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men’s health

HEART HEALTH AT ANY AGE think You don’t need to WorrY aBout Your ticker in Your Younger Years? think again.

By Shyla Nott

APRIL 2017 Columbus monthly

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When it comes to medical matters of the heart, men are at a greater risk of heart attack. Since 1910, cardiovascular disease has remained the leading cause of death in men in the U.S., claiming responsibility for one in four deaths—that’s more than 300,000 men’s lives each year. Although these are sobering statistics, there is good news: Heart disease is largely preventable and controllable. In addition to clean eating and regular exercise, there are plenty of things men can do at each stage of their lives to drastically lower their risk of a heart attack or stroke and protect their ticker. in Your 20s Your 20s are typically a time of peak physical strength. For most men at this age, a sudden heart attack or stroke is probably the last thing on their minds. A 2011 survey by the American Heart Association and the American Stroke Association found that most young adults between 18 and 24 believe they are living a healthy lifestyle and aren’t concerned that stroke and heart disease will affect them. Experts, however, warn that too much fast food, alcohol and sugar now will have consequences down the road. While it is rare for younger men to experience serious heart problems, it’s never too early to start protecting the body’s most vital organ, says Dr. Douglas Van Fossen, a cardiologist with Mount Carmel Clinical Cardiovascular Specialists. One of the first steps toward better heart health is to get a health screening that checks blood sugar, blood pressure, cholesterol and body weight. “If your numbers are off, what better time to start lifestyle modifications that you can carry with you throughout your life?” Van Fossen asks. “Developing a lifestyle [in your 20s] is much easier than when it becomes engrained.”

healthY living While patients cannot change their family histories, they do have control over their lifestyles. Adopting sensible heart habits can reduce the risk for cardiac disease by 82 percent, according to Dr. David Sabgir of Mount Carmel Medical Group. The American Heart Association gauges cardiovascular risk based on four health factors, yet Sabgir says less than 1 percent of people are following these lifestyle recommendations: No Smoking With more than 4,000 chemicals packed into one cigarette, lighting up is a major risk factor that can cause the blood to thicken and form clots, according to the Centers for Disease Control and Prevention. OhioHealth’s Dr. Anupam Basuray adds that you should also avoid other extreme behaviors, such as excessive drinking. Men should limit their alcohol intake to one or two drinks per day. Get Physical The sweet spot for longevity is 30 to 40 minutes of brisk walking, swimming or stationary biking each day, says Dr. Ragavendra Baliga, of Ohio State University’s Wexner Medical Center. He often compares heart health to a car engine. “Doing just 20 minutes [of exercise] is like running the car idly in the garage,” he says. “Running marathons is overdoing it ... like drag racing, forcing too much on the car.” Watch Your Weight The heavier a person is, the harder it is on the heart to pump blood. Unfortunately, Americans too often consume large amounts of sugar and carbohydrates, leading to obesity. “These are the type of calories that if we don’t use up, we store,” says Mount Carmel Medical Group’s Dr. Douglas Van Fossen. Try eating four or five smaller portions over the course of a day to boost metabolism and aid in weight loss. Eat Your Vegetables This is about more than just being a healthy weight; a healthy diet includes eating foods that help you manage your cholesterol, blood pressure and blood sugar. Also, cut back on salt. The average adult should consume about three grams of sodium each day, says Baliga. Prepackaged frozen dinners and other processed foods can equate to about 12 grams of salt, and fast food meals can far exceed that. A Mediterranean diet high in virgin olive oil, fish, vegetables, fruits, whole grains and nuts has shown to be one of the most effective options when it comes to reducing the risk of heart disease.

Heart disease may still seem like a distant prospect, but problems can arise slowly early on, sometimes going undetected until a major event happens. As many as 10 percent of all heart attacks in men occur before age 45, according to Harvard Medical School. For men in their 30s, life now may be a bit more complicated—not to mention stressful—due to family responsibilities, household tasks and work deadlines. That stress takes a toll on the heart muscle. Dr. David Sabgir, another cardiologist with Mount Carmel Clinical Cardiovascular Specialists and board president of the Central Ohio American Heart Association,

Columbus monthly APRIL 2017

in Your 30s

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says stress is a secondary risk factor that can contribute to obesity and sleep issues in addition to heart problems like high blood pressure. He says meditation and yoga are great techniques to help relieve stress, but he also encourages his patients to engage in physical activity, even if that means simply going for a walk. Sabgir is also the founder of the nonprofit Walk with a Doc, a national health program that lets patients walk with local physicians and ask questions about their health. “I think there’s a [misconception] that walking isn’t enough, when actually it is,” he says. “If you’re walking 100 steps per minute or 7,500 steps a day, you’re getting the benefit.”

At this point, your lifestyle has likely stabilized, but so has your metabolism. In fact, it’s probably slowed down. But even if heart health has not been a priority until now, don’t worry. At this point, your key focus should be adjusting your eating habits to be heart-conscious and avoid weight gain. Dr. Anupam Basuray, an advanced heart failure and transplant cardiologist with OhioHealth, says to steer away from saturated fats, particularly those found in red meat and other animal products such as dairy. “Fat can potentially put more stress on the heart by depositing fat into the blood vessels,” he says. This causes the blood vessels to narrow as fat and cholesterol build up along the artery walls. Over time, this waxy plaque buildup hardens the arter-

Columbus monthly APRIL 2017

in Your 40s

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ies in a process called atherosclerosis. With age, these plaques can narrow—and sometimes completely block—blood flow through the arteries, which can ultimately result in a heart attack or stroke. Unfortunately, reversing atherosclerosis by making plaque disappear is not possible, but there are strategies to slow or halt its progression. First, a balanced, low-cholesterol diet can prevent fatty deposits from forming. Low-density lipoprotein, or LDL, is the dangerous, plaque-building cholesterol. Boosting “good” cholesterol (high-density lipoprotein, or HDL) helps remove and carry LDL away from the bloodstream. A Mediterranean-style diet rich in olive oil, fish, vegetables, fruits and nuts—and low in refined carbohydrates such as white flour and added sugars—can reduce heart disease by 30 percent. “Good fats come from vegetables and nuts, which appear to be less linked with coronary disease,” Basuray says.

in Your 50s By now, you may have been diagnosed with Type 2 diabetes, high cholesterol, high blood pressure or another condition that increases your risk for coronary heart disease. Continue following any prescription

knoW the signs No one plans to have a heart attack, so take the time to learn the early warning signs. “We see a lot of men with a ‘tough guy’ attitude,” says Dr. Anupam Basuray of OhioHealth. “They think, ‘Oh yeah, I might have had some shortness of breath,’ and the tendency is to ignore it or hope it goes away.” Toughing out the symptoms is not only dangerous; it can be fatal. Chest pain, heaviness, tightness, pressure or discomfort, particularly while exerting yourself, can all be red flags, Basuray says. While some heart attacks strike suddenly, others can take hours, days or weeks to develop. Because not everyone will suffer from severe chest pain, other warning signs include shortness of breath, sudden nausea, lightheadedness, sweating or pain in the jaw or arm. If you suspect you’re having a heart attack, call 911 immediately.

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regimens or treatment plans, eating clean and exercising daily, but also make sure to get enough sleep. Adults should sleep at least seven to nine hours per night. If you’re struggling to fall asleep and stay asleep through the night, bring it up with your doctor. Sabgir says sleep apnea—a common cause of poor sleep, especially among those carrying a few extra pounds—is a rampant problem that often gets overlooked by health care professionals. “Sleep apnea can do a few things that are pretty nasty,” he says. “It increases your diabetes risks significantly and causes endothelial dysfunction, which means poor health for the inside of the blood vessel, and it contributes to atrial fibrillation, a heart rhythm disorder that can lead to stroke.”

Men at this stage may have the luxury of retirement or semi-retirement, but these changes do not warrant a slack in hearthealthy living. In fact, it’s even more important to pay attention to your heart, because blood pressure and cholesterol levels tend to rise with age. The risk of heart attack also goes up; the average age for a first-time heart attack in men is 65. Dr. Ragavendra Baliga, associate director of cardiovascular medicine at Ohio State University’s Wexner Medical Center, tells his patients to watch their weight by avoiding late-night eating. “There’s a saying: ‘Eat like a king for breakfast, a queen for lunch and a pauper for dinner,’ ” he says. “After 5 p.m., avoid eating carbohydrates, starches and sugars. Your body is sleeping; it doesn’t need it. All of that will just be converted into adipose tissue, or fat.” If you are trying to lose weight, however, don’t try to do too much at once, Baliga cautions. “What we don’t want is for people to overcorrect or to recycle their weight,” he says. “I’d much rather my patients lose weight in a slow, methodical manner. I encourage them to have a three- to four-year time frame about losing weight and increasing activity.” Ultimately, weight loss boils down to energy balance—80 percent diet and 20 percent exercise. Rather than shedding tons of weight all at once, Baliga recommends losing no more than two or three pounds per month for optimal heart health. “It seems like a small bar, but after a year you’ve lost about 25 pounds. That’s significant.”