Understanding the facts about heart disease




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The numbers are staggering. Heart disease is the No. 1 killer of men and women in the nation. And, while many still see heart disease as a “man’s disease,” in reality nearly twice as many women than men die of heart disease each year. In fact, according to the American Heart Association, more women die of heart disease than all forms of cancer combined. Despite the facts, heart disease is often silent, hidden and misunderstood.

The American Heart Association talked with Dr. Lian Shaw, a cardiologist at Legacy Salmon Creek Medical Center in Vancouver, to learn the risk factors for heart disease and steps you can take for prevention.

What is the most important indicator of heart disease and how do genetics factor into this?

While genetics are important to be aware of and may be a highly important for some, the most important information for all to know for heart health are your risk factors, which make you more susceptible to heart disease, and then working on changing the ones you can control. The risk factors you can change are: modify your diet, start exercising and, if you smoke, quit! Prevention is the key.

Other significant risk factors include diabetes, high blood pressure/hypertension and being overweight (BMI greater than 25). Diet, exercise and tobacco cessation will help with these risk factors as well but there may also be a need for taking the appropriate medications, as prescribed by your doctor, to get these risk factors under control.

It’s important to “Know Your Numbers,” so what should your numbers be?

The basic four numbers you should know and keep in check are: blood pressure, cholesterol, body mass index (BMI) and blood glucose. The targets for these numbers:

  • Blood pressure: 120/80 (or less)
  • Cholesterol – four parts: (measured in mg/dL):
  1. Total cholesterol less than 200
  2. LDL (think of “L” as lousy – or the bad number) less than 80
  3. HDL (think of “H” as happy – or the good number) above 40 for men and above 50 for women
  4. Triglycerides below 150
  • Body Mass Index (BMI): Less than 25 (between 18.6 and 24.9)
  • Blood glucose (GHbA1C = glycosylated hemoglobin – often referred to as “A1C”): Less than 7 percent

How much exercise is really needed to positively affect heart health?

Exercise is really the key to maintaining a healthy heart and for prevention of heart disease. Doing some form of aerobic exercise for just 30 minutes a day, five days a week to get your heart rate up to your target heart rate, will go a long way to keeping your cardiovascular system in good shape. Target heart rate is calculated as: (220 – your age) x 0.85 = target heart rate.

Another important factor about exercising regularly is that it will better help signal signs of heart disease. It’s an early warning system. If you’re exercising regularly but start to notice changes like shortness of breath and lessened capacity to exercise with chest pressure or tightness, it’s time to see your doctor to determine what underlying factors may be causing these changes.

What are the signs and symptoms of a heart attack? Is it the same for men and women?

The difference between the symptoms for men and women can vary greatly and while we’re conditioned to look for the classic signs of chest pain, there are some other signs that have been less associated with heart disease.

While men may feel the heavy, crushing chest pain with pain radiating down their arm, women’s symptoms may seem more subtle and cause them to more easily dismiss them. Women may feel general fatigue, have nausea and vomiting, experience back pain, shortness of breath, and instead of the commonly associated heavy chest pressure or pain, may experience only a sense of chest tightness.

Any of these signs in men or women need to be evaluated immediately by a physician.

photoDr. Lian Shaw, cardiologist, Legacy Salmon Creek Medical Center.

About the author:

Lian R. Shaw, M.D., is a cardiologist at Legacy Salmon Creek Medical Center in Vancouver, where he specializes in cardiology and cardiovascular disease with a subspecialty in internal medicine. Dr. Shaw earned his medical degree from the Oregon Health Sciences University, completed his internship and residency at University of Nevada Medical School and then completed his cardiology fellowship at the University of Texas, Health Science Center at San Antonio. He later obtained certification in cardiac CTA from UCLA at Harbor California. The Pacific Northwest has been home to Dr. Shaw since childhood. He has worked as a cardiologist in the Vancouver area since 2004.