Mount Sinai experts share tips for Heart attack prevention

New York – Heart disease is the leading cause of death among both men and women in the United States, but according to the American Heart Association, it is preventable 80 per cent of the time. The U.S. Centers for Disease Control and Prevention reports that nearly 650,000 people die from heart disease every year, accounting for one in every four deaths.

The cardiologists from the Mount Sinai Health System are sharing tips on prevention and lowering risk, and emphasizing the importance of optimism to help avoid cardiac events on the eve of  American Heart Month in February.

Mount Sinai cardiologists say they are seeing more patients, especially women, with stress-related heart conditions. Most of the stressors involve work or family. Research shows women tend to internalize stress more, making them more prone to stress-related health issues. Stress releases "fight or flight" hormones that can elevate heart rate and blood pressure, leading to complications including chest pain, palpitations, and irregular heartbeat. Additionally, those who work long hours, travel frequently, do not sleep enough, and have a poor diet can also have abnormal blood pressure and cholesterol levels. In some cases, work stress has been so extreme that several patients have actually fainted on the job.

"I have noticed an increased number of women coming in with stress-related heart problems and some cases have been so extreme, patients have quit their jobs in order to survive. Women and men have different symptoms when it comes to stress-related heart issues. Men with heart problems feel pain or pressure like an 'elephant on their chest,' but for women, that is not the case. Their symptoms may present as a headache, or they feel like they're coming down with a cold or have indigestion, and they may not realize they have a heart problem until it becomes more advanced and more difficult to treat," says Icilma Fergus, MD, Director of Cardiovascular Disparities for the Mount Sinai Health System. "It is absolutely critical for everyone to take steps to de-stress and protect your heart health. During stressful times, I advise my patients to stop and take a few minutes to breathe. Relaxation is key, and it is important to set aside time for yourself to decompress. I also advise patients to keep a positive attitude and remain optimistic. These simple steps go a long way."

Optimism Linked to Lower Risk of Cardiovascular Events and Death

Having an optimistic mindset is linked to a lower risk of cardiac events and all-cause mortality, according to research from the Icahn School of Medicine at Mount Sinai. In a study published in Jama Network Open, a team of researchers reviewed 15 published medical studies, involving 230,000 patients, that investigated the association between optimism and pessimism, and the subsequent occurrence of cardiovascular events and/or all-cause mortality.

Overall, the investigators found that those with optimism had a 35 per cent reduction in risk of cardiovascular events (heart attack, stroke, and cardiac death) when compared to the pessimistic subjects in the study. The results remained significant after adjustment for co-occurring depression, physical activity level, gender, and education (risk factors for disease).

Risk Groups

Everyone is at risk of heart disease, but people are more susceptible to getting the disease if they have high cholesterol or blood pressure, smoke, are overweight, and don't exercise or eat a healthy diet. Age is also a factor, specifically for women over 65 and men older than 55, along with those with a family history of heart disease and people who sleep less than six hours a night.

Certain minority groups, including African Americans and Latinos, are also at higher risk due to genetic predisposition, diet, and lifestyle factors. However, illness in any population can be prevented by taking simple steps towards a healthier lifestyle.

"It's critical to detect and diagnose heart disease early on to prevent a possible heart attack or stroke. Starting at age 20, patients should have cholesterol checked, and even at younger ages (12 years) in those with a strong family history of heart disease. Adults should engage in at least 150 minutes per week of moderate-intensity physical activity, like brisk walking, or 75 minutes per week of vigorous physical activity, such as tennis," says MaryAnn McLaughlin, MD, Director of Cardiovascular Health and Wellness at Mount Sinai Heart.

Tips for Lowering Risk

• Know your family history and tell your doctor if there is a history of heart disease
• Be aware of five key and ideal numbers cited by the American Heart Association
• Blood pressure: 120/80 mm Hg
• Total cholesterol: less than 200 mg/dL
• HDL or "good cholesterol": 60 mg/dL or higher
• Body mass index (BMI): 25 kg/m2
• Fasting glucose levels: 100 mg/dL
• Maintain a healthy diet, eating nutrient-rich food, limiting salt, and eliminating sweets
• Limit alcohol consumption to no more than one drink per day
• Quit smoking
• Watch your weight and exercise regularly
• Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in arms, back, neck, or jaw; breaking out in a cold sweat; lightheadedness; fatigue; nausea or vomiting, or indigestion