Preventing Heart Disease Begins Before There Is Heart Trouble

By Andrew Wilson

Valentine’s Day may seem like great marketing for February when American Heart Month is celebrated, but it’s also a great time to raise awareness about the effects of cold, wintry weather on people’s hearts.

“There is an increased risk of heart disease and cardiovascular disease in winter months,” said Michael Bashline, M.D., a cardiologist with St. Clair Medical Group Cardiology. “Cold weather causes blood vessels to constrict or narrow, which can worsen symptoms in patients with underlying blockages that can lead to a heart attack or stroke.”

According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death for both men and women in the United States. Chest pain is the most well-known sign of a heart attack, but other warning signs and symptoms can be more subtle and differ from person to person, especially between women and men.

“There’s a difference between someone who is having an acute heart attack versus someone with discomfort in the chest, but it goes away. We call that stable angina,” Dr. Bashline said. “Someone with stable coronary artery disease may not describe chest discomfort as ‘pain’ but as a weird sensation or pressure in the chest, especially when it is caused by physical exertion. It could be a lung issue, but it could be a sign of underlying heart disease.”

In addition to chest pain or discomfort, symptoms can include nausea, indigestion, pain radiating down the left arm, or profuse sweating while at rest. How the symptoms first present can differ between men and women.

“There’s definitely a difference between men and women,” said Dr. Bashline. “In general, men tend to have heart disease earlier, while the risk for heart disease in females goes up after menopause.”

He said that females also present with less classic symptoms, less often chest pain and more often nausea or heart burn. That can lead to mistakenly believing that the problem is a gastrointestinal one, perhaps acid reflux or an ulcer.

“Anything that is unusual should be investigated,” said Dr. Bashline. “It’s never a bad idea to see a heart doctor. Our job is to focus on the heart.”

Part of that focus involves raising awareness of prevention through controlling the risk factors of heart disease. High blood pressure, high cholesterol – particularly lipids known as LDL or “bad cholesterol” – lack of physical activity, and smoking all increase a person’s risk of developing heart disease.

Dr. Bashline calls smoking the greatest risk factor for coronary artery disease, not only because it is addictive, but also because many people smoke out of habit – like when they are having a morning cup of coffee or following meals. Breaking those habits can be difficult psychologically, but it can be done. In fact, he says there are more effective methods to quit smoking than ever, including multiple medications.

A healthy diet and regular physical activity can go a long way to controlling blood pressure and cholesterol.

“Overall, the best diet is the Mediterranean diet, which is composed of less red meat and more fish and vegetables,” Dr. Bashline said. “The type of physical activity can vary depending on a person’s age, but most people are good at walking. The American Heart Association recommends a 30-minute session of activity for at least five days a week.”

Such a daily commitment may be difficult for some people, particularly those who are starting from a point of little to no physical activity but starting with two 30-minute sessions a week is an improvement over no activity whatsoever. Dr. Bashline says that how aggressive a person needs to be depends on a number of factors.

“Family history is important. Genetics are a huge risk factor,” he said. “Diabetes is a significant factor for heart disease, so patients need to control their blood sugars and their A1C levels. Both type 1 and type 2 diabetes are associated with an increased risk of heart disease.”

Of course, the biggest reason people may be more aggressive in controlling the risk factors is if they have already had a heart attack.

“Having a heart attack convinces people to make changes,” Dr. Bashline said. “After a heart attack, we talk about the exact same stuff we talked about before the heart attack, but afterwards people are much more receptive.”

There are a number of ways to prevent a future occurrence. There are medications for people at highest risk, such as blood thinners and statin therapy, but cardiac rehabilitation, where a regular exercise is prescribed and monitored, may show the greatest benefits.

“Patients who do cardiac rehab post-op live longer than people who don’t,” he said matter of factly, adding that the best approach to surviving a heart attack is preventing one from occurring in the first place. “I can’t urge prevention enough, especially for people with a strong family history of heart disease. It’s never a bad idea to see a heart doctor.”

Dr. Michael Bashline earned his medical degree from the Lewis Katz School of Medicine at Temple University. He completed his residency and a fellowship in cardiology at the University of Pittsburgh Medical Center. He is board certified by the American Board of Internal Medicine (CSQ – Cardiovascular Disease). Dr. Bashline practices with St. Clair Medical Group Cardiology and sees patients at St. Clair Health Village Square Outpatient Center located at 2000 Oxford Drive, Bethel Park, PA, 15102. He can be reached by calling (412) 942-7900.