By now you have heard enough about heart disease, right? Well, maybe not. Most people have some idea that things like heart attack and stroke can be very dangerous, if not fatal. But how do heart attacks and strokes really happen? What can you do to prevent it? How can you avoid this serious life threatening detour off the road of good health?
Long before the average person has a heart attack or stroke, there is usually a process going on in the body called atherosclerosis. “Athero” means fat; “sclerosis” means narrowing. So what is happening is that a person’s arteries are being clogged with fat. The arteries are the vessels that carry blood containing oxygen away from the heart to feed the other organs and tissues of the body. Besides narrowing the blood vessel, this fat (cholesterol) forms ragged-edged plaques inside it and sometimes, as the blood cells are passing by the plaque, they can get snagged on it. The more cells that get caught there, the greater the possibility that a blood clot will form.
Arterial blood is propelled through the body by the pumping action of the heart, which is a muscle. With this force, the blood clot can break loose from the plaque where it was stuck and travel through the body. If the clot lodges in the heart, it may block the artery so that a piece of the heart muscle loses its nourishing blood supply and dies. That’s what a heart attack is - a part of the heart muscle dying. The more the muscle is damaged, the greater the likelihood the person will die since the pumping action will be lessened and blood can’t get to the rest of the body like it should. If the clot lodges in the brain and a part of the brain dies, that’s called a stroke (cerebrovascular accident or CVA in medicalese). A heart attack is called a myocardial infarction or MI (myocardial refers to the heart muscle and infarction means tissue dying as a result of lack of blood supply).
The plaques that form are made from bad cholesterol, also known as LDL cholesterol. The good cholesterol, known as HDL cholesterol, actually is believed to eat up some of the bad stuff and clean out your arteries. But how do you feel when you have high blood cholesterol? Most people don’t feel anything in particular, and that’s the bad news. If you felt bad, you would probably do something about it, right? Except in extreme cases, there usually are no symptoms.
The only way to find out if your cholesterol is abnormal is to have a blood test which checks the two types of cholesterol and another fat called “triglycerides”. The most important change you will have to make, if this is the case, will be in your diet and the amount of exercise you get. Some people will need to take medications if they can’t lower their cholesterol and triglycerides (don’t worry - there’s no spelling test at the end of this) with diet and exercise alone. Taking medicine is not a substitute for improved diet and exercise, but something additional. There has been great emphasis over the past several years on the obesity epidemic in this country; our increased weight as a nation is contributing to the amount of heart disease and stroke we have. Some tricks to help with weight loss are included in my February 2003 article On the Road to Better Health. Even restaurants and fast food places are now replacing the usual fare with smaller portions and fewer calories. Most people are programmed to eat everything on their plates, so if your plate is loaded up restaurant style, you’re bound to eat it unless you make a conscious decision not to.
At least once a year you should have your blood tested while you are fasting (nothing to eat or drink except water for 8-12 hours before they take your blood). This is the most accurate way to check your cholesterol and triglycerides. Your health care provider might want to order some newer blood tests on you also, such as C reactive protein and/or homocysteine levels. These are other substances in the blood that may contribute to or indicate the risk of heart disease.
Two important questions you might want to ask your health care provider are: 1) Should I be taking one baby aspirin every day? The reason for this is that when you have abnormally high blood fats that may form plaques in the blood vessels, if you thin out the blood a little with small amounts of aspirin, it is less likely to form a clot; and 2) Should I be taking a folic acid supplement or vitamin with folic acid? Folic acid makes your blood vessels less likely to form plaques, so if you have any risk of that, folic acid might be a good idea.
Some people have family histories that make their risk of heart attack greater than for others. There are some thin people who may have very high cholesterol because it’s in their genes to have high cholesterol in spite of the fact that they are not overweight. If someone in your family has died from heart disease before the age of 50, you may also have a greater risk. We know that overweight and obesity increase your risk for heart disease and stroke and, of course, smoking will as well.
After a heart attack or stroke, rehabilitation may be necessary. This includes diet changes and daily exercise and may even include some psychological counseling. Depending on how much damage is done to the brain with a stroke, occupational, speech and/or physical therapy may be done. People may become paralyzed with a stroke; some will have speech difficulties and may have difficulty controlling emotions.
Bottom line - it’s better for men and women to prevent heart attack and stroke before they get a chance to put you in the hospital. Avoid this deadly detour and stay on the road to better health!
~ Norma Stephens Hannigan is a Family Nurse Practitioner
with many years of experience treating truck drivers. She writes from her home
in Laredo, Texas.
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