Heart disease continues to be the leading cause of death in the United States and the second leading cause of death in North Carolina. Did you know that, each year, more than 600,000 people in the US die as a result of heart disease? The American Heart Association (AHA) estimates that 85.6 million people in the US are living with some type of heart disease. Alarmingly, African Americans suffer at a 20% higher rate than Whites, and African Americans account for almost 25% of all US deaths due to heart disease! In NC, over 24,000 people died as a result of heart disease in 2013, accounting for 29% of all deaths in the state, and more than 5,000 of those deaths were African Americans.
Why are African Americans at greater risk for heart disease?
Recent research, cited by the AHA, suggests there may be a gene that makes African-Americans much more sensitive to the effects of salt, which in turn increases the risk for developing high blood pressure. High blood pressure is one of most significant risks for heart disease. African Americans also tend to have higher rates of obesity and diabetes, which then puts them at greater risk for high blood pressure and heart disease.
What is Heart Disease?
Heart disease is defined as any illness that affects the heart’s ability to function normally. Heart disease is also known as cardiovascular disease, coming from the words “cardia” referring to the heart, and “vascular” referring to the arteries and blood vessels that carry blood throughout your body. Adapted from the National Institutes of Health and the American Heart Association, we have prepared a mini-glossary of heart disease terms below.
Angina – A type of chest discomfort or pain caused by inadequate blood flow through the blood vessels of the heart muscle.
Arrhythmia – An arrhythmia is any disorder of your heart rate or heart rhythm, such as beating too fast, too slow or irregularly. This occurs when the electrical impulse that signals the parts of your heart to contract in a synchronized manner is interrupted.
Atherosclerosis – A disease that occurs when fatty material and a substance called plaque builds up on the walls of your arteries.
Congestive Heart Failure (CHF) – happens when the heart can no longer pump enough blood to the rest of the body. Heart failure is almost always a chronic, long-term condition, although it can develop suddenly. This condition may affect the right side, the left side, or both sides of the heart.
Coronary Artery Disease (CAD) – is a narrowing of the small blood vessels that supply blood and oxygen to the heart. CAD is usually caused by atherosclerosis. As the coronary arteries narrow, blood flow to the heart can slow down or stop, causing chest pain (stable angina), shortness of breath, heart attack, and other symptoms.
Heart Attack – A heart attack occurs when low blood flow causes the heart to starve for oxygen. Heart muscle dies or becomes permanently damaged. Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. The coronary arteries bring blood and oxygen to the heart. If the blood flow is blocked, the heart starves for oxygen, and heart cells die.
Heart Murmur – a blowing, whooshing, or rasping sound produced by unstable blood flow through the heart valves or near the heart.
What are the risk factors for heart disease?
There are two types of risk factors for heart disease: controllable risk factors, and non-controllable risk factors. Non-controllable risk factors include: age (being 50 years old or older) and having a family history of heart disease, especially if your relative had it before age 55. Controllable risk factors for heart disease include having hypertension (high blood pressure), high cholesterol, and/or diabetes; being obese; being sedentary (lacking physical activity); and smoking.
So what can I do if I have these risk factors?
- Control your blood pressure. Hypertension is defined as having blood pressure greater or equal to 140/90 mmHg. For adults with diabetes, blood pressure should be below 130/80 mmHg. Pre-hypertension, a risk factor for hypertension, is defined as having a systolic (upper number) blood pressure of 120-139 mmHg or a diastolic (lower number) blood pressure of 80-89 mmHg. Check your blood pressure regularly and make sure that your healthcare provider checks your pressure every time you go to see him or her.
- Keep your cholesterol in check. There are two types of cholesterol: LDL (low density lipoprotein) and HDL (high density lipoprotein); high levels of HDL (greater than 50mg/dl) and low levels of LDL (less than 130mg/dl) are healthy for your heart. According to the American Heart Association, everyone who is 20 years of age and older should have a fasting lipoprotein profile every five years. If you have diabetes or heart disease, more frequent checks may be needed.
- Control your diabetes. If you have diabetes, it is very important to keep your blood sugar under control. Your doctor may order a glycosylated hemoglobin (HbA1c) test to determine how well your blood sugar is controlled. The higher your HbA1c is, the greater your risk for heart disease and other diabetes complications. A normal level of HbA1c is less than 7.0 percent.
- Control your weight. Body mass index, or BMI, is a measure that indicates our “body fatness” or level of weight control. It is based on a ratio of your weight to your height. For an adult, obesity is defined as having a BMI of greater than or equal to 30. Between 25.0 to 29.9 is considered overweight, and 18.5 to 24.9 is normal. Getting adequate physical activity (as discussed below) and eating a healthy diet can help keep your weight under control.
- Get active! Physical activity doesn’t have to be boring; there are plenty of ways to be active and enjoy a healthy lifestyle. According to the CDC, adults should engage in moderate-intensity physical activities for at least 30 minutes on 5 or more days of the week, or engage in vigorous-intensity physical activity 3 or more days per week for 20 or more minutes per occasion. Physical activity can include anything from jogging to biking, brisk walking, swimming, and mowing the yard.
- Stop smoking and/or avoid secondhand smoke. If you are a current smoker, there are many resources available to help you quit. Quitting smoking may be difficult, but you have a much higher chance of succeeding if you involve your doctor, your family, and your friends in your decision to stop. Getting involved in tobacco support groups may increase your chances of success because you will be able to talk to people who are feeling the same way you are. Talk to your doctor about what resources are available in your area to help you stop smoking.
How is Heart Disease Diagnosed?
Your doctor may perform several tests, examples of which are: resting or non-resting electrocardiogram (ECG or EKG), chest X-ray, exercise stress test, computed tomography (CT) scan, and magnetic resonance imaging (MRI). The CT and MRT scans allow the doctor to see a 3-D image of your heart. Your doctor may also perform a cardiac catheterization, during which a doctor inserts a thin plastic tube (catheter) into an artery or vein in the arm or leg. From there it can be sent into the chambers of the heart or into the coronary arteries, allowing the doctor to see what areas are blocked or affected by disease.
Medications and Procedures
There are a variety of heart medications you can take to treat or prevent heart disease. These drugs lower your blood pressure, reduce the level of cholesterol in your blood, or help your body get rid of excess fluids that affect your heart’s ability to pump blood. There are many procedures done to treat heart disease, such as angioplasty, bypass surgery, cardioversion, and heart transplant. There are also devices that can be used, such as a pacemaker, a small device that sends electrical impulses to the heart muscle to maintain a correct heart rate and rhythm. Some of the common procedures include:
Balloon Angioplasty: A small balloon is threaded through a catheter and inflated to compress fatty tissue around your coronary artery; the balloon can also stretch the artery a bit to increase blood flow to the heart. A stent is a small metal mesh tube that supports the inside of your coronary artery to help keep it open and reduce the risk of further blockage. These are sometimes put in place during the balloon angioplasty. Some stents contain medicine and are designed to reduce the risk of reblockage.
- Bypass Surgery creates a new path for blood to flow to the heart when coronary arteries are blocked. During coronary artery bypass graft surgery, a blood vessel is removed or redirected from one area of the body and placed so that it “bypasses” the blockages and restores blood flow to the heart. This vessel is called a graft. These substitute blood vessels can come from your chest, legs, or arms. It’s safe to remove grafts from these areas because there are other pathways that take blood to and from those tissues.
- Cardioversion is a treatment for arrhythmia (heart rhythms that are irregular). During cardioversion, a special machine sends electrical energy to the heart muscle to restore normal rhythm. The procedure restores the normal heart rate and rhythm, allowing the heart to pump more effectively.
- Heart Transplant is the replacement of a person’s diseased heart with a healthy donor’s heart. A heart transplant procedure is considered when heart failure is so severe that it does not respond to all other therapies, but the person’s health is otherwise good.
Preventing Heart Disease by living a healthy lifestyle and being aware of your risk factors is essential, along with having regular checkups with your doctor. Treat your heart right so it can take care of you for many years to come!
Do you need further information or have questions or comments about this article? Please call toll-free 1-877-530-1824. Or, for more information about the Maya Angelou Center for Health Equity, please visit our website: http://www.wakehealth.edu/MACHE.