What we don't know can kill us
Boise tent and awning maker Rick Pew, who suffered a massive cardiac arrest and emerged intact from a weeklong coma early in 2007, thought he was too young to worry about his heart. Pew knew his blood pressure was OK, but figured he didn’t need to have his cholesterol checked until he was older. Never mind that for 34 years he smoked, the No. 1 risk factor for heart disease. Against all odds, Rick survived his cardiac arrest, quit smoking and threw out all the salt in the house. (OK, it was his family who threw out the salt. He wanted salt for his birthday.)
Most people are like him, said Deb Twedt, cardiac community education coordinator at St. Luke’s Boise Regional Medical Center. The public, by and large, is short of potentially lifesaving information about heart disease.
Did you know?
Most people should have their cholesterol checked for the first time at age 25 (some experts even favor age 20). The blood test is called a fasting lipoprotein profile and measures total cholesterol, LDL (bad) cholesterol, HDL (good) cholesterol and triglycerides. See the American Heart Association’s Web site for definitions. Its award-winning cholesterol site offers a hard-to-find combination of important detail and plain English.
Only about 13 percent of Americans know what all the numbers and words mean on their cholesterol tests, Twedt said. The Heart Association’s site walks you through each number. Get a copy of your most recent test results, check the Web site and use a tracking tool to plot your results over time.
"Metabolic syndrome," a term used to describe a cluster of risk factors for heart disease and diabetes, is an increasing problem as more of us gain too much weight. Yet many of us never have heard the word. Risk factors include a beer belly, low HDL cholesterol, high triglycerides, high blood pressure and other factors. Up to 25 percent of adults may have the syndrome.
Sometimes, age 25 is too long to wait to start checking for high cholesterol, high blood pressure and other obesity-related troubles. Heavy teens may need those checks now, Twedt said. "It’s very frightening," she said. "(Despite) the advances we’ve made, in this generation coming up, we are going to go backward until we get it under control."
Heart attack symptoms
Twedt, who gives community brown-bag lectures on heart disease, tries, among other things, to help people understand the common symptoms of a heart attack, so they will know when they need to go to the hospital. If they tarry, they risk death or permanent damage to their heart muscles.
- Feeling of pressure, squeezing, fullness or pain in the chest
- Pain in one or both arms, the back, neck, jaw or stomach
- Shortness of breath
- Cold sweat
- Nausea
- Light-headedness
- Mainly for women: extreme fatigue
Don’t wait more than five minutes before calling 911 if you or someone you are with has one, or especially more than one, of these symptoms.
The senior crowd, ages 65 to 80 years old, is most at risk for heart disease, but also sometimes the hardest sell for education, Twedt said. "They are very tough, and they don’t always listen to their bodies and do what they should do," Twedt said. "They don’t want to be a burden."
Lifestyle changes
Patients often can reduce their risk for heart disease through diet and other lifestyle changes. Here are some tips from Liz Warhurst, dietitian at Saint Al’s:
Exercise: 30 minutes a day of moderate to intense activity most days, if not every day, to reduce the risk of chronic disease. Moderate exercise is hiking, gardening, yard work, golf, bicycling, dancing, walking or stretching. Vigorous exercise is running or jogging, aerobics, walking at 4.5 mph, heavy yard work, basketball, lap swimming.
If you want to achieve or maintain a healthy body weight in addition to warding off chronic diseases, add 30 more minutes of exercise, for a total of one hour. And if you are short of time, exercise in three to six 10-minute segments each day.
Other easy exercise options: Park the car farther away. Take the stairs instead of the elevator. Use an exercise ball while watching TV or working on the computer. Sit in chairs without arms to prevent leaning.
Diet changes/recipe substitutions
Two egg whites can be substituted for one egg in baking.
Cook pasta, rice, potatoes, etc., with vegetable stock/broth to add flavor instead of adding butter or oil.
Add a variety of steamed vegetables or pasta, rice, beans, etc., to increase fiber.
Choose vegetarian dishes when you eat out. You’ll eat less fat and add vegetables to your diet.
Cook with water or a little olive oil instead of butter or saturated fat.
Take your medicine
If lifestyle changes such as a healthy diet and an increase in exercise don’t improve your numbers, your doctor may prescribe medicine. "Medications to control cholesterol and other heart problems have come a long way, and people who take them live longer than those who don’t," said Dr. Robert Duerr, an interventional cardiologist in the Valley. A lot longer. Instead of dying in your 50s, as you might have 20 years ago, you can live into your 70s or 80s, Duerr said.
But there’s a problem. Most recent studies shows patients don’t take their medication, at least not for the long haul. If they did, the number of deaths from heart disease would decline even more dramatically.
Hospitals improve emergency care for heart patients
The quality of care heart and other treatment that patients get at Treasure Valley hospitals is usually better than at the average hospital nationwide. Hospital Compare is a Medicare Web site intended to help patients rate the quality of care at specific hospitals and see the specialties of each facility. That helps patients decide where to go for elective procedures.
Saint Alphonsus Regional Medical Center and St. Luke’s Boise Regional Medical Center get high marks for the care they give heart attack patients.
In separate ratings, an independent accrediting agency called the Joint Commission also gave Saint Al’s, St. Luke’s Boise and Mercy Medical Center in Nampa above-average ratings in their care of heart patients.