselves in many ways besides chest pain. And you need to be ready to recognize the symptoms, which may include sweating or just sudden confusion. Any delay in treatment can make the consequences of a heart attack much, much worse.

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You A Healthy Life Style!

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Pot Belly May Signal Diseased Arteries

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Q Glen, Should my big stomach, give me reason to worry about diseases?


A. Waist-to-Hip Ratio May Be More Telling Than BMI, Study Shows

Aug. 13, 2007 -- The tape measure may beat the scale as a low-tech indicator of atherosclerosis, new research shows.

Atherosclerosis means the hardening of the arteries, which makes heart attacks and stroke more likely.

Doctors have sophisticated tools to search for signs of atherosclerosis. But a tape measure may give you a rough idea of your risk -- and if you've got a pot belly, watch out.

So say James de Lemos, MD, FACC, and colleagues at the University of Texas Southwestern Medical Center at Dallas.

"We think the key message for people is to prevent accumulation of central fat early on in their lives," de Lemos says in a news release. "To do so, they will need to develop lifelong dietary and exercise habits that prevent the development of the 'pot belly.'"

Pot Belly or Flat Abs?

The new study included 2,744 Dallas residents who were in their mid-40s, on average (age range: 30-65).

Participants got noninvasive scans to check for evidence of atherosclerosis, which can start years before a heart attack or stroke. They also got their height, weight, waist circumference, and hip circumference measured.

Based on those measurements, de Lemos and colleagues calculated participants' BMI (which relates height to weight) and waist-to-hip ratio (waist circumference divided by hip circumference).

BMI vs. Waist-to-Hip Ratio

BMI (body mass index) is often used to gauge obesity. But BMI can be misleading.

BMI can't tell muscle from flab. It also doesn't show where body fat is located. Carrying extra fat around your waist may be unhealthier than having extra fat around your hips.

Because of BMI's drawbacks, some experts prefer the waist-to-hip ratio to gauge obesity.

In the Dallas study, waist-to-hip ratio trumped BMI as a marker of atherosclerosis.

That is, participants' waist-to-hip ratio was more sensitive than BMI at indicating who had scans showing evidence of atherosclerosis.

Abdominal fat may play an active role in promoting heart disease, warn de Lemos and colleagues.

Their study, published in next week's edition of the Journal of the American College of Cardiology, didn't directly test that theory.

Looking to lose a pot belly? Your doctor can give you pointers on doing so safely -- and on maintaining your progress.

SOURCE:
See, R. Journal of the American College of Cardiology, Aug. 21,

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You Great Health!

Any questions? Ask Glen

Young at Heart

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Q. Glen, I have pains in my chest sometime, I am afraid of having a heart attack! Is there any way I can have a more youthful heart?


A. Yes! Here are 5 secrets to turning back the clock on your ticker

Over the past few years, cardiologists across the country have begun aggressively trying to prevent heart disease in at-risk men, rather than treating them only after their blood pumps have broken down. "My patients who follow a preventive treatment program almost always live free of heart attacks," says Arthur Agatston, M.D., author of The South Beach Heart Program. To help you spot subtle risk factors and correct them before they bury you, we canvassed cardiologists at leading research institutes to compile this list of things they wish you knew.

Your Heart's Mortal Enemy is Often Invisible to Doctors

"I was taught in medical school that when a heart attack happens, vessels have closed gradually, like pipes filling up with sludge," says Dr. Agatston. "We now know that blockages occur suddenly, from soft-plaque ruptures, which often go undetected by standard cholesterol tests and exercise stress tests." The soft plaques resemble pimples in the arterial walls, except instead of pus, they're filled with cholesterol.

Why it's so dangerous: When those pimples pop, a small blood clot forms to heal the injury, followed by scar tissue and tiny calcifications along the arterial wall. By then, you're already incubating an attack, which strikes when a violent explosion of one of the pustules creates a clot big enough to block an artery.

How to ID the problem: If you have a family history of heart disease, schedule a 64-slice CT scan. It's the only test that snaps pictures of the heart quickly enough to reveal minute calcifications in the coronary arteries. Just make sure the scanner has ECG dose modulation, the latest radiation-limiting technology. If trouble's spotted, you may need statins.

How to defend yourself: Toss pecans onto your salad or into your oatmeal. Loma Linda University researchers had 24 people replace 20 percent of their daily calories with pecans for a month, and found the nuts lowered levels of lipid oxidation (the process that turns cholesterol into plaque) by 7 percent, enough to help ward off arterial damage. "Pecans are rich in gamma-tocopherol, a form of vitamin E that isn't in supplements," says lead author Ella Haddad, Dr.P.H., R.D. Even a handful a day can help, she says.

An Untrained Heart Won't Reach the Finish Line

Not every heart test needs to take place in a cath lab. In a 23-year study of 6,000 men in the New England Journal of Medicine, researchers revealed that the greatest predictor of death from heart attack was the ability of a man's heart rate to adapt during and after a workout. "The faster your heart rate goes down after exercise, the healthier you are," says Steven Nissen, M.D., chairman of cardiovascular medicine at the Cleveland Clinic.

Why it's so dangerous: Those men whose heart rates didn't drop by at least 25 beats per minute (bpm) within 1 minute of finishing an intense workout were more likely to suffer a fatal heart attack than those whose heart rates dropped efficiently. The reason? How your heart adapts to exercise is a good indication of how well it will respond to the extreme stress produced before and during an actual infarction.

How to ID the problem: Complete 10 minutes of sprints, check your heart rate, and then check it again 1 minute later.

How to defend yourself: Improve your heart-rate variability by applying the principles of interval training to your lifting regimen. Wear a heart-rate monitor and don't end your first set until the monitor reads 160 bpm, says Alan Stein, C.S.C.S. "Then wait till it drops below 130 bpm to begin your next set."

You've Never Even Heard of the Cholesterol that Wants You Dead

Researchers now realize that the size of cholesterol particles is even more important than their number. Small particles of LDL, called Lp (a), are a particularly damaging form of cholesterol, according to Michael Ozner, M.D., medical director of the Cardiovascular Prevention Institute of South Florida. These particles aren't only smaller, they have a tail, says Dr. Ozner, making it easier for them to sneak into the arterial wall. On the flipside, the larger your HDL particles, the more easily they can usher LDL cholesterol out of your arteries.

Why it's so dangerous: A recent study in the Journal of the American College of Cardiology reveals that people with high Lp (a) were 10 times more likely to suffer a heart attack than those with lower levels.

How to ID the problem: Ask your doctor to schedule a Vertical Auto Profile (VAP) test. (Check it out at www.the vaptest.com. It's covered by most insurance plans.) This detailed blood profile includes a measure of Lp (a)--an ideal level is below 10 milligrams per deciliter--as well as big and small HDL particles.

How to defend yourself: Diet, exercise, and even statins have proven ineffective against Lp (a). But in a review of 8 years of studies on prescription niacin, Dutch researchers determined that swallowing 2 grams of this potent B vitamin lowered Lp (a) by 17 percent and raised the number of large HDL particles by 18 percent. Ask your doctor for a slow-release version of niacin. Research has shown that these formulations produce fewer side effects.

Carbohydrates, Not Fat, are the Real Heartbreakers

The more carbohydrates you consume, the higher your blood sugar and, in turn, your levels of insulin, a hormone that lets us use sugar as energy. But excess insulin may also increase your risk of heart disease, according to a review in Preventive Medicine. "The inflammatory process leading to hardening of the arteries is mediated through insulin," says Wolfgang Kopp, M.D., the study's lead author. Translation: High levels of insulin boost your body's production of stress hormones, which send blood pressure skyrocketing. That increased pressure damages the arterial wall, making it easier for cholesterol to slip inside.

Why it's so dangerous: Insulin may not act alone. It's theorized that the excess carbohydrates that cause insulin to increase to an unhealthy level are turned into triglycerides in your liver. And the more triglycerides you have circulating in your bloodstream, the more Lp (a)--the lethally small cholesterol--you're likely to have.

How to ID the problem: Johns Hopkins University researchers showed that for every 1 percent increase in hemoglobin A1c (HbA1c), an indicator of long-term blood-sugar levels, patients experienced a 14 percent increase in heart-disease risk. If diabetes appears anywhere on your family tree, schedule an HbA1c test. A level higher than 4.6 percent of total hemoglobin often warrants dietary changes and sometimes blood-sugar-lowering drugs.

How to defend yourself: Pour yourself a cabernet. According to a recent study in the Annals of Epidemiology, small amounts of alcohol may help control your blood sugar, and, by extension, your insulin. Researchers studied the drinking habits of people with type-2 diabetes and found that compared with teetotalers, those who indulged in just one alcoholic beverage per night had levels of HbA1c that were 1.3 percentage points lower on average.

Your Heart Might Be Misfiring

One in four men will develop an irregular heartbeat, or arrhythmia, by the time they reach 40. Yet they often don't experience obvious symptoms until they're clutching their chests during cardiac arrest or they suffer a stroke. Your heartbeat originates in the sinoatrial (SA) node, a collection of specialized heart cells that acts as your heart's control center, says Jennifer Cummings, M.D., director of electrophysiology research at the Cleveland Clinic. "It reacts to information from your body and brain about how much blood needs to be pumped, then sends an electrical impulse telling your heart when to beat."

Why it's so dangerous: "When an arrhythmia occurs, the heart stops listening to the SA node, turning its attention to other electrical signals," says Dr. Cummings. One form of arrhythmia, called atrial fibrillation, or AFib, can occur even in young athletic men. "It's like there are 300 voices inside the heart telling it what to do," says Dr. Cummings. Chaotic heartbeats cause the blood to swirl and eddy instead of flowing smoothly through the ventricles, and clots form as a result.

How to ID the problem: One telltale sign of an arrhythmia is a dramatic decline in endurance. If your regular cardio workout is suddenly a lot more exhausting, ask your doctor for an EKG. If that comes up clear, request a Holter monitor. It records your heart rhythm for 24 hours to detect more infrequent missed beats. Passing out may also be a sign of serious heart-rhythm trouble.

How to defend yourself: One of the most common causes of arrhythmia is high blood pressure, so keep yours under 120/80 millimeters of mercury. A massage may provide pleasurable stress relief. In a recent University of South Florida study, people who underwent three 10-minute massages a week experienced an 18-point drop in their systolic blood pressure and a 5-point drop in their diastolic blood pressure after just 10 sessions.

Relax--You're Not Dying

Four alarming chest sensations that can impersonate an infarction

A Fluttering or Pounding Heartbeat

"Some perfectly healthy and normal individuals may feel extra or skipped heartbeats on occasion, and those can be benign," says P.K. Shah, M.D., a Men's Health cardiology advisor. If the sensation is brief and the onset gradual, they are probably the harmless result of too much caffeine or stress. However, frequent flutterings, or those accompanied by lightheadedness or dizziness, could be serious.

Chest Pressure When You Swallow

If you feel a squeezing pain beneath your breastbone and it hurts to swallow, especially in the evening, you may just have heartburn or, at worst, an esophageal spasm. But if it persists most nights of the week, see your doctor to rule out gastroesophageal reflux disease or other more serious conditions.

Shooting Pain on One Side

"Sharp, fleeting pain on the left side of the chest is typically not life-threatening," says John Elefteriades, M.D., a Men's Health cardiology advisor. It can signal pleurisy (an inflammation of the lung lining), a muscle pull, or even a broken bone.

Mild Pressure, Shortness of Breath, and Numbness

Hyperventilation is commonly mistaken for a heart attack. If the pressure in your chest isn't severe, and you lose feeling in your lips or hands, you may simply be hyperventilating. Lie down, try to relax, and breathe into a paper bag for 5 minutes. Still have symptoms? Call 911.

Reference:

Mayo Clinic , Cleveland Clinic, Harvard Medical, Web MD, Mens Health

Any personal health questions or problems mental or physical or before starting any diet or exercise program. Please consult your physician !

Wishing You Great Health!

Any questions? Ask Glen

Heart Attack Risk May Be Genetic

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Q. Glen, Are Heart Attack Risk Genetic?

A. At the risk of being Captain Obvious, your chance of having a heart attack is largely tied in with your diet and fitness choices. But there may be one other factor to consider: your genes.

Two new studies, from separate research teams, show that gene variants in a certain chromosome may make coronary heart disease -- which is the number one cause of death in the U.S. -- and heart attacks more likely.

The scientists don't know exactly what the gene variants in chromosome 9p21 do, but their findings suggest that the effects aren't good for the heart.

They screened the DNA of more than 23,000 white people in Canada, the U.S., and Denmark. A common variation in chromosome 9p21 was "consistently associated" with coronary heart disease.

The genetics of heart disease may differ among ethnic groups, note the researchers. The researchers aren't recommending gene tests, and they're not blaming the gene variants for all coronary heart disease or heart attacks.

The studies did not include information on the participants' diet, exercise, medical care or other heart-related lifestyle habits.

Any personal health questions or problems mental or physical or before starting any diet or exercise program.Please consult your physician !

Wishing You Great Health!

Any questions? Ask Glen