One club you don’t want to join

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 [email protected].