• Defying the 'silent killer'

    Online chat tackles questions on heart disease
  • It continues to be the No. 1 killer of both women and men in the United States. But heart disease is preventable and controllable.
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    In observance of American Heart Month, a Feb. 12 online chat was conducted by Debra Brock, R.N., clinician for Orange Regional Medical Center's Healthy Heart Program.
    Here's a partial edited transcript of readers' questions, along with Brock's answers.
    To view the complete chat transcript, go to recordonline.com/apps/pbcs.dll/article?AID=/20130212/NEWS/130219949
    Q. How important is cholesterol?
    A. It's desirable to have a healthy total cholesterol of under 200. However, HDL (good cholesterol) should be over 40 mg/dl, and LDL (bad) should be under 129mg/dl.
    Q. What is considered a healthy, or normal, blood pressure?
    A. Anything less than 130/85 is considered healthy. But the American Heart Association now recommends 110/70 for prevention of heart disease.
    Q. I've heard back pain can be a sign of heart problems. So if I have back pain (which is sometimes), at what point should I think about potential heart problems?
    A. Back pain can cause an increase in blood pressure. If the pain is changing, and you have pain and nausea and it's intensifying, call 9-1-1 right away.
    Q. Are there going to be any Healthy Heart screenings in Sullivan County coming up?
    A. Absolutely! We will be at Hudson River Healthcare in Monticello on 23 Lakewood Ave. Our next visit there is April 4 from 8 a.m.-noon.
    Q. Can you still have a heart attack if your blood pressure is normal?
    A. Yes. However, a heart attack will raise your blood pressure because you'll have pain and be anxious.
    Q. My total cholesterol has been around 200 for a few years now, but all my other numbers are good. Should I do anything proactive to address this number? My primary care doc doesn't seem concerned.
    A. Continue to eat healthy and exercise. Do a fasting heart-risk screening yearly if you have a history of cardiovascular disease; without cardiovascular family history, it is recommended every five years.
    Q. Now that the FDA has eliminated trans fats from processed food, is there any evidence that it has helped prevent heart disease yet?
    A. This has not happened yet. Trans fats have not been eliminated out of our foods in the grocery store or even in all restaurants. They prolong shelf life for these products. It is important to read your labels and understand what a trans fat is, and stay away from them! Though a food may be advertised as having zero trans fats, the FDA has allowed companies to include .5 mg trans fats per serving size, to reflect zero trans fats. So, please, read your labels carefully!
    Q. My sister told me to get the new aspirin crystals by Bayer and keep them in my car and in the house, and not to lie down if you're having symptoms. And, for the screening on April 4, any pre-instructions? Thanks.
    A. After you call 9-1-1 with heart attack symptoms, experts state that taking an aspirin can help; however, it is NOT a cure for a heart attack. So call 9-1-1 right away! Regarding the April 4 screening: It's best to come after fasting, but not necessary.
    Comment: Thank you for hosting this chat to help people learn about heart health! The American Heart Association also has info at heart.org.
    Q. What happens at the screening? Is there a stress test? Why do so many people have heart disease and don't know it till it's right on top of you? Is it just denial?
    A. Denial IS our best friend at times — however, it will catch up with you! At the screening for heart risk, we will check your blood pressure, calculate your body mass index (BMI), do a blood test for your triglycerides, total cholesterol (HDL & LDL), along with a glucose blood test for diabetes. Unfortunately, heart disease is a silent killer.
    Q. Tell me about chocolate. How much is too much? Should we even be eating it at all?
    A. Dark chocolate is known to have lots of antioxidants; however, it is important to stick to your portion control and read the label to see what the portion size is.
    Q. By the way, I have a friend who had the stenting done at L.I. Jewish (Medical Center) a month ago, and it definitely saved his life. He is only 58, vegetarian and leads yoga hikes and is not overweight!
    A. Heart disase affects everybody! Family history and genetics play a large role. However, family eating habits need to be looked at.
    Q. My friend takes fish oil capsules because she swears it will protect her heart ... and she doesn't exercise! I told her that the news is that you have to eat actual fish to get the benefit. She doesn't believe me ... can you set her straight?
    A. Raw oils are important. Once we cook an oil, the omega-3 factors are affected. Yes, it is important to eat fish at least three times a week, take an omega-3 vitamin (it does help), at least 800mg daily. However, exercise is essential for heart healthiness.
    Q. How much do homocysteine levels affect heart health?
    A. Homocysteine levels can affect your heart health, but the Healthy Heart Program does not screen for this.
    Q. I've had an occasional fast heart rate (tachycardia), maybe about once a month. When I take my B/P at that time, pulse rate can go up to 240.
    A. I would suggest that you see your cardiologist. This can be treated. It's an electrical physiological problem with your heart that has nothing to do with cholesterol.
    Q. Is calcium scoring necessary for someone who has a family history of heart disease? Is this service used frequently at Orange Regional?
    A. Calcium can affect blockages in the arteries; however, the Healthy Heart Program does not screen for this. Please see your doctor. It's usually related to family history.
    Q. Why does heart disease continue to be the nation's No. 1 killer despite all the advances in technology and treatment? Do you think this country has a obesity problem?
    A. Yes, this country has an obesity problem. Therefore, it is important to read our labels and eat healthy. It's a matter of healthy choices and sharing them with those you love.
    Q. Is stress testing necessary at a certain age in someone who has no symptoms of heart disease?
    A. Any age can have a stress test. It is important to test heart function where there may be symptomatic problems.
    Q. Is there a link between gingivitis and heart disease?
    A. Yes. There is research indicating this is true. Your mouth is very vascular. Bacteria in your mouth can cause more problems than heart disease.
    Coming next Tuesday: Part 2 of the Healthy Heart chat with Debra Brock, R.N., includes questions on caffeine, diabetes, stress and children's heart health.
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