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Cardiac Rehab~Have you heard of it? #hearthealth @CardioSmart #CardiacRehab #exerciseworks

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BW ARA labcoatHeart and Vascular Health result from a mix of a lot of different ingredients; we cover many of these ingredients here at the Heart Health Doctors (for example exercise, diet). Think of mixing or using the best ingredients possible (healthy weight, not smoking, healthy diet, staying active) as PRIMARY prevention (for someone who has never had a heart event).

Another important way to work on the ‘ingredients’ is by SECONDARY prevention – how to regain strength, heal after injury, and build back to great Heart & Vascular Health after an EVENT.

Cardiac Rehab is how. The event that will trigger going to Cardiac Rehab may be having a heart stent, a heart attack, open heart surgery for bypass of blocked heart arteries, valve replacement or repair, chest pain or angina, or most recently, a diagnosis of congestive heart failure; even a combination of these.

It would be great to have Cardiac PREhab programs; for now that is what we do at our blog – education for maintaining heart and vascular health.

Cardiac Rehab remains the program that can reduce mortality (death) by 25% if people who have had a heart event complete the program when compared with people who have had a heart event who did not complete a Cardiac Rehab program.

This CardioSmart video gives a great overview of Cardiac Rehab.

The benefits of Cardiac Rehab in our communities cannot be overstated. Often patients will tell me that they plan to “exercise on their own” or that (women here) they are busy making sure their families are organized and cared for, so “no time.” One program offers discount rate for a spouse to attend rehab sessions and exercise with the patient to help increase participation. I encourage and – to use doctor terminology – order my patients to enroll and participate in Cardiac Rehab despite excuses.

At Cardiac Rehab the exercise is monitored – so the patient’s physician learns of any heart arrhythmia, or of any blood pressure issue (under or over treatment). The patient learns about their heart disease, heart healthy habits, how to follow their personal exercise prescription, eat heart healthy, and how to identify and manage stress. It is time well spent. A challenge for patients of late unfortunately can be cost; many programs have financial aid to help patients attend and complete a rehab program, but I had no argument for my patient whose co-pays for cardiac rehab would have approached $2000 for his sessions. He simply could not participate. The hope is that that is an exception; insurers have the data that shows Cardiac Rehab programs result in patients having fewer followup procedures, come out with better quality of life, and are more prepared to succeed with SECONDARY prevention.

Often patients have up to a year to enroll in a Cardiac Rehab program after a qualifying heart EVENT.  Make it a priority to include this therapy and improve Heart & Vascular Health.

 

 

Nutrition Counts

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BW ARA labcoatAnyone who is interested in heart and circulatory health, whether or not you have a direct diagnosis or medical reason to pay particular attention, will benefit from learning about nutrition.  March is National Nutrition Month, a great time to learn more – from an appointment with a registered dietician to review your own specific nutrition goals, or from browsing articles/ resources. Here are some options to check out –

A healthy diet and good nutrition play an integral role in heart and circulatory wellness.  The American College of Cardiology’s CardioSmart website Eat Better has a lot of information on eating habits, family eating, reading labels, goals for diet (see managing hypertension).  The American Heart Association Nutrition Center covers topics such as sodium’s impact on cardiovascular health and how we eat it (The Salty Six:  Bread & rolls, Cold Cuts/meats, Pizza, Poultry, Soup, Sandwiches).  Who thought Bread & Rolls and not Pizza were #1 for the most sodium we eat?

Being heart healthy includes maintaining a healthy weight; not always straightforward because of how work, life, & daily schedules interact with our available food which often comes high calorie, in large portions.  Counting calories plays a role in considering weight and fitness.  Dr. Sherry Pagato, a psychologist, writes about weight in her article, Do I Really Need to Count Calories to Lose Weight? She relates tracking calories to tracking spending (money) and gives a great example of the anxiety that can make both a challenge (here it is a conversation with a friend having financial difficulty).   Attention to detail pays off for both finances and nutrition.

Counting vegetables to be sure you are eating the recommended servings will payoff with heart and circulatory health.  Fruits and Vegetables, Are You Getting Enough? gives great examples for knowing portions, and ways to supplement the diet with more fruits/veggies.  Examples include building a meal around a vegetable as main focus (rather than meat), adding berries to salads, even adding leafy greens to smoothies.  Bottom line, counting servings of fruits & veg gives an objective assessment of your diet, much like tracking pedometer steps/activity.

Choose real food, try to eat local, keep it simple; track what you eat, and learn as much as you can about recommendations for healthy eating.  Take your own dietary inventory for Nutrition Month; do you eat ice cream? Butter? Sweets?  How many vegetables?  Are you eating out?  Are you at your goal weight?  What healthy additions can you make?

The impact of what we eat – from cholesterol and trans fats, to sugar – on heart health is significant. Cholesterol, trans fats, and sugar contribute to atherosclerosis/hardening of the arteries as well as lead to obesity which further compromises heart and circulatory wellness.

We can choose to eat for heart and circulatory health.  For those in central Ohio, check out the McConnell Heart Health Center’s Nutrition Month seminar 10 Ways to Improve Your Diet Now on March 18th.

Wrapping Up #HeartMonth

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IMG_9814rtEvery month is Heart Month here at Heart Health Doctors.  That said, February 2014 is the 50th anniversary of American Heart Month.  The Columbus Dispatch 2/23/14 supplement Your Health focuses on Heart Health with tips to use through the coming year & beyond.  In this post I  summarize a few of the articles and have added heart specific information.

Your Health covers the heart health benefits of activity, consideration of medication – from aspirin therapy to high blood pressure medicine, and diet.  There is a great photo of a treadmill desk; these are desks where users can actually walk while using a computer or reading.  As well as standing desks, the treadmill desks offer great alternatives to sitting.  Breaking up sedentary behavior – or encouraging people to just “move more”  will improve heart health. “Sitting is the new smoking” is now a common comment from physicians interested in prevention.

Understanding why you are taking any pill or food is important; we don’t always consider closely what we eat – be it food or medicine – and may lapse in consistency.  The importance of taking medication for high blood pressure is reviewed.

Here is a good video about high blood pressure:

Your Health also writes about, the ‘miracle’ heart drug aspirin.  Aspirin has risks and benefits – with evidence for benefit for healthy men older than 50 years to prevent heart attack and stroke (and colon cancer), but for healthy women that benefit doesn’t outweigh risk of bleeding until age 65 years old.  Any medicine choice is a time to talk to your health care provider; because many different factors are involved.

As outlined here at Heart Health Doctors, your diet is a key part of overall heart health.  But what if you are not at goal weight?  Using different ways to get to goal weight are reviewed with Jennifer Burton RD at the McConnell Heart Health Center who was interviewed for the Your Health Dispatch supplement.

Finally, as winter in central Ohio has shown us, weather and how to prepare for it, can challenge anyone’s best intentions to stay active.  Sports Medicine Physician and athlete Dr. Darrin Bright is interviewed for the article on Exercise Smart.  Cardiologists in particular appreciate the risk of cold weather activity.  The stress of cold temperatures combined with strenuous activity such as, specifically, snow shoveling can be dangerous and a set up for heart attack.

Any consideration of cold weather activity should include asking “have I been active?” and “am I ready for this?”  Don’t ignore symptoms (chest pain, shortness of breath, back pain, shoulder jaw or neck pain, dizziness/lightheadedness among others); proceed gradually.

Dr. Bright’s recommendations to dress according to the temperature help guide anyone wanting to be active during winter.  The recommendations in the article to dress in layers and be prepared for changes in footing apply; I like the message that weather should not stop us from being active year round.

We know the benefits of exercise, but the goal is to be safe – and ready.  Exercise Smart has great information for winter activity; but what Central Ohioans (this one at least!) are definitely ready for this year, is spring.