Heart disease is a leading cause of death in the United States, with significant impacts on public health. Monitoring heart health routinely can be important for many individuals. As monitoring can unveil and alert us to risk factors associated with cardiovascular disease, this article will focus on heart health awareness and how you can support your heart health. We will discuss the risk factors for heart disease, comprehensive labs that may be considered bi-annually, self-assessment tools and resources, and the importance of monitoring symptoms and body signals.
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Importance of Heart Health Awareness
Living with heart health in mind can help support cardiovascular well-being and, additionally, can help to optimize and improve your quality of life. Risk factors for developing heart disease like hypertension and high cholesterol may have no signs or symptoms, and thus a person may not know their risk of heart disease is increasing. Similarly, one out of every five heart attacks is “silent,” meaning the person doesn’t know he or she had a heart attack. The sneakiness of heart disease and its risk factors should be a significant cause of concern since heart disease is a leading cause of death in the United States and makes heart health awareness all the more critical. Being aware of your risk for heart disease can be beneficial.
Understanding the Risk Factors for Heart Disease
The Centers for Disease Control (CDC) estimates 47% of Americans have at least one of these three significant risk factors for cardiovascular disease: high blood pressure, high cholesterol, and smoking. Other health conditions that may increase the risk of heart disease include obesity and diabetes mellitus.
High Blood Pressure
Blood pressure is a measurement of the pressure of your blood pumping against the arterial walls. Blood carries oxygen, nutrients, and blood cells to tissues all around the body; thus, having a normal blood pressure range is important. A normal blood pressure is considered to be 120/80 mm Hg; when the pressure becomes elevated, called hypertension, it can affect organs such as the kidneys, brain, and heart. Hypertension is often referred to as a “silent condition” because it frequently presents without symptoms.
High Cholesterol
Cholesterol is a fatty substance that, in normal amounts, is not only used but necessary, as it is utilized in the body to make vitamins, hormones, bile acids, and cell membranes. However, in high amounts, certain types of cholesterol can become concerning. Excessive amounts of cholesterol have the potential to stick to the arterial wall, causing narrowing of the arteries, called arteriosclerosis. In turn, blood flow to critical organs, including the heart, brain, kidneys, and lungs, is reduced. While there are no signs of high cholesterol, arteriosclerosis caused by high cholesterol can lead to shortness of breath, chest pain, and fatigue.
Diabetes Mellitus
Diabetes is a condition where the body does not process blood glucose, or blood sugar, properly. Excessive amounts of glucose in the blood can cause damage to the arteries that supply the heart. Type 1 and type 2 diabetes are both risk factors for heart disease.
Smoking
Smoking is detrimental to overall health in many ways, including raising the risk of heart disease. Smoking negatively impacts cardiovascular health by raising triglyceride levels and increasing plaque buildup in blood vessels. Additionally, smoking damages the cells that line blood vessels and also cause them to narrow and thicken, making it harder for blood to pass through. Smoking also makes blood sticky, making it more likely to clot and thus block blood flow.
Bi-Annual Comprehensive Lab Testing To Consider
Bi-annual labs to consider for monitoring heart health in patients include blood pressure measurements, lipid, diabetes, and inflammation panels, as well as electrocardiograms.
Blood Pressure Measurement
Blood pressure testing measures the pressure in the arteries that causes blood to be circulated throughout the body and reflects how the heart is pumping. A blood pressure reading has two numbers: the top number is the systolic pressure, and the bottom number is the diastolic pressure. Systolic pressure represents the contraction or squeezing of the heart, resulting in blood being pumped. Diastolic pressure is pressure measured between contractions or heartbeats. A normal blood pressure measurement is below 120/80 mmHg. 120-129/80 mm Hg is considered to be elevated blood pressure; 130-139/80-90 mm Hg is stage 1 hypertension; 140+/90+ mm Hg is stage 2 hypertension.
Lipid Panel
Since elevated cholesterol can increase the risk of heart disease, cholesterol should be monitored bi-annually. A basic cholesterol, or lipid, panel looks at total cholesterol, triglycerides which are fats in the blood, and the two main types of cholesterol, LDL and HDL. LDL is known as the “bad” cholesterol since it transports the cholesterol from the liver to the rest of the body. HDL is considered the “good” cholesterol since it does the reverse and takes cholesterol from circulation to the liver for disposal. A comprehensive lipid panel goes a step further by evaluating the markers included in a basic lipid panel with the addition of sdLDL, a type of LDL that is more likely to form a clot, and apoproteins. Apoproteins are carriers of cholesterol, and certain ones can increase the risk of cardiovascular disease.
Diabetes Panel
A diabetes panel should include a comprehensive metabolic panel (CMP), checking blood sugar, and kidney and liver function. Hba1c is an average of the last three months of blood sugar levels and thus can help to indicate diabetes risk and/or status. Lastly, insulin, the transporter of blood sugar in the body, should also be monitored, as it plays a role in the development and progression of diabetes.
Inflammatory Markers
Inflammatory markers are essential to measure and monitor as they can significantly affect the risk of heart disease. A well-researched marker associated with hs-CRP can indicate inflammation, specifically in the cardiovascular system. LpPLA2 reflects arterial disease activity and immune functioning in the cardiovascular system. Myeloperoxidase (MPO) is specific to inflammation in the arteries.
Electrocardiogram
An electrocardiogram, commonly known as an “EKG,” is a noninvasive test that measures the heart's electricity. An ECG monitors the electric signals that make the heart beat by placing electrodes strategically around the chest wall. An EKG can reveal abnormal heart rates and rhythms, heart attacks, structural changes in the heart, and more.
Self-Assessment Tools and Resources
There are many self-assessment tools and at-home accessible resources that can be done to help monitor heart health and assess the risk of heart disease. These tools are invaluable, as they offer a low-risk, safe option for anyone to gain more information on their cardiovascular risk.
Risk Assessments
The American College of Cardiology created the Atherosclerotic Cardiovascular Disease (ASCVD) risk calculator, which assesses the risk of a person developing cardiovascular disease over the next ten years in people aged 40 to 79 and the lifetime risk for those aged 20 to 59. Cardiovascular disease is strongly associated with atherosclerosis, a narrowing, and hardening of the arteries. A shorter assessment is the online American Heart Association (AHA) Cardiovascular Risk Calculator, which the AHA and the American College of Cardiology made. Both calculators will offer suggested therapies based on results.
Blood Pressure Monitoring
Just like at the doctor's office, blood pressure can be taken at home with the purchase of an automatic blood pressure machine. Anyone can purchase a blood pressure machine, and the American Heart Association recommends anyone with high blood pressure (hypertension) to monitor their blood pressure routinely at home, as it can be helpful to know your numbers and also can help information for your physician to adjust or alter medication dosage. Once a machine is purchased, it's recommended to take it to your next appointment with your physician to discuss proper use of the machine, including where to place the cuff. Additionally, it's important to remember to sit up straight with your feet on the floor and legs uncrossed and to remain still. Taking multiple blood pressure readings can be helpful, and taking readings every day at the same time can also be beneficial in identifying trends. Lastly, it's recommended to avoid caffeinated beverages, smoke, and exercise 30 minutes prior to taking your blood pressure.
*A blood pressure of 180/120 mm Hg while experiencing symptoms including chest pain, shortness of breath, changes in vision, back pain, numbness or weakness, or difficulty speaking is a medical emergency; immediate medical care should be taken. A reading of 180/120 mm Hg without symptoms should be retaken; if the reading is still at or above that level, it may indicate a hypertensive crisis, and a medical provider should be contacted.
Monitoring Physical Symptoms and Body Signals
Signs and symptoms of cardiovascular disease are important signals that your body sends to alert you that there is something wrong. Common symptoms of cardiovascular disease can include chest pain and shortness of breath. Chest pain, medically known as angina, occurs when narrowing and/or blockage occurs in the arteries in the heart: this condition is known as coronary artery disease. Shortness of breath is due to the lack of oxygen being delivered due to impaired blood flow from the heart. Symptoms that may not seem to be related to the heart but can be due to heart disease include fatigue, swelling in the legs and feet, lightheadedness, dizziness, confusion, pain or tingling in the arms, jaw, shoulders, or back, cough, and low-grade fever. Because of the vast array of symptoms that heart disease can manifest, it's important to talk with your provider if you're experiencing any of the above symptoms or if you do not know the cause of them.
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Summary
Heart health should be at the top of every functional medicine practitioner’s mind, as it is a leading cause of death in the United States. Monitoring heart health throughout the year through testing, self-assessment tools, and resources, and knowing and monitoring signs and symptoms, can be beneficial. Functional medicine testing can elevate awareness through advanced markers that reveal more information about a person's cardiovascular system status and obtain a higher level of understanding of risk factors.
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