How to manage the rising epidemic of heart disease

Click to listen to Dr. Samer Najjar’s podcast on heart failure.

Heart disease is the leading cause of death for both men and women in the United States.

While heart attacks and strokes get much of the attention when it comes to heart-related conditions, there is another common killer: congestive heart failure.

In fact, recent statistics indicate that more than five million Americans are living with congestive heart failure (CHF), and nearly 550,000 new cases are diagnosed each year.

Unfortunately, many people aren’t even aware that they are living with this very deadly disease.

"The difficult thing about heart failure is that it doesn’t have just one way that it presents itself,” says Samer Najjar, MD, director of the Advanced Heart Failure Program at MedStar Heart & Vascular Institute at MedStar Washington Hospital Center. “With heart attacks and strokes, when you have symptoms, you have to go to the hospital very early because there are things that can be done. The longer you wait, the more injury can happen. Heart failure is different. There is a myriad of different types of symptoms people can have, which makes it harder to distinguish who has heart failure and who does not."

Once a patient has been diagnosed with heart failure, Dr. Najjar explains it’s quite likely he or she will need to continue treatment for a lifetime. “This is not just a condition of something happened and you ended up in the hospital, we treat you and you go home and it’s over with. Not at all. Heart failure is something people live with for the rest of their lives.”

Signs & Symptoms

Common symptoms of CHF include swelling of the legs, shortness of breath, lethargy, loss of appetite and abdominal pain.

Dr. Najjar explains there are two different types of heart failure. In one form, the heart is trying to pump but the muscle is too weak to do so efficiently. “If the muscle is weak, it’s having a hard time pumping the blood forward. Therefore, the blood will back up. It will back up into the lungs which is what causes shortness of breath and then it backs up into the rest of the body and that’s how patients start retaining fluid.”

The other form of heart failure, known as preserved ejection fraction, can be deceiving, because despite the fact that the heart appears to be squeezing normally, it’s having difficulty getting blood to the rest of the body. “That’s something that we in the medical field have struggled with for some time, because it’s not immediately obvious to us,” says Dr. Najjar.

Risk Factors

Anything that can cause injury to the heart puts people at risk for having heart failure. For example, high blood pressure, high cholesterol, high blood sugar, previous heart attack(s), smoking–all of these can contribute.

However, approximately 30 to 40 percent of those with heart failure have no discernible risk factors.

Still, Dr. Najjar is quick to emphasize that while some cases seem to appear out of nowhere, “there are known risk factors, which is why these risk factors have to be addressed during one’s lifetime.”

There are also lifestyle choices that are very important. “Exercise is a huge risk factor modifier and our population needs to do much more physical activity and exercise than what is common.”

Treatment Options

Advancements in medical science have provided a variety of treatment options, including oral medications.

“There are a lot of medications that have been studied, and several have been shown without any doubt that they actually improve survival. People live longer and feel better,” says Dr. Najjar. With these medications, it’s important for patients to keep close contact with their doctors until the correct dosage has been determined.

Other treatment options include devices such as pacemakers and defibrillators.

And, there are steps patients need to take to ensure these treatments remain viable. For example, salt is a huge culprit in terms of fluid retention. Patients also need to monitor how much fluid they take in on a daily basis. Consistent weigh-ins can be helpful to monitor fluid retention and identify a problem prior to the appearance of any other symptoms.

Life-Long Care

Once a patient has heart failure, Dr. Najjar explains it’s quite likely he or she will need to continue treatment for a lifetime.

The crucial thing to remember is that you cannot ignore risk factors. “You don’t want to wait until you have a problem, either a heart attack or heart failure,” says Dr. Najjar. “You have to be able to modify those risk factors in middle age, in young age, as soon as you find out that they happen, because when you’ve already developed the disease, you’ve already lost the opportunity to prevent them.”

Click to listen to Dr. Najjar’s full podcast on heart failure.

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29 Things You Should Do for a Healthy Heart

You’re heard it many times before -- follow a healthy lifestyle for a healthy heart. Sounds simple, right?  But it’s not always so easy to pull off. A heart healthy lifestyle can reduce the risk for heart disease by as much as 80%!  But what is a “heart healthy lifestyle”?  It’s a commitment to many habits in our daily lives centered on our activity, diets, mindset and awareness.  There is no one “magic” thing. When lifestyle isn’t enough, talk with your doctor to set goals you can realistically achieve, such as losing weight or lowering your cholesterol or blood pressure levels. Sometimes, it takes medications that can be very helpful to optimizing your heart risk.

So, commit to making the many small lifestyle changes that make a healthy heart a snap! The key to success is to make small changes in many areas. No matter what you do, remember to take it day by day, and work to sustain your gains.

With that in mind, we’ve compiled 29 heart health tips. Knowledge is power!  Read on to find out what you can do to keep your heart healthy. Only you can love your heart. So start today!

1. Make time for exercise: Exercising 30 to 60 minutes on most days will cut your heart risk in half.

2. Know your heart disease risk: Calculate your risk by plugging your numbers into an online calculator.

3. Never ignore your chest pain:  Pain can be felt anywhere in the chest area, arms, your back and neck.

4. Check your blood pressure: Let the healthy blood pressure number be below 140/90. Both numbers matter!

5. No smoking: Don’t smoke, and ask your loved ones to quit.

6. Aspirin: Should you take aspirin? If you have heart disease, yes! If you don’t have heart disease, then maybe not! Ask your doctor.

7. Moderate exercise: How do you know whether you are exercising moderately? You should able to carry on a light conversation

8. Stress: Is it bad for your heart? Yes, sustained stress is, no matter the source. Learn to control your stress to prevent heart disease.

9. Second hand smoke is dangerous! Public smoking bans in the community have reduced heart attack risk by 20%.

10. Sex: Is your heart healthy enough for sex? Sex has a “heart workload” like climbing two flights of stairs.

11. Dark chocolate: Give your loved ones chocolate as a gift on Valentine’s day! Regular chocolate eaters have less heart and stroke risk!

12. Order wine with your dinner! Moderate intake is associated with lower heart risk. (Consume wisely!)

13. Red or white wine? Is one better for your heart? Wine, beer or spirits all show a similar relationship to lower heart risk.

14. The “Mediterranean diet” is the most heart healthy way to eat. Studies show this diet reduces heart attack risk up to 30%.

15. Mediterranean diet = veggies, fruits, nuts, seeds, grains, herbs, spices, fish, seafood, olive oil, poultry, eggs, cheese, yogurt and wine.

16. Take your heart meds fully and faithfully! It’s the only way to get the full benefit of the treatments!

17. Stairs burn twice as many calories as walking. Regular stair climbing reduces your risk of premature death by 15%!

18. The quantified self. Keep moving! Steps per day: Very active >10,000, active >7500, sedentary <5000.

19. Fish eaters have less heart disease! Think about fish as a first choice when eating out- let somebody else do the cooking!

20. Did you know that people who are optimistic have less heart disease? See the bright side- it is truly good for your heart!

21. If you snore, tell your doctor. Snoring can be treated, and could signal risks for your blood pressure and heart rhythm.

22. Want to really know your risk of heart attack? Get a calcium scan of your heart. Accurate, safe, and costs less than dinner for 2!

23. Do you know CPR? Simple! Learn it here and double somebody’s chance of surviving cardiac arrest.

24. Ditch the soda and energy drinks. Please.

25. Coffee lover? For your heart’s sake, it is OK! (But, skip the donut!)

26. Like music? So does your heart! Music listening lowers your heart rate, and blood pressure!

27. Are statin cholesterol drugs safe? For most patients, yes! Unfortunately, over the counter supplements aren’t very helpful.

28. Heart attack or stroke symptoms? Don’t delay! Call 911 immediately. Minutes matter to save lives!

29. Taking vitamins or other supplements for heart disease risk? Be careful- few have little, if any, proven benefit.

Have any questions?

We are here to help! Contact us for more information about heart health or to schedule an appointment. Call us at 202-877-3627.

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