One club you don’t want to join Featured

8:00pm EDT October 26, 2007

The phrase “as serious as a heart attack” is used to indicate that people are deadly earnest about a subject.

Business owners and managers should take the phrase literally as well, according to Emil Hayek, M.D., medical director at Akron General’s Heart and Vascular Center.

“Nobody is immune to heart failure,” says Hayek. “There are, however, many things one can do to reduce the risk of heart failure. You don’t want to join the heart disease club. Once you’re in, you can’t get out. There is no way to cure it. You can only manage it.”

Smart Business spoke with Hayek about heart disease, and what business owners and employees can do to prevent it.

Is it easier to prevent or cure heart disease?

Coronary heart disease is a chronic and incurable disease that is the No. 1 killer of American men and women, despite significant advances in both medications and mechanical interventions, such as angioplasty and stenting. Therefore, as with most chronic health conditions, it is always preferable to prevent the disease than to treat it.

The health and economic impact of heart disease is due to the progressive and incurable nature of the disease, which often leads to recurrent hospitalizations, expensive and invasive procedures and the need for lifelong and multiple medications, in addition to compromises in one’s quality and quantity of life.

Heart disease is, at least in part, a preventable disease. A majority of the world’s population does not die prematurely from this illness as Americans do. Heart disease develops as a consequence of genetics and environmental factors, the latter playing a major role in the Western world.

What are some causes of heart disease?

Dietary habits — like consuming high fat, especially trans-fat, high-cholesterol foods — obesity, physical inactivity and smoking are all choices one makes that may lead to heart disease. These also are associated with the development of high blood pressure, high cholesterol and diabetes, which are chronic illnesses associated with heart disease.

Heart disease, the development of plaque in the coronary vessels, is a process that likely begins at a very young age in most Americans, with some evidence of early atherosclerosis in one’s 20s. However, symptomatic disease, like a heart attack, affects individuals between the fourth and seventh decades, with the risk of dying of heart disease greatest in those older than 65.

Are people more prone to heart failure based on race, sex or age?

Men and women are both affected; however, men are predisposed to develop symptomatic heart disease earlier than women, by approximately one decade. But, it’s the leading cause of death for American women, far in excess of the risk of dying of breast cancer, lung cancer, colon cancer and HIV combined. A family history of premature heart disease is associated with an increased risk, particularly when the relative is a primary relative, i.e. parent or sibling, who developed heart disease early in life — prior to age 65 for women and 55 for men. Heart disease is more prevalent among African-Americans, Mexican-Americans and American Indians.

How can one reduce the risk of heart failure?

There are several steps to take to reduce the risk of developing coronary heart disease, the leading cause of heart failure. For one, quit smoking! Control blood pressure with medication, if necessary. Control cholesterol with diet and medication, if necessary. Adults should know their cholesterol, both LDL ‘bad’ cholesterol and HDL ‘good’ cholesterol, and what their goal levels should be. Exercise, of course, is key. Maintain a healthy body weight and waistline. Waist size is highly predictive of development of heart disease. Men should shoot to be at less than 40 inches, women fewer than 35 inches. Diabetics should control blood sugar with a combination of a healthy body weight, exercise, diet and medication, if necessary. Finally, follow a low-fat, no trans-fat, low-cholesterol diet, with an emphasis on vegetables, fruits and whole grains, and no processed or fast foods.

Is any exercise better than none?

Everyone should try to exercise at moderate intensity for at least 30 minutes a day as many days of the week as they can. But 10 minutes, three times a day, for those who have less time is probably just as good.

What tests should one get during an annual physical to scan for heart disease?

At their annual physicals, all adults should have an assessment of body weight, including waist circumference, blood pressure, complete history and physical exam, cholesterol screening and possibly an electrocardiogram. Stress testing should be considered if one is having concerning symptoms, such as chest pain or shortness of breath, or if the individual has multiple risk factors present.

What can a business do to prepare for possible on-the-job heart attacks?

CPR courses — and possibly obtaining an automated external defibrillator (AED) for larger work environments — is an excellent means to having the work force trained as ‘first responders.’ This may improve the chances of surviving cardiac arrest. The American Red Cross can provide information on CPR and AED training.

EMIL HAYEK, M.D., is the medical director at the Akron General Medical Center’s Heart and Vascular Center. Reach him at (330) 342-0806 or ehayek@agmc.org.