180312 March 12, 2018

    If you read last week's edition, you are aware of my recent open-heart surgical saga, requiring six (6) coronary artery bypass grafts.  Prevention is the key to avoiding this surgery, in addition to sudden death from a cardiac event.  Risk factors for Coronary Artery Disease (CAD) and Stroke include high blood pressure, elevated cholesterol, diabetes, cigarette smoking, obesity, sedentary lifestyle and family history of heart disease.  Another risk factor is stressful lifestyle, associated with those of us cursed with ambition who work too hard and too long in a desire to succeed; these folks (I should say "We Folks," as I belong to this club) are referred to as having a "Type A Personality."   One of our cardiologists thinks that those of us with Type A Personalities have more heart attacks because we have to spend most of the day dealing with people who have Type B Personalities.

    Alcohol consumption is NOT a risk factor for heart attack or stroke; actually, daily alcohol consumed in moderation decreases risk, as it raises levels of High Density Lipoprotein (HDL), the "good type" of cholesterol.  One other thing that raises HDL is regular exercise.

    The simplest recommendation to follow is taking low-dose aspirin (81 mg, 1/4 the amount of a regular aspirin, which is 325 mg).  A large part of what causes hardening of arteries is platelets clumping together to form a blood clot inside the arterial wall, eventually causing blockage of blood flow to heart and brain.  Aspirin chemically coats the platelets, keeps them from sticking together to form a blood clot.  Daily aspirin also decreases risk of developing colon polyps, which are considered pre-cancerous.   A recent study compared colon cancer rates between daily aspirin takers and those who did not;  the aspirin half of study decreased their rate of colon cancer by 27%.  Little risk of taking daily aspirin, unless there is a history of stomach ulcer or gastritis;  easy bruising may occur, especially in women, whose skin is more thin and fragile than in men, because of female hormones.

    There are now five statin agents, all of which are generic.  Most people are aware that statins lower cholesterol, but they also have potent anti-inflammatory properties, and the development of atherosclerosis/hardening of the arteries is an inflammatory process.  A study published in early 2017 compared people our age and older who had taken a statin agent for at least 5 years, compared to control population (no statin).   Among statin takers, women had a 15% decrease in Alzheimer's Disease; men had a 12% decrease.  This makes a lot of sense, because if you are taking a med to keep arteries to the heart open, it should keep arteries to the brain open as well.

    Unless you have already had this done, I highly recommend getting an External Beam Heart Scan (EBCT) to diagnose or rule out risk for heart attack or stroke.  It is a non-invasive, user-friendly imaging study; the person lies on a table in an open room (no worries about claustrophobia, like for an MRI) and the scanner moves over the chest.  It is sort of like your heart and part of the lungs are a loaf of bread, and images are taking out one thin slice at a time, looking for calcium in each of the 4 arteries to heart muscle.  A calcium score is measured in each artery, and added up for a total calcium score.  If elevated, the next step is seeing a cardiologist for a stress test, to be certain you are not a heart attack waiting to happen.  An EBCT is not covered by insurance, costs usually around $100, but is money well spent.  In most places, a doctor's order is not even needed for a free-standing imaging unit.  In Atlanta these places, some of which are affiliated with hospitals,  advertise on the radio and TV, quoting a rate of $99 for a single person, and $149 for a couple.   There is NO RISK to this procedure, and NO DOWNSIDE.  I hope very much that classmates and other readers heed my advice, as I am certain there are more than a few of us who are walking around now with clogged arteries, a heart attack or stroke waiting to happen.