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Reduce Your Risk For Heart Disease

Drs. Binh An P. Phan & David Najman February 01, 2011 12:00 PM This chat has ended. Thank you for participating.
Patrick (Moderator) - 12:02 PM:
Welcome! Today’s chat: Reduce Your Risk For Heart Disease will begin shortly. Please start submitting your questions and Drs. Binh An P. Phan & David Najman will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Cardiovascular Care Center to obtain more information about Heart Disease.

Drs. Binh An P. Phan & David Najman (NorthShore) - 12:06 PM:
Good afternoon and welcome to today's chat. We're happy to answer any questions you may have about how to prevent heart disease. Drs. Binh An P Phan and David Najman have a particular interest preventive cardiology and cholesterol treatment.

Jeff Halada (Evanston, IL) - 12:07 PM:
What to you think about the Merck trial drug anacetrapib. Do you think that it is likely to one day replace the need for a statin and niacin combination to raise HDL and lower LDL?

Drs. Binh An P. Phan & David Najman (NorthShore):
Excellent question, and there is no data yet to answer your question. There was a similar drug previously in development which failed because more people died when taking it. It is unknown if that was due to the class of drugs, or if it was specific to the previously studied agent. Towards the end of this year or early next year there will be 2 very large trials assessing the benefits of Niacin in addition to a statin, named "AIM-HI" and "HPS2-THRIVE" which will give us definitive data with Niacin. There will also be more data with anacetrapib around the same time, and although none of these trials are comparing the agents to each other, we will have much more information to answer the question.

Lorry Jenkins (Chicago, IL) - 12:12 PM:
What percent of the time approximately is a heart attack triggered (without) you exerting physical energy, or exercising prior to the attack?

Drs. Binh An P. Phan & David Najman (NorthShore):
There is no good answer to your question, as we are unaware of any data to give us this answer. Although exercise may trigger an event, the underlying disease process began long before the actual heart attack. People who engage in more regular exercise and better diet have a slower progression of arterial disease (plaque in the arteries), and also have more of a warning mechanism before an actual heart attack. For those who do not engage in regular activity, they should be very careful shoveling snow today and tomorrow as this places a huge demand on the heart. For those who know their heart is fine, shoveling snow is a great form of exercise and burning calories.

Davonda Buck (Chicago, IL) - 12:18 PM:
I was diagnosed at 16 with Hypertension, recently had a heart attack (37yrs old now)what can I do to live, how closely should I be followed by a doctor, the cardiologist doesn't want to see me again until April. Thank you!

Drs. Binh An P. Phan & David Najman (NorthShore):
Patients who have heart attacks in their 20's and 30's usually have several risk factors. You mentioned high blood pressure, but other concerns which hopefully have been examined are diabetes (glucose), smoking, and cholesterol (not just the total, but the good - HDL, and bad - LDL and TG). Your body mass index if elevated should also be watched, and kept under 25. It is hard to answer the question of your future risk without knowing what was abnormal prior to this point, but the most important factors we listed above should be followed on a regular basis, and the frequency is dependent on how well they are controlled. We would also recommend periodic stress tests to follow your heart, this dependent on how many blockages you had at the time of your heart attack, how severe they were, and if you develop any symptoms.

Bill (Evanston, IL) - 12:24 PM:
Doctors, Any tips on how I can not overexert myself while shoveling snow in the next few days?

Drs. Binh An P. Phan & David Najman (NorthShore):
Get on a plane to Florida if you still can, wait until everything melts, then come back. :-)As written 2 questions ago, this is a concern and with each significant snow fall we see many patients coming in with a heart attack. For those who exercise on a regular basis, shoveling is still a greater demand on the heart and body, so as with anyone if you develop any chest discomfort, (can be tightness, squeezing, sharp pain..., there is not 1 specific symptom to watch out for), you should rest, and if it has not gone away for 5 minutes either call 911 or go to the ER.

Kim - 12:31 PM:
What can "40-somethings" who are on high blood pressure meds already (family history) do to ensure a healthier lifestyle? I am an avid commit to regular exercise but wonder what else I can do to best take care of myself. Thank you very much for your time.

Drs. Binh An P. Phan & David Najman (NorthShore):
It is our pleasure to answer these questions. It is great that you are exercising on a regular basis, that unfortunately is the minority in this day and age. Avoiding all smoke, screening (and treatment if necessary) for your cholesterol and glucose, and maintaining a body mass index under 25 are all important. Given your blood pressure, limiting your sodium (salt) intake will also help this, the guidelines which just came out yesterday recommend 1500mg/day as a maximum.

Doug (Glenview, IL) - 12:35 PM:
I can't tolerate statins but my HDL is below 40 and my total cholesterol is about 200. Also my triglycerides are moderately high. Is there anything else I can do besides diet and exercise?

Drs. Binh An P. Phan & David Najman (NorthShore):
There are several other options, either with lifestyle, over the counter meds, or other prescription meds. It is dependent on many factors beyond what you typed above, so a generic answer would not suffice. Factors such as diabetes, weight, and the exact numbers of your cholesterols, glucose, and average blood sugars all need to be taken into consideration. We are concerned about you as an individual, if your regular doctor can not answer your questions adequately feel free to come in to see either one of us, Dr. Phan's office is attached to Glenbrook Hospital, Dr Najman's office in Skokie. You can call 847-663-8410 and ask to schedule an appointment with either one of us, please bring all of your blood tests with you, not just the recent ones, and we will gladly address this in more detail.

Naik (Vernon Hills, IL) - 12:41 PM:
Does BP has any indication of heart diseases? My family has a member with consistent BP of 135-140/85-90 from 4-5years, is a male of age38 and 165lbs and his bad cholesterol level not so perfect.

Drs. Binh An P. Phan & David Najman (NorthShore):
BP is a risk factor for developing arterial disease, both in the heart and throughout the body. The combination of this along with other risk factors is additive in developing vascular disease. Everyone has a genetically determined start point of their cholesterols, good and bad, and guessing on your origin based on your name, there is a preponderance of people with elevated bad cholesterol (ldl) in western asia/middle east, even if someone is skinny and eats well. It is important to look at all of the risk factors together, and with this we assess an individual's risk of having a heart attack. Based on this we decide at what point to recommend just lifestyle changes, or medications to keep you healthy. Dr. Hani Salti's office (847-941-7970) is very close to you (on Milwaukee just south of 60), it would be a good idea to look at you and your families' numbers to hopefully keep you healthy and prevent you from developing heart disease.

Michelle (Northbrook, IL) - 12:49 PM:
What is considered high blood pressure?

Drs. Binh An P. Phan & David Najman (NorthShore):
Ideal BP is a systolic under 120 and a diastolic under 80. A systolic between 120 and 140 is borderline, over 140 is high.

Erica (Evanston, IL) - 12:51 PM:
What exactly is cholesterol?

Drs. Binh An P. Phan & David Najman (NorthShore):
It is a substance found in animal tissues and various foods. It is made by the liver and is important as a constituent of cell membranes and a precursor to steroid hormones. An individual's cholesterol is initially determined genetically, but lifestyle (exercise and diet) will effect both the good and the bad cholesterol levels.

Michelle (Northbrook, IL) - 12:54 PM:
Does menopause have anything to do with heart disease?

Drs. Binh An P. Phan & David Najman (NorthShore):
Absolutely. We could talk about this question for hours, but will limit it to a few salient points. After menopause the hormones which prevent or delay vascular disease go down significantly. That is the main reason why a pre-menopausal woman's risk of heart disease is lower than a man's, but a woman's risk of heart disease is greater than a man's after menopause. Several other changes tend to occur, good cholesterol can go down, bad cholesterol tends to go up, and blood pressure may go up.

Patrick (Moderator) - 12:55 PM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

Matt (Glenview, IL) - 12:58 PM:
What is arrhythmia?

Drs. Binh An P. Phan & David Najman (NorthShore):
Arrhythmia refers to any abnormal heart rhythm, slow, fast, regular, or irregular. Some are benign, some are very concerning. The heart has an electrical system built into it, and if this electrical system is disrupted that is when we see arrhythmias.

Kyle (Lake Forest, IL) - 1:00 PM:
I am 24 and suffer from heart arrythmias. I am currently taking Lidocaine for my symmtoms. Does this decrease your chance for heart disease or is it simply for symptoms and play no part in the prevention of heart disease? I also take a baby aspirin a day.

Drs. Binh An P. Phan & David Najman (NorthShore):
"Heart disease" is a broad topic, and relates to any part of a complex organ. Lidocaine only has effects on the heart's rhythm, and does not have other effects on preventing build up of plaque in the arteries which cause heart attacks.

Drs. Binh An P. Phan & David Najman (NorthShore) - 1:06 PM:
Thank you for joining us over the past hour. I hope you learned more about preventive cardiology and importance of cholesterol in heart disease. If you have any further questions we would be glad to discuss them with you in more detail, Dr. Phan can be reached at 847-657-1819, and Dr. Najman at 847-663-8410.

Patrick (Moderator) - 1:06 PM:
Thank you again for participating in our chat today. For more information please visit our Cardiovascular Care Center pages.

Also, a transcript of this chat will be available shortly.
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