Carlsbad Doctor Helps North County 'Go Red'

Written by Dr. Sharon Slowik, MD, Medical Director of Cardiac Rehab at Tri-City Medical Center

As National Go Red for Women month, February is a time to raise heart disease awareness among women. After all, it’s an unfortunate fact that one in four women in the U.S. will die from heart disease. But Go Red month doesn’t have to be just about women. Heart disease affects us all. According to the CDC, an American will have a coronary event about every 26 seconds, and about one person will die from a coronary event every minute. In the spirit of upcoming Go Red events and Valentine’s Day, let’s learn a few simple ways to protect our hearts.

Pumps wear out: Your heart is beating 24 hours a day, 7 days a week. So what if you’re only given 3 billion beats in a lifetime? At 60 beats per minute, 3 billion will give you 95 years. At 90 beats per minute, 3 billion will give you only 63 years. Train it with exercise to create a slow resting pulse and make it last.

The law of supply & demand: Exercise creates a demand for blood and oxygen supply to the muscles. Ultimately, your heart wants to learn the most efficient way to do its job so if you train it with exercise, it won’t have to pump as often when your body is at rest. This extends its viability over time.

The heart muscle itself also demands blood flow when working harder with exercise. Supply is via the coronary arteries. A narrowed coronary will lead to angina when demand goes up but supply can’t meet it. For example, think of the coronary artery as a sprinkler or hose in your yard. If you block the flow of water, the grass will die. Likewise, when there is no blood flow to the heart, that region of the heart will die. That’s what we call a heart attack.

Think about it – what is easier to push against: a brick wall or a trampoline? Blood pressure is the resistance to the pump: the heart has to push against it. Think about it as the pressure in your arteries when your heart beats. The systolic (or top number) is the heart pumping pressure. The diastolic (or bottom number) is the heart resting pressure. 115/75 is what we should shoot for.

However, one in three adults has high blood pressure. This is a silent condition, as there are often no symptoms. If the heart has to work too hard for too long to pump blood, it becomes enlarged, eventually leading to congestive heart failure. When pressure is high, arteries can also harden and cause heart attack, stroke or kidney failure. 

Death from ischemic heart disease and stroke increase progressively and exponentially from a normal pressure of 115/75. For every 20mm Hg systolic or 10 mm Hg diastolic increase in blood pressure, the mortality risk from both ischemic heart disease and stroke doubles.

The treatment for high blood pressure is simple: maintain a healthy body weight, quit smoking, eat food lower in salt and fat, consume more fruit and vegetables, drink less alcohol and exercise. Your doctor may also prescribe medication.

Clogged Pipes: Think of high cholesterol as the equivalent of having clogged pipes. Cholesterol is a fatty, wax-like substance found in the blood. Some cholesterol is essential for good health. Our bodies make all the cholesterol we need, but we also get it from eating animal products like meat, butter, eggs and milk. A person should shoot for:

• Less than 200 mg/dl of total cholesterol
• 60 mg/dl or greater of good cholesterol (HDL)
• Less than 100 mg/dl of bad cholesterol (LDL)

Keep an eye on your rate: 

• Normal heart rate: Your heart rate when you’re at rest. For adults, normal heart rate is 60 – 100 beats per minute. 
• Maximum heart rate: The highest your pulse rate can get. To find yours, follow this formula: 220 – (your age) = (predicted maximum heart rate). Please note this is NOT your workout rate.
• Target heart rate: 60 – 85% of your maximum heart rate. This is usually accomplished with exercise.

To find your heart rate, locate the radial pulse, or the pulse on the inside of the wrist. Use the pads of three fingers. Place these just below the wrist creases at the base of the thumb. Press lightly until you feel a pulse (blood pulsing under your fingers). If necessary, move fingers around until you feel the pulse. What to do if you can’t find your pulse? Use your fingertips instead of having your fingers lay across your wrist. Put them in different places and stop in each location for five seconds. Vary the pressure of the fingertips on your wrist. You may need to lighten up or press harder. Hold your arm pointing down towards the floor.

Top tips to keep coronary artery disease and heart attacks at bay:

• Be willing and open to make lifestyle changes. It’s important to actively educate yourself on health issues and put prevention into practice.
• Exercise: Shoot for 3 – 5 times a week and make sure you’re hitting 60 – 80% of your maximum heart rate. A best practice is to engage in 30 – 60 minutes of aerobic activity each time, followed by 10 – 20 minutes of strengthening and stretching.
• Reduce stress 
• Quit smoking
• Eat a healthy, nutrient rich diet; reduce reliance on processed foods; consume plenty of fruits and veggies; reduce intake of bad fats (i.e., bacon, steak) and increase intake of good fats (i.e., avocado, nuts)
• Drink more water
• Keep an eye on your heart rate

If you’ve already had a heart event or are worried about your risk for one, don’t hesitate to join a support group. There is a “Mended Hearts” support group for heart patients, families and caregivers on the 2nd Tuesday of each month at 11 a.m. at Tri-City Wellness Center (6250 El Camino Real, Carlsbad) and the 4th Thursday of each month at 12:30 p.m. at Tri-City Medical Center (4002 Vista Way, Oceanside). For women, there is the “Women Heart” support group on the 1st Tuesday of each month at 10:45 a.m. at Tri-City Wellness Center. The support groups are free to the public.

If you’re looking for nutritional guidance, Tri-City Medical Center is leading a tour of the VONS grocery store with a registered dietician on February 12 at 1 p.m. Participants will learn how to read labels, distinguish the difference between organic and natural foods, learn about trans fat, and more.

Additionally, Tri-City Medical Center is offering 2-for-1 heart screenings for the entire month of February. Participants get a clear picture of their heart health, an accurate assessment of their chances of developing heart disease and education on the appropriate steps to decrease risk of stroke and heart attack. For more information and to schedule a screening, visit Tri-City online.

These tips are highlights from a free “The Doc is In” lecture, hosted by the Tri-City Wellness Center on February 6. Learn more about heart disease risk factors and prevention in the Tri-City Wellness Center at 6250 El Camino Real in Carlsbad. For more information and to RSVP, visit tricitywellness.com or call (855) 222-8262.