To prevent heart disease, exercise is one of the most crucial interventions. Cardiologists-such as Amir R. Haghighat – lead by example, carrying out an active lifestyle, to set a good example for their patients. Even cardiologists need to look after their heart health!
Exercise does play a pivotal role in preventing the development of heart disease. But did you know that exercise is just as beneficial once diagnosed with chronic heart disease? People with chronic heart disease should incorporate exercise into their lives as it:
- Lowers cholesterol.
- Lowers blood pressure
- Builds a healthier heart
- Improves muscle strength
- Can decrease the need for medication
- Decreases stress
- Helps control weight
There are three main types of exercise that are beneficial to those with chronic heart disease:
- Stretching: increases flexibility and prevents injuries
- Strength training: tones muscles
- Aerobic exercise: activity that raises heart rate
The most beneficial of these three exercise groups, for those with chronic heart disease is aerobic exercise. Walking (briskly), hiking, jogging, cycling, rowing, swimming and stair climbing are all activities included in this group.
Prior to commencing an exercise regime it is of pivotal importance-when suffering from chronic heart disease- to see your doctor/cardiologist beforehand. They may need to carry out some tests to determine what keep of exercise, and which intensity is best suited to your disease. The most common tests they may run are a physical/exercise stress test. They may also teach you how to monitor your heart rate when exercising, so you can know when it is at the right level. A general rule of thumb is: if you cannot exercise and talking it is probably too intense, however if you can sing while exercising, you may need to increase intensity.
When carrying out your exercise regime it is also important to put safety first. Monitor how your body feels and how it is responding to the exercise. A tip is to keep an activity journal so you can assess progress over time, as well as pinpoint what kind of activities/intensities are not suitable for you body. Some general rules for exercising with chronic heart disease are:
- Start off slowly, improvement will come with time
- Listen to your body, are there signs that you are doing too much?
- If you cannot talk while exercising, are short of breath, feel nauseated/chest pain/ dizziness STOP exercising
- If symptoms persist see your cardiologist/physician-you may need to alter your exercise routine
- If you feel completely wiped out the day after exercise, adjust your exercise routine-you may be doing too much
- Do not exercise in bad weather
- Do not do any heavy lifting that is not recommended by your doctor
- Do not hold breadth while doing exercises such as push-ups etc. Your heart needs oxygen to work!
- Extremely hot/cold showers after working out should not be taken
- And most importantly, do not exercise if your disease is not under control!
Carotid artery stenosis – the narrowing and hardening of the carotid arteries located on either side of the neck – is a leading cause of stroke in the United States. Though the condition normally presents at first with transient ischemic attacks (also known as TIA or mini-strokes), the occurrence of such an attack means that the person is at an increased risk of having a major stroke and should seek help from a cardiologist.
According to cardiologists in Florida Cardiovascular Institute of Northwest Florida – also known as Cardiology Associates – there are three main treatment options for carotid artery stenosis.
Conservative: Medical Therapy
Conservative medical therapy is usually the first step and the safest way to treat carotid artery stenosis. The treatment involves:
- A healthier diet plus more exercise
- Medications to treat high cholesterol, hypertension and atherosclerosis
- Anti-clotting medications
- Quitting smoking
Medical therapy is quite safe and can offer excellent results for patients in the early stages of carotid artery stenosis. Unfortunately, advanced cases may need a more drastic solution.
Surgical: Carotid Artery Endarterectomy
This is a surgical procedure in which the vascular surgeon opens the artery and manually removes the plaque inside. Well-qualified surgeons have an excellent track record with this procedure – but, as with any serious surgical procedure, there are a number of risks. These risks are more pronounced in older patients, patients with heart disease, lung failure, high blood pressure, or certain anatomical features that prevent access to the arteries through the neck. Even low-risk patients often dislike the idea of having surgery while less invasive options are available.
Minimally Invasive: Carotid Artery Stenting
In this procedure, the vascular surgeon threads a catheter through the femoral artery of the leg up to the carotid artery. The device can then be used to widen the artery and insert a stent – a tube-shaped device used to hold the blood vessel open – inside the artery. The procedure is performed with only a local anesthetic, and it eliminates the risks of having cardiac surgery. The procedure is performed faster and with a significantly lower recovery time than surgery.
The American Heart Association has issued the annual heart health report card and reports that there is a lot of room for improvement.
The report, “Heart Disease and Stroke Statistics — 2012 Update,” is published in Circulation: Journal of the American Heart Association.
The American Heart Association list these seven factors most important to heart health:
- Smoking status
- Healthy weight
- Physical activity
- Healthy diet
- Good cholesterol levels
- Normal blood pressure levels
- Normal blood sugar levels
According to the report, 94% of U.S. adults have at least one of these factors at ”poor” levels, and 38% of adults score poorly on three or more. Half of U.S. children ages 12 to 19 meet four or fewer of the factors. Heart researchers find that exercise and maintaining a healthy weight continue to be major problems for many Americans.
According to Centers for Disease Control and Prevention (CDC) there are over 27.1 million adults in the U.S. diagnosed with heart disease and many more that are not diagnosed.
EMR clinical data mining is proving to be a valuable tool to identify early signs of heart disease and potentially save many people’s lives. By analyzing patient health record databases medical researchers can track possible causes, the disease’s progression, and use the data to create systems that identify early stages of the disease.
What is Clinical Data Mining?
Clinical data mining is the process of extracting, analyzing, and interpreting clinical data in order to build medical knowledge and improve health care practices
As more hospitals and medical practices are adopting EMR systems, there is a wealth of biological, clinical and administrative data that can be available to researchers.
What Does Research Say?
A study conducted in the UK found that mining primary care EMRs was just as effective in preventing heart disease as a NHS plan to screen nearly all UK residents in order to target patients at high risk for cardiovascular disease.
The research team from Cambridge University and Addenbrooke’s Hospital discovered that by exporting routine data from patient EMR software, they can assign a cardiovascular disease risk score and effectively treat the top 20 percent of patients with the highest risk.
A new study has found that Carotid Artery Stenosis might not be as effective as medical therapy in stroke prevention. The study found that the risk of stroke after carotid artery stenting was much higher than was originally thought; and at the same time the results of medical therapy for stroke prevention were much better than they had expected.
A stroke occurs when the blood supply to the brain is cut off or significantly reduces. Doctors have been increasingly using stents, especially in patients who have already had a stroke and run the risk of a second stroke occurring in the same place as the first. Carotid artery stenting involves the insertion of a small balloon into the blocked carotid artery to open up the artery and therefore the blood supply to the brain. Previous trials have shown it is a relatively safe procedure, however, it now seems that it might not be as safe as we think.
The trial, published online on September 7th in the New England Journal of Medicine, found that carotid artery stenosis was associated with more strokes and death than medical therapy. Carotid artery stenosis is an extremely advanced surgery that requires highly trained surgeons, therefore, its success is far from guaranteed. It seems that the insertion of the stent could in fact be damaging the artery and causing a stroke. This was also found to be the case in brain stents which were damaging the blocked blood vessels in the brain upon insertion, resulting in strokes as opposed to preventing them.
Medical therapy, on the other hand, involves aspirin, clopidogrel, management of LDL and blood pressure, to prevent strokes. This turned out to be a far safer and more effective treatment than they had thought. Therefore, perhaps medical therapy is the best option for high risk patients than carotid artery stenting which, far from preventing stroke, might actually be causing them.