Living with Cardiovascular Disease
Care for your heart and live a vital life
We’ve all heard the sobering statistics. Cardiovascular disease is prevalent and the leading cause of death (of both men and women) in our society. But the good news is that, thanks to increased awareness, changes in lifestyle and habits, and improved treatment methodologies, the rate of death from heart disease is actually decreasing. If you or someone you love has been diagnosed with cardiovascular disease, you should know that it is not a death sentence! There are many positive steps you can take to maintain and even improve your health and quality of life.
Cardiovascular disease (or heart disease), is a catch-all term used for a variety of different conditions that affect the heart. Some of the most common heart problems include:
- coronary artery disease (“CAD”), caused by atherosclerosis (plaque build-up in the arteries)
- congestive heart failure (when the heart doesn’t pump enough blood, often due to CAD)
- valvular disease (problems with the heart valves)
- arrhythmia (irregular heartbeat)
- heart attack (when blood flow to the heart is diminished, often a result of CAD)
Now, whether you have a history of heart problems or just want to keep your heart as healthy as possible, there are two key dynamics that need to be managed in your body:
- Cholesterol levels
- Blood pressure
What’s the deal with cholesterol, anyway? Every cell in the body needs cholesterol to function properly. However, plaques containing cholesterol can build up inside your arteries and block the flow of blood (a condition called atherosclerosis), which can cause chest pain, heart attack, or stroke. That’s why it’s important to carefully monitor your cholesterol levels and keep them under control. This is especially true if you have a history of heart disease.
The best ways to manage cholesterol are:
- Eat a healthy, balanced diet low in saturated fat and high in fiber. Choose fruits, vegetables, lean proteins (like fish, chicken, and dairy), grains, and nuts. Stay away from fried and fast foods.
- Exercise regularly within your ability. Get your heart pumping by moving around as much as possible. Walk, swim, dance, play a round of golf, take a class at the recreation center—do whatever you enjoy that keeps you moving. (If you have a serious condition or are recovering from an illness or surgery, be sure you consult with your physician about what kind of exercise is appropriate for you.)
- Don’t smoke. Just don’t. Enough said.
- Use medications if appropriate. There is a class of medications called “statins” which are helpful in managing cholesterol levels. Statins work by blocking production of an enzyme in your liver which makes cholesterol. Your doctor will know if you are a good candidate for these medications.
What about blood pressure? Your blood pressure measures the force of the blood being pumped against your artery walls. It is possible to have high blood pressure, or hypertension, without any symptoms. But long term, if it’s not controlled, hypertension can increase the risk of heart attack and stroke. Blood pressure can be managed with many of the same lifestyle adjustments we discussed above. In addition:
- Lose excess weight. Even ten pounds can make a big difference.
- Limit consumption of sodium, alcohol, and caffeine. All three can contribute to hypertension. (That said, studies suggest that red wine, in moderation, is good for the heart. Same with dark chocolate. So don’t feel that you have to completely deprive yourself!)
- Reduce your stress level. Stress can have a direct impact on blood pressure, so watch out for the things that make you feel stressed or anxious. Although it can sometimes be difficult to manage or eliminate the factors that stress you out, you can learn skills like deep breathing or meditation that will help manage the effects of stress on your body.
- Use medications if necessary. Your physician will be able to determine if your hypertension can be improved through the use of blood pressure medications. Oftentimes, a simple daily aspirin tablet can be helpful.
What kind of routine medical care do I need? If you are healthy and have not been diagnosed with cardiovascular problems, I suggest that you see your physician at least once a year for a routine physical. You should have your blood pressure checked, a lipid panel (blood tests that check for cholesterol levels), and perhaps a baseline EKG to determine the “healthy” condition of your heart.
If a patient has an established disease but is stable and doing well, I like to have them monitor their blood pressure at home and come in to see me about three times a year for follow-up visits. If someone is not doing as well, I will want to see them more frequently and keep a close watch on what’s going on.
Should I have the surgery, doc? Quality of life is key. In geriatric medicine, one of our core beliefs is that we should always strive to maximize our patients’ functionality and quality of life. While it can be troubling for a patient to decide whether or not to have an invasive procedure like heart surgery or angioplasty, I encourage them to consider this: while it may not, necessarily, measurably prolong your life, it might significantly improve the quality of your life. It’s likely that a corrective procedure might help you to do more and feel better in your day-to-day life.
What should I do to recover from surgery? There are excellent outpatient cardiac rehabilitation (CR) programs available to patients who have previously been hospitalized due to heart conditions or procedures. Depending on your specific diagnosis and recommended treatment plan, Medicare is likely to pay for at least 36 (and potentially more) CR sessions. I’ve had patients who have benefited greatly from and thoroughly enjoyed their CR regimens. Check with your physician for more information.
It is possible to live a happy, vital life with cardiovascular disease. Talk to your healthcare providers and make positive lifestyle changes to care for your heart and keep it beating strong.