Wellness Wednesday: Getting back to your life with cardiac rehab

Cardiac rehabilitation can’t change your past, but it can help you improve your heart’s future.

istock_000062785180_mediumCardiac rehab is a medically supervised program for people who have had a heart attack, heart failure, heart surgery, or other coronary intervention.

A cardiac rehab program involves adopting heart-healthy lifestyle changes to address risk factors for cardiovascular disease. It is a team effort—partnering you with doctors, nurses, pharmacists, family members and friends—to take charge of the choices, lifestyle and habits that affect your heart.

To help you adopt lifestyle changes, a cardiac rehab program will include exercise training, education on heart-healthy living, and counseling to reduce stress and help you return to an active life. It can improve your health and quality of life, reduce the need for medicines to treat heart or chest pain, decrease the chance you will go back to a hospital or emergency room for a heart problem, prevent future heart problems, and even help you live longer.

The American Heart Association explains cardiac rehab as three equally important parts:

  • Exercise counseling and training: Exercise gets your heart pumping and your entire cardiovascular system working. You’ll learn how to get your body moving in ways that promote heart health.
  • Education for heart-healthy living: Managing your risk factors, choosing good nutrition, quitting smoking…education about heart-healthy living is a key element of cardiac rehab.
  • Counseling to reduce stress: Stress hurts your heart. This part of rehab helps you identify and tackle everyday sources of stress.

Active Senior Woman Exercising on TreadmillCardiac rehab is provided in an outpatient clinic or in a hospital rehab center. The cardiac rehab team includes doctors, nurses, exercise specialists, physical and occupational therapists, dietitians or nutritionists, and mental health specialists. Sometimes a case manager will help track your care.

Your cardiac rehab team will design a program to meet your needs. Before starting your program, the rehab team will take your medical history, do a physical exam, and perform tests. Possible tests include an electrocardiogram (EKG), cardiac imaging tests, and a treadmill or stationary bike exercise test. You also may have tests to measure your cholesterol and blood sugar levels. During cardiac rehab, you will learn to exercise safely and increase your physical activity. The length of time that you spend in cardiac rehab depends on your condition.

For more information about the cardiac rehabilitation program at Mercy Health System, visit our website at www.mercyhealth.org/heart/rehab.

Sources: American Heart Association, National Institutes of Health


Before you go … Check out Mercy Health System’s 2017 Go Red Dance Video to support American Heart Month!


More Information:

What is Cardiac Rehab? [PDF]

How Can I Live with Heart Failure? [PDF]

Cardiac Rehabilitation (Medline Plus)

Medicine Chart [PDF]

Wellness Wednesday: Hypertension, The Silent Killer

High blood pressure or hypertension is a symptomless “silent killer” that quietly damages blood vessels and leads to serious health threats.

What is Blood Pressure?

Blood pressure is the force of your blood pushing against the walls of your blood vessels. It is recorded as two numbers and a written as a ratio.
normal blood pressure digital monitor

  • Systolic: The top number in the ratio, which is also the higher of the two, measures the pressure in the arteries when the heart beats.
  • Diastolic: The bottom number in the ratio, which is also the lower of the two, measures the pressure in the arteries between heartbeats.

In order to survive and function properly, your tissues and organs need the oxygenated blood that your circulatory system carries throughout the body. When the heart beats, it creates pressure that pushes blood through a network of arteries, veins and capillaries. This pressure—blood pressure—is the result of two forces: it rises with the first force (systolic) as blood pumps out of the heart and into the arteries. And it falls during the second force (diastolic) when the heart relaxes between beats.

What is High Blood Pressure (Hypertension)?

Blood Pressure InfographicHypertension occurs when your blood pressure is consistently too high. High blood pressure (HBP) causes harm by increasing the workload of the heart and blood vessels—making them work harder and less efficiently.

Normal blood pressure for adults is defined as a systolic pressure below 120 mmHg and a diastolic pressure below 80 mmHg. It is normal for blood pressures to change when you sleep, wake up, or are excited or nervous. When you are active, it is normal for your blood pressure to increase. However, once the activity stops, your blood pressure returns to your normal baseline range. Blood pressure also normally rises with age and body size.

Stages of High Blood Pressure in Adults

This chart is a guide for healthy adults. People with diabetes or chronic kidney disease should keep their blood pressure below 130/80 mmHg.

Stages

Systolic
(top number)

 

Diastolic
(bottom number)

Prehypertension

120–139

OR

80–89

High blood pressure Stage 1

140–159 OR

90–99

High blood pressure Stage 2

160 or higher

OR

100 or higher

You may not feel that anything is wrong, but high blood pressure could be quietly causing damage that can threaten your health. The best prevention is knowing your numbers and making changes that matter in order to prevent and manage high blood pressure.


About 85 million Americans (one out of every three adults over age 20) have high blood pressure. And nearly 20 percent don’t even know they have it.


How Does High Blood Pressure Affect Your Health?

siluet_mochevojOver time, the force and friction of high blood pressure damages the tissues inside the arteries. In turn, LDL (bad) cholesterol forms plaque along tiny tears in the artery walls, signifying the start of atherosclerosis.

The more the plaque increases, the narrower the insides of the arteries become—raising blood pressure and starting a vicious circle that further harms your arteries, heart and the rest of your body. This can ultimately lead to other conditions ranging from arrhythmia to heart attack and stroke. It can also lead to kidney disease as well as blindness.

Hypertension and Stroke

High blood pressure is the single most important risk factor for stroke because it’s the Number 1 cause of stroke.

Similar to a heart attack, most strokes occur when blood vessels in the brain narrow or become clogged, cutting off blood flow to brain cells. This type (ischemic) represents about 87% of all strokes. High blood pressure causes damage to the inner lining of the blood vessels. So this adds to any blockage that is already within the artery wall.

The remaining 13% of strokes occur when a blood vessel ruptures in or near the brain (hemorrhagic). Chronic high blood pressure or aging blood vessels are the main causes of this type of stroke. The force of HBP puts more pressure on the blood vessels until they eventually rupture over time.

Causes of Hypertension

A number of factors and variables can put you at a greater risk for developing hypertension. Understanding these risk factors can help you be more aware of how likely you are to develop high blood pressure.

Common hereditary and physical risk factors for high blood pressure include:

  • Family history: If your parents or other close blood relatives have high blood pressure, there’s an increased chance that you’ll get it, too.
  • Age: The older you are, the more likely you are to get high blood pressure. As we age, our blood vessels gradually lose some of their elastic quality, which can contribute to increased blood pressure.
  • Gender: Until age 45, men are more likely to get high blood pressure than women are. From age 45 to 64, men and women get high blood pressure at similar rates. And at 65 and older, women are more likely to get high blood pressure.
  • Race: African-Americans tend to develop high blood pressure more often than people of any other racial background in the United States.

Lifestyle risk factors include:

  • Lack of physical activity
  • An unhealthy diet, especially one high in sodium
  • Being overweight or obese
  • Drinking too much alcohol

What can you do to prevent or lower high blood pressure?

Eat Less SaltMaintain an active lifestyle and exercise at least 30 minutes each day. Get plenty of rest and eat a healthy, low-sodium, high-potassium diet. These are the best ways to affect your blood pressure. When these don’t work, your doctor may prescribe certain medications, such as a diuretic or beta blocker, to help lower your blood pressure.

Talk with your doctor about blood pressure and the risk of heart disease or stroke. If you would like to find a Mercy physician, visit our Find-A-Doctor tool on our website at: www.mercyhealth.org/find-a-doctor.

Sources: National Institutes of Health, American Heart Association


Before you go … check out Mercy Health System’s 2017 Go Red Dance Video to support American Heart Month!


More Information:

What Is High Blood Pressure? [PDF]

High Blood Pressure and Stroke [PDF]

Why Should I Limit Sodium? [PDF]

What Can I Do To Improve My Blood Pressure? [PDF]

Blood Pressure Log [PDF]

Sodium Tracker [PDF]

High Blood Pressure Risk Calculator

Mercy Health Library: High Blood Pressure

Mercy Health Library: Stroke

Wellness Wednesday: Heart Disease Does Not Discriminate

Just before Christmas, people across the world learned that beloved Star Wars actress and best-selling author Carrie Fisher suffered a cardiac emergency while on a flight home to LA. Within a few days, we were all mourning her death.

istock_000019034549_largeDuring this time, media outlets all over the world were reporting on her condition. Some news stories reported she suffered a heart attack; others reported she suffered a cardiac arrest. And many simply used both of those terms interchangeably.

But is there a difference?

Definitely.

A heart attack, also called a myocardial infarction (MI), occurs when the blood flow that brings oxygen to the heart becomes partially or completely blocked. This happens because the coronary arteries can become narrowed from a build up of fat, cholesterol and other substances, called plaque. When the plaque breaks, a blood clot forms around the plaque and can block the blood flow.

Recovery from a heart attack depends on the length of time the heart muscle is without blood flow, which heart vessel is blocked, and whether or not treatment is immediately started. Emergency care is required for a heart attack. So if you have symptoms, get to an emergency room immediately. And don’t drive! When at all possible, call 911 for an ambulance. Paramedics will have equipment to help treat you on the way to the hospital and can get you there quicker.


Every 34 seconds, someone dies from heart and blood vessel diseases, America’s No. 1 killer. 


A cardiac arrest is when the heart malfunctions and stops beating or ‘arrests’. Death occurs in minutes after the heart stops because oxygen-enriched blood is no longer flowing through the body. In some instances, immediately performing cardiopulmonary resuscitation (CPR) and use of an automatic external defibrillator (AED) can help provide oxygen to the body and get the heart started again.

cardiacarrest-heartattack.jpg

In the instance of Ms. Fisher, witnesses on the airplane have said that she stopped breathing for 10-15 minutes. Passengers, trained in CPR, tried to revive her and when the plane landed, paramedics continued to provide advanced life support on the way to the hospital.

However, the amount of time she was without oxygen proved to be irreversible. A death certificate issued by the LA County Department of Health confirmed that her cause of death was cardiac arrest. What may have contributed to her heart stopping is still being determined.

Carrie Fisher’s death, as well as the death of her mother just a few days later from a stroke, highlights the importance of raising awareness of heart disease in women. While we don’t know if Fisher had any symptoms prior to boarding a plane that day, what we can take from this is that it can happen to anyone. Heart disease is the #1 killer of women and it sometimes has no symptoms, which is why it is called the silent killer.

grfw_aha_liw_v_macy_krSo, during this American Heart Month, we would like to encourage women (and men) to take care of their hearts. Get regular checkups. Talk to your doctor about what you can do to stay healthy. If you are in a higher risk group, or if you have a family history of heart disease, ask you doctor what you can do to lower that risk.

To find a cardiologist at Mercy Health System, visit our website and use our Find a Doctor tool at www.mercyhealth.org/find-a-doctor.

Sources: American Heart Association, Centers for Disease Control and Prevention


Mercy Health System Articles:

Heart disease: What every woman needs to know

Heart attacks in women. Yes, they happen

Don’t ignore heart attack symptoms

Q&A: Chest pain. When is it an emergency?


More Information:

Cardiac Arrest vs. Heart Attack

Heart Attack Symptoms in Women

Warning Signs of a Heart Attack

Cardiac Arrest Warning Signs

Heart Attack Tools and Resources

 

Wellness Wednesday: Eating Healthy During the Holiday Season

The holiday season is filled with hustle and bustle, shopping, decorating, gift-giving (and receiving) and spending time with family and friends. But let’s face it … it’s also a time for over-indulging in some pretty awesome food!

Head of the family cutting the turkeyBetween Thanksgiving and New Years, if you’re like most people, there is no shortage of family and friend get-togethers filled with great feasts and delicious treats. There’s turkey and ham, stuffing, sweet potato casserole, seven fishes (if you’re Italian), Christmas cookies, chrusciki (if you’re Polish), pies (oh, so many pies!) and lots of candy treats.

And if you’re Jewish, or invited to the home of Jewish friends or family, you’ll likely find plenty of chocolate gelt, rugelach, kugel and sufganiyot (jam-filled doughnuts) as well.

It’s easy to get carried away and many of us have felt that bloated feeling of eating too much during this time. And if you’re dieting … it can become a make a break time if you’re not careful.

But it doesn’t have to be so difficult. You can indulge in some of your favorites if you just remember … moderation. If you are the one doing the cooking or baking, you can make some changes in the menu or recipe to help keep calories down without losing flavor.

Sweet potatoes vs. sweet potato casserole. Instead of candied yams or sweet potato casserole, which is often loaded with butter and sugar, make fresh sweet potatoes and offer cinnamon and sugar or sugar substitute on the side. Sweet potatoes are actually very nutritious and loaded with potassium.

Use olive oil instead of butter in recipes when possible.

Applesauce instead of butter. If you’re making a cake, you can substitute and equal amount of apple sauce for butter in the recipe, and it will still taste great with less calories.

But what if you’re visiting friends and family? How do you eat well when you’re out?

Mandarins covered with chocolate and pistachio, top viewBring a healthy dessert. It’s always polite to bring something when you visit someone’s home. So bring along a home-baked dessert. This way, when everyone is having sweets, you can partake and won’t be as tempted to eat something you shouldn’t.

And don’t forget to stay physical during the holidays. Do you tend to make a New Years resolution? Start early. Physical activity is helpful to increasing your metabolism and it also can make you feel better and help beat holiday blues.

Start taking a walk around the block each night after dinner or in the morning before work, then increase to twice around the block. It can help clear your mind and relieve the stress that is often felt during this time of year. Take the family for a walk through the neighborhood to look at the lighted houses. You can do a few blocks each night. And you won’t notice because you’ll be enjoying the view.


More Information:

AHA Holiday Healthy Eating Guide

Wellness Wednesday: It’s Healthy Aging Month

Chinese Grandparents Sitting With Grandchildren In ParkPeople in the U.S. are living longer than ever before. Many seniors live active and healthy lives. But there’s no getting around one thing: as we age, our bodies and minds change. There are things you can do to stay healthy and active as you age:

Eat a balanced diet

Studies show that a good diet in your later years reduces your risk of osteoporosis, high blood pressure, heart diseases and certain cancers. As you age, you might need less energy. But you still need just as many of the nutrients in food.

Keep your mind and body active

Exercise is perhaps the best demonstrated way to maintain good health, fitness, and independence. Research has shown that regular physical activity improves quality of life for older adults and decreases the risk of cardiovascular disease and many other illnesses and disabilities. In many ways, it is the best prescription we have for healthy, successful aging.

Don’t smoke

iStock_000018054489_LargeDo we really need to explain this one? Smoking is bad for you. So if you smoke, you should quit. There are many programs out there that can help you kick the habit. Visit the classes and events page on our website to join a free smoking cessation group, or ask your doctor for more information on ways to quit. Even if you’ve spent a lifetime smoking, you will benefit from stopping now.

Get regular checkups

Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. Which exams and screenings you need depends on your age, health and family history, and lifestyle choices such as what you eat, how active you are, and whether you smoke.

To make the most of your next check-up, here are some things to do before you go:

Practice safety habits to avoid accidents and prevent falls

A fall can change your life. If you’re elderly, it can lead to disability and a loss of independence. If your bones are fragile from osteoporosis, you could break a bone, often a hip. But aging alone doesn’t make people fall. Diabetes and heart disease affect balance. So do problems with circulation, thyroid or nervous systems. Some medicines make people dizzy. Eye problems or alcohol can be factors. Any of these things can make a fall more likely.

Sources: Centers for Disease Control and Prevention, NIH: National Institute on Aging

Wellness Wednesday: Keeping Your Cholesterol in Check

SeniorsSeptember is National Cholesterol Education Month, a good time to get your blood cholesterol checked and take steps to lower it if it is high. More than 102 million American Adults have total cholesterol levels above healthy levels (at or above 200 mg/dL). More than 35 million of these people have levels of 240 mg/dL or higher, which puts them at high risk for heart disease.

What is cholesterol?

Cholesterol is a waxy, fat-like substance found in your body and in many foods. Your body needs cholesterol to function normally and makes all that you need. Too much cholesterol can build up in your arteries. After a while, these deposits narrow your arteries, putting you at risk for heart disease and stroke. Not all cholesterol is bad. Cholesterol is just one of the many substances created and used by our bodies to keep us healthy.

Total cholesterol is a measure of the total amount of cholesterol in your blood and is based on the HDL, LDL and triglycerides numbers.

HDL (high-density lipoprotein) cholesterol

HDL cholesterol absorbs cholesterol and carries it back to the liver, which flushes it from the body. HDL is known as “good” cholesterol because having high levels can reduce the risk for heart disease and stroke. Low HDL cholesterol puts you at higher risk for heart disease. People with high blood triglycerides usually also have lower HDL cholesterol. Genetic factors, type 2 diabetes, smoking, being overweight and being sedentary can all result in lower HDL cholesterol.

LDL (low-density lipoprotein) cholesterol

LDL cholesterol makes up the majority of the body’s cholesterol. LDL is known as “bad” cholesterol because having high levels can lead to plaque buildup in your arteries and result in heart disease and stroke. However, your LDL number should no longer be the main factor in guiding treatment to prevent heart attack and stroke, according to new guidelines from the American Heart Association. For patients taking statins, the guidelines say they no longer need to get LDL cholesterol levels down to a specific target number. A diet high in saturated and trans fats raises LDL cholesterol.

Triglycerides

Triglycerides are a type of fat found in your blood that your body uses for energy. Normal triglyceride levels vary by age and sex. A high triglyceride level combined with low HDL cholesterol or high LDL cholesterol is associated with atherosclerosis, the buildup of fatty deposits in artery walls that increases the risk for heart attack and stroke

How do you know if your cholesterol is high?

cholesterolHigh cholesterol usually doesn’t have any symptoms. As a result, many people do not know that their cholesterol levels are too high. However, doctors can do a simple blood test to check your cholesterol. High cholesterol can be controlled through lifestyle changes or if it is not enough, through medications.

It’s important to check your cholesterol levels. High cholesterol is a major risk factor for heart disease, the leading cause of death in the U.S. The National Cholesterol Education Program (NCEP) recommends that adults aged 20 years or older have their cholesterol checked every 5 years.

Preventive guidelines for cholesterol screening among young adults differ, but experts agree on the need to screen young adults who have other risk factors for coronary heart disease: obesity, smoking, high blood pressure, diabetes and family history

Conditions That Increase Risk for High Cholesterol

Diabetes mellitus increases the risk for high cholesterol. Your body needs glucose (sugar) for energy. Insulin is a hormone made in the pancreas that helps move glucose from the food you eat to your body’s cells. If you have diabetes, your body doesn’t make enough insulin, can’t use its own insulin as well as it should, or both. So this causes sugars to build up in the blood.

Behaviors That Increase Your Risk for High Cholesterol

Unhealthy Diet: Diets high in saturated fats, trans fat, and cholesterol have been linked to high cholesterol and related conditions, such as heart disease.

Physical Inactivity: Not getting enough physical activity can make you gain weight, which can lead to high cholesterol.

Obesity: Obesity is excess body fat. Obesity is linked to higher triglycerides and higher LDL cholesterol, and lower HDL cholesterol. In addition to high cholesterol, obesity can also lead to heart disease, high blood pressure and diabetes. Talk to your health care team about a plan to reduce your weight to a healthy level.

Family History Can Increase Risk for High Cholesterol

Portrait Of Extended Family Group In ParkWhen members of a family pass traits from one generation to another through genes, that process is called heredity.

Genetic factors likely play some role in high cholesterol, heart disease and other related conditions. However, it is also likely that people with a family history of high cholesterol share common environments and other potential factors that increase their risk.

If you have a family history of high cholesterol, you are more likely to have high cholesterol. You may need to get your cholesterol levels checked more often than people who do not have a family history of high cholesterol.

The risk for high cholesterol can increase even more when heredity combines with unhealthy lifestyle choices, such as eating an unhealthy diet.

Some people have an inherited genetic condition called familial hypercholesterolemia. This condition causes very high LDL cholesterol levels beginning at a young age.

If you have high cholesterol, what can you do to lower it?

Your doctor may prescribe medications to treat your high cholesterol. In addition, you can lower your cholesterol levels through lifestyle changes:

  • Low-fat and high-fiber food (Eat more fresh fruits, fresh vegetables and whole grains).
  • For adults, getting at least 2 hours and 30 minutes of moderate or 1 hour and 15 minutes of vigorous physical activity a week. For those aged 6-17, getting 1 hour or more of physical activity each day.
  • Maintain a healthy weight.
  • Don’t smoke or quit if you smoke.

Sources: Centers for Disease Control and Prevention, American Heart Association


More Information:

Know the Facts About High Cholesterol [CDC Fact Sheet]

American Heart Association’s Cholesterol SmartHub

Wellness Wednesday: Keeping Yourself Healthy

Two separate recent studies suggest that being married may improve the likelihood of surviving a heart attack and may also help you beat cancer.

iStock_000022455486_Medium

It is possible that the reason for this is that married folks have a significant other nagging … er, I mean strongly encouraging … them to go to the doctor on a regular basis and get a checkup.

Preventive care and early detection are key to maintaining and continuing a healthy lifestyle as you age. Finding cancers early, learning about diseases or conditions at an early stage, gives you a better chance of doing something about it.

The best way to proactively keep yourself healthy is to take care of your body. So whether you have a spouse to ‘encourage’ you or not, there are some steps you can take to get in shape and keep healthy.

Be physically active.

Walking briskly, mowing the lawn, playing team sports, and biking are just a few examples of how you can get moving. If you are not already physically active, start small and work up to 30 minutes a day of moderate physical activity for most days of the week.

Eat a healthy diet.

Concept, food, meal.

Fruits, vegetables, whole grains, and fat-free or low-fat dairy products are healthy choices. Lean meats, poultry, fish, beans, eggs, and nuts are good, too. Try to eat foods that are low in saturated fats, trans fats, cholesterol, salt and added sugars.

Stay at a healthy weight.

Try to balance the calories you take in with the calories you burn with your physical activities. As you age, eat fewer calories and increase your physical activity. This will prevent gradual weight gain over time.

Drink alcohol in moderation or not at all.

MenhealthCurrent dietary guidelines for Americans recommend that if you choose to drink alcoholic beverages, you do not exceed 2 drinks per day for men (1 drink per day for women). Some people should not drink alcoholic beverages at all, including

  • Individuals who cannot restrict their drinking to moderate levels.
  • Individuals who plan to drive, operate machinery, or take part in other activities that requires attention, skill, or coordination.
  • Individuals taking prescription or over-the-counter medications that can interact with alcohol.
  • Individuals with specific medical conditions.
  • Persons recovering from alcoholism.

Don’t smoke.

For more information on quitting, visit Quit Smoking section.

Take aspirin to avoid a heart attack.

If you are at risk for a heart attack (you’re over 45, smoke, or have diabetes, high blood pressure, high cholesterol, or a family history of heart disease), check with your doctor and find out if taking aspirin is the right choice for you.

Sources: AHRQ, UC San Diego Health, British Cardiovascular Society


More information:

Man and Life: How Marriage, Race and Ethnicity and Birthplace Affect Cancer Survival

Marriage could improve heart attack survival and reduce hospital stay


Watch Mercy Dance to Support Men′s Health Month