October 16, 2019 // Perspective

How not to have a heart attack

Dr. David Kaminskas

The Catholic Doctor Is In

The No. 1 killer in America remains coronary heart disease. If your family history includes coronary events such as heart attacks, bypass surgery or coronary stent placement, your risk is significantly increased and prevention is a must. Although a person cannot change their genetic predisposition, there are many risk factors that can be controlled.

The large majority of people who sustain a heart attack, or myocardial infarction, under the age of 40, are smokers. As soon as a person takes a few puffs of a cigarette, abnormal changes occur in the lining of the arteries. Continued smoking promotes cholesterol plaque buildup and plaque instability, and may eventually cause plaque rupture that triggers the clotting cascade. When a clot occludes a coronary artery, suddenly the person is in the throes of a major heart attack.

Fatal cardiac arrhythmias can occur just seconds after the onset of a heart attack. This cannot be any more straightforward. Don’t smoke!    

Study after study has definitively proven that an elevated cholesterol level, and more specifically LDL cholesterol, or bad cholesterol, is highly correlated with coronary artery disease and coronary events. The American College of Cardiology and the American Heart Association have easily accessible risk calculators available. The guidelines recommend that if a person’s 10-year risk of Atherosclerotic Cardiovascular Disease calculates to be greater than 7.5%, then a cholesterol-lowering medicine called a statin should strongly be considered.

Statins prevent thousands of heart attacks each year. Statins are actually well-tolerated without side effects in 95% of the people who are prescribed one. A survey at one of the national ACC meetings a few years ago found that well over half of all cardiologists attending were on a statin. Maybe they know something? A statin may be right for you.

Diabetes is also a major risk factor. Type 2 diabetes (adult onset) accounts for 90%-95% of all diabetics. The first recommendation for a newly diagnosed diabetic should be weight loss. Nearly 90% of all diabetics are overweight.

Here is the truth: If every person, at the time of being diagnosed with diabetes, lost 15% of their body weight, most would no longer even have diabetes. Staying near ideal body weight, along with exercise, will dramatically lower the risk of ever getting diabetes — and a heart attack.

High blood pressure is linked closely with cardiac events. Blood pressure over 130/80 is hypertension, based on the latest guidelines. Salt restriction, weight loss if needed, and exercise are the first line of treatment, although most people will still need medicine. There are dozens of highly effective meds that are cheap and efficacious, so there is no reason to have high blood pressure in 2019; but sometimes it may take three or four different meds to get to goal. If your family physician cannot get your high blood pressure under control then you need to consult a specialist.

Let’s move on to everybody’s favorite subject: diet. It seems like nutritional guidelines are changing all the time. Here are some dietary recommendations to prevent heart disease that are unlikely to ever change.

Minimize red meat and stay away for processed meat. Eat more fatty fish like salmon but skip fried fish. Eat lots of vegetables. Avoid fast food. Reduce the carbohydrate load to prevent hunger and weight gain. It’s really that simple.

Finally, exercise prolongs life. Regular exercise will lower blood pressure, help keep weight in check, increase brain endorphins to bolster mood and lower the risk of cardiovascular disease so that you can have a more productive earthly life to better serve the Lord.