Heart health: The risks that no one thinks about
It isn’t easy to surprise a cardiologist who’s been in practice for more than 30 years, treating a wide range of patients with every type of medical challenge. Still, sometimes patients and physicians face the unexpected.
Northwell Health shares some surprising truths faced in cardiology practices.
Young people can have heart attacks
There's this idea that only old, overweight, cigar-smoking men have heart attacks, but even a 52-year-old runner and nonsmoker in (seemingly) good shape could be at risk. It was a sobering reminder — both to doctors and patients — to question what they think they know about the demographics of patients and remember that optimizing heart health requires paying close attention to our bodies.
This truth brings us back to the basics: Doctors and patients need to identify risk factors early, control lifestyle factors such as eating and exercise, and, of course, listen for subtle warnings. When something “doesn’t feel right,” it’s a conversation with a clinician, not dismissing care because your age makes it seem unlikely.
In fact, while the average age for men to have a heart attack is about 65 and for women is 72, 1 in 5 heart attack deaths occur in patients younger than age 64. The proportion of people under 50 having heart attacks rose by 2% between 2000 and 2016, and 20% of people in the under-50 heart attack category were 40 or younger.
Sleep (really) matters
Patients are sometimes surprised to learn there's a connection between sleep quality and patterns and heart health. Science does not support burning the candle at both ends or accepting poor sleep long-term. Sufficient, quality sleep is critical. One in 3 adults reports not getting the approximately seven hours of recommended sleep per night. That may be sustainable for a couple of nights, but over time, poor sleep may lead patients to develop high blood pressure, Type 2 diabetes, and obesity, raising the risk of a heart attack. Some patients experience stress associated with not sleeping well or enough and find it difficult to have the energy to make heart-healthy choices about fitness and nutrition.
Together, patients and doctors can discuss sleep hygiene and habits, uncovering whether patients might be experiencing sleep apnea, when the airway is repeatedly blocked during sleep, or insomnia, trouble falling asleep, staying asleep, or both. Addressing sleep-related conditions goes a long way to improving cardiovascular health.
Kidney and heart function are intertwined
This is for patients who are surprised when asked about their urine and kidney function: The heart and kidneys depend on each other. In fact, kidney disease and heart disease have common risk factors.
Here’s how it works: The heart pumps oxygen-rich blood throughout the body, supplying the kidneys with resources needed to filter waste and excess fluid, regulating blood pressure, supporting red blood cell production, and maintaining bone health. In turn, healthy kidneys are crucial for proper heart function, as they maintain a balanced blood volume and pressure. If either organ is compromised, it can trigger a cascade of issues — cardiovascular disease, kidney disease, and metabolic disorders like diabetes and obesity (called cardio-renal-metabolic or cardiovascular-kidney-metabolic syndrome). There’s even an online calculator that includes questions about kidney function to help predict the future risk of heart disease and stroke.
Pregnancy history is a bellwether for cardiac health
Many patients express surprise when asked about the health of their pregnancies, sometimes decades later — but a patient’s reproductive history has an impact on future heart health.
Pregnancy often is described as a stress-test on the body; that's certainly true when it comes to the heart, which pumps about 50% more blood during pregnancy, labor, delivery and the postpartum period. While many people's hearts adapt and then return to pre-pregnancy cardiovascular health within months of delivering, sometimes pregnancy can worsen underlying heart conditions, reveal previously undiagnosed ones, or lead to complications, including high blood pressure, preeclampsia, gestational diabetes, a weakened heart (cardiomyopathy) and irregular heartbeats (arrhythmias).
A complicated pregnancy doesn't guarantee future heart problems, but it does offer patients and their physicians a chance to address controllable cardiovascular risk factors. The field of cardio-obstetrics is taking a much-needed look at the heart health of those progressing through pregnancy.
Patients sometimes avoid easy solutions
Whether patients’ reluctance stems from uncertainty, anxiety, or even misinformation, seek open collaboration about how to keep hearts healthy. Together, doctors and patients can address concerns to avoid a few cardiovascular surprises.
Stacey Rosen is the executive director of Northwell Health's Katz Institute for Women's Health and president of the American Heart Association.
This story was produced by Northwell Health and reviewed and distributed by Stacker.
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