Deborah Heart and Lung Center Health Report
Heart Disease Prevention Through the Holidays and Beyond - Pt. 1
Welcome to another episode of the Debora Health Report, where we dive into current health and medical topics to keep the Delaware Valley informed and updated. Last month, we focused on sleep disorders and how sleep specialists are helping each patient develop an ideal sleep strategy. This month, we discuss heart disease prevention through the holidays and beyond. Here's Rasa Kay. Hi, I'm Rasa Kay. Yippee, the holidays are here, but you shouldn't take a holiday from healthy habits. It may seem like it's just a once a year indulgence, but at real talk, it's weeks of treats, all those trays of cookies in the break room, meetups at a bar with friends and colleagues, specialty dishes prepared with all the love in the world for a big family get-togethers, plus missing sleep and workouts. It can complicate or even increase the risk for cardiovascular conditions. But lest you think this podcast will be nothing but buzzkill, Debora cardiologist Dr. Sheena Rustoke offers easy ways to protect your heart as well as your holiday fun. Protection is prevention. She and her colleagues are already bracing themselves for the inevitable uptick in cardiac crises we all want to avoid. You don't have to be one of them. We do tend to see a spike in heart attacks. A lot of that is just a mixture of different factors to people who are gathering for the holidays, maybe not really taking care of themselves because of the change in routine. People overexerting themselves out in the snow, excessive alcohol intake, overeating all of those things kind of culminate into an acute event. So we definitely see a higher incidence, I think, of heart attacks. There's this condition called holiday heart syndrome, which we'll be talking about. That's essentially a condition where with excessive alcohol intake, you have a triggering of arrhythmias, which can cause a lot of downstream consequences. Another frequent condition that we all brace ourselves for that was very rightly put. We do brace ourselves for this one particular one and that's heart failure exacerbations. We do see an uptick in this in particular because people when they're indulging in holiday seasonal foods, they tend to have a higher consumption of sodium rich things. And so when you have a higher consumption of salt, you tend to retain more fluid. If you have a normal heart, it's probably okay. But if you have pre-existing heart failure, then you're going to hold on to that water and your heart is not going to be able to take that overload. So you're going to start feeling symptoms of shortness of breath and fatigue. And there are a lot of ways, a lot of trajectories in which a heart failure exacerbation can go in. So it's good that people do seek the attention that they do when they have heart failure exacerbations. So we do see an uptick in that. We also see an uptick in high blood pressure for the same reasons. High blood pressure is something that is very sensitive to salt, excessive salt intake, and you can get a lot of uncontrolled blood pressure that way. So those, I think, are some very frequent conditions that we see. It would behoove us all to try to maintain a healthy heart and kind of step that up during the holiday season, correct? Yeah. All right, so how do you do it? I think the holiday season can be tricky, particularly because families gathering, everybody's celebrating, and people are eating and indulging in very rich foods. So I would say, first and foremost, give yourself some grace. It's okay every now and then to have a moderate amount of sweets, particularly during the holidays. It's a once every now and then sort of occasion. And when you're with your family, you should celebrate. But in moderation, be judicious and be intelligent about your food choices. So one thing you can do is making sure you're very intentional about how you're setting up your plate. So half your plate should be vegetables, fruits, one quarter of your plate should be lean protein, and then the other quarter of your plate should be whole grains. If you can try to maintain that balance, that should offset any kind of negative effects that you might experience from having otherwise really rich desserts and rich foods. I think another thing that's helpful is limiting your portion sizes and not going for seconds if you're not hungry. Another thing you can do is just be aggressive about your water intake because that helps you stay hydrated. And that also helps with appetite control. Staying active is also really important. So when you're traveling, meeting family for the holidays, that is very inherently a change in routine. And that can disrupt your exercise regimen, for example. So be intentional about getting exercise 15 to 20 minutes every day. If you're able to do that, then I think you are going to be able to make it through the holiday season while still observing your heart healthy goals. You know, it doesn't have to be a drag. You can tell your family members to join on in with you, whether it's playing an active game or it's going for a family walk. You can make it a family oriented activity as long as you're moving your body. That's important. Now you talked about the foods. How about the beverages? Caffeine, alcohol, punches, nog, some things like that. Yeah, it's the same story. In moderation, it should be okay. You have to be judicious. If you have an access of anything, it can be it can be harmful to your health. One of the beverages you just mentioned, alcohol, being sensible about your alcohol intake, particularly during the holiday season, is very, very important. Because an excess amount of alcohol can cause cardiovascular issues, particularly in people who are predisposed to developing them. You know, when families are getting together, they are they are drinking alcohol together. And so I think one drink per day for women and two drinks per day for men. Those are the limits that are set by U.S. guidelines. Any more than that, and it is considered excessive. So definitely being judicious about your alcohol intake is very, very important because alcohol does have an effect on cardiovascular health. It can trigger irregular heart rhythms. One heart rhythm that is very, very prevalent is called atrial fibrillation. And it's a condition where the electrical impulses in your heart are getting conducted in a very chaotic fashion. And so that results in an asynchronous contraction of the heart, which can lead to a lot of symptoms like shortness of breath and palpitations. And if that's left unchecked, that can result in heart failure. So you have to be very, very careful. So I would say if you are taking anything in moderation, the first thing on that list should be alcohol. So the AFib and holiday heart, basically holiday heart is an AFib situation. How soon might holiday heart set in after you've overdone the alcoholic? Are you going to start feeling bad within a couple of hours? Or is this something that takes effect during the season days after an overindulgence? Yeah, it's that's a good question. I would say that it's a gradual process. Alcohol is a substrate. There are many different substrates for atrial fibrillation, and alcohol is one of them. If over a period of time you are consuming alcohol in an excessive fashion, that can eventually degenerate into holiday heart syndrome. So it's not like, you know, one night, maybe you had a few too many that you should be worried necessarily about developing atrial fibrillation. The tendency for somebody to actually develop atrial fibrillation varies amongst different types of people. It depends on your age. It depends on your gender. It depends on your body habits. It depends on your other comorbid conditions. So it really is a variable, but yes, over a period of time, if left unchecked, you can develop atrial fibrillation. So the holidays can be kind of stressful. This year, getting together with family might be more stressful than usual. It's been a time. How does stress play into all of this and affect your heart? Stress definitely has an effect on cardiovascular health. One thing I'll say is chronic stress triggers a response in your body called fight or flight, which I'm sure many people have heard of. And it's basically a condition where certain hormones in your body get elaborated. Those are adrenaline, noradrenaline, and cortisol. So those hormones are really, really important because those increase blood sugar. And that allows you to fight or flight and engage in that sort of a situation. But if over a period of time, your heart is constantly getting exposed to those hormones, it can have a deleterious effect in that these hormones do cause your blood pressure to go up. When your blood pressure goes up, it's a strain on your heart. And if you have a pre-existing cardiovascular condition, that can be harmful. So stress, that's the physiology behind chronic stress in a nutshell. The other part of it is chronic stress also leads to inflammation in the body. And inflammation is something that can trigger the formation of plaque within the arteries of your body. So specifically your coronary arteries, which are the arteries that feed blood to the heart and the arteries in your brain. So a blockage in the arteries in your brain can result in a stroke and a blockage in your heart can cause a heart attack. It's very important to manage stress during the holidays, not just for your own mental health and peace, but also your physical health. So I'd say some things that you can do are basic things, like making sure that you're getting enough sleep, making sure that you're being intentional about regular exercise, 150 minutes of moderate intensity exercise is a recommendation, which translates to about 20 or 30 minutes every day, and making sure that you are eating healthy. Going out in the cold from a warm house. How does that affect your circulation and the burden on the heart? Yeah, the cold can affect circulation. The way that happens is the vessels in your body, they constrict. And that's the body's natural way of conserving heat. But the problem with that is, again, when your heart sees that extra high blood pressure, that can put a string on the heart. Another really common thing that we see is folks who are out in the cold, shoveling heavy snow. That's a common scenario. And these people tend to come in with immersion events, like heart attack, for example. And the reason for that is that combination of cold weather and exertion can cause this phenomenon called plaque rupture, which is essentially when heart attack is super, super serious, and you do need immediate attention. So in the cold weather, if you do need to go outside, try to not overexert yourself. And if you do have to exert yourself, take frequent breaks and take your own symptoms seriously. Do not delay getting medical attention if you feel like you need it. When you have a sudden onset of symptoms that are unusual for you, trying to get immediate medical tension should be priority. If it is an emergency situation, for example, one of the most frequent presentations is chest pain. So if chest pain is unusual for you, you should seek medical attention immediately. And that chest pain typically feels like a crushing sensation or pressure-like sensation in the center of your chest. Sometimes it can radiate up your jaw through your back, down your arm. Those are also very common presentations. And usually get triggered with immense amount of exertion or even a little bit of exertion. Those symptoms, they tend to go away when you rest. So those are sort of the very, very classical presentations of chest pain that could be a sign of an emergency if you're having chest pain. And if it's new to you and if it feels odd, seek attention. And the reason why I say that is because there are so many unique presentations for heart attack because everybody's different. Men are different from women, for example, the way women present could be something as simple as belly pain. It could be nausea. It could be very, very nonspecific. So to leave that assessment in the hands of a medical professional is the smartest thing you can do. Not to try to just kind of downplay your own symptoms. And that's something that happens really frequently during the holidays. It's very sad. Patients downplay their own symptoms. They are very dismissive of their medical condition, even if it's an emergency because they don't want to disrupt family activities. So I would say be sincere, be genuine. If you're feeling like something is happening, do yourself a favor. Give yourself a gift in this holiday season. Give your family a gift by being honest and saying, Hey, I don't feel good. I think I need help. And I think that can definitely improve outcomes because the sooner you seek medical attention in the setting of an emergency, the better the outcome will be for you. It's not always as straightforward. It could be very, very subtle, your symptoms, but it could mean something more serious. So again, just leave that assessment in the hands of somebody who can actually make that diagnosis in an, in an accurate and clinically sound way. Unhealthy lifestyle habits are basically the opposite of what you just described, you know, sitting around watching TBL day and eating snacks. How do they lead to cardiovascular disease? What is going on in the body when you are not doing what your cardiologist would like you to be doing? So I would, I would like to start answering that question by talking about five risk factors for cardiovascular disease. It's really important to understand what those are because lifestyle habits can precipitate those cardiovascular risk factors. So number one is diabetes. Number two is high blood pressure or hypertension. Number three is high cholesterol, which is hyperlipidemia. And then number four is cigarette smoking. Number five is a family history of coronary artery disease or even stroke. The first three that I mentioned are directly related to, to lifestyle. Most times, sometimes even if you are doing your earnest best to have good habits, these conditions might still be uncontrolled. But still, they do have a direct correlation with lifestyle. And in fact, one of the first line means of managing these conditions is lifestyle. For example, remaining sedentary, like you mentioned, not doing what your cardiologist is asking you to do. If you have high blood pressure to begin with, then managing that is going to be a lot harder if you're not moving your body. And it's the same thing with diabetes. You know, when you have high amounts of insulin resistance, that's when diabetes gets out of hand. When you're exercising, when you're moving and you're being mindful of what you're eating, that insulin resistance comes down. And when it comes down, your diabetes gets under better control. Cholesterol is a bit more tricky. But generally speaking, if you are mindful of the things that you're eating, you can definitely control at least your triglycerides. The bad cholesterol, which is the LDL, many times the best way of managing that apart from being mindful of what you're eating is medications. But that's a discussion that, you know, you and I can have. But yeah, to answer your question, those are the ways in which not being mindful of your lifestyle can can definitely snowball into a heart condition. Okay, so we're looking at a new year, and it's always a great time to start a new habit or make your resolutions. What do you recommend as a new year's resolution or two or three for preventing heart disease or just getting your heart more healthy? I think the first and foremost thing is smoking cessation. Smoking is a very huge risk factor for cardiovascular disease and stroke. So if you can kick that habit, that would be a huge accomplishment. There are a lot of ways that your cardiologist can help you quit. You don't have to do it on your own. Those include nicotine replacement therapy, so patches and lozenges. There's the gums, and there's also medications that also help with quitting. Talk to your cardiologist. It's okay to seek help, even if it's pharmacologically. As long as you kick the habit, that's what matters the most. Cigarette smoking, it goes without saying, is extremely harmful, and you know, it's not just your lungs. It's also your heart. Cigarettes, they contain over 300 chemicals, and they can cause a lot of damage to the inside of your coronary arteries, and the more damage that there is inside of your coronary arteries, the more readily plaque can develop, and that's how that happens. If you don't smoke cigarettes, I would say the next resolution you should have is exercise. Keep fitness goals for yourself, but even more so in calculating good habits, I think is most important. So getting shredded, I know, is something that you might want, but aiming for that goal is probably not as fruitful as saying, okay, today, I'm going to exercise for 20 minutes, and if I exercise for 20 minutes, I know that I've done myself a good thing, and then over time, kind of build on that to the point where you're going to the gym regularly, it's sustainable, it's a part of your routine, and then slowly but surely you can start to kind of make your goals a little bit more sophisticated that, okay, I want to lose this weight, I want to get toned in this way, this is the way that I want my body to look. That's important, and that's great, but first, have good habits. That's Dabora cardiologist Dr. Sheena Rastogi. We continue the conversation on cardiovascular disease prevention and some recent advances in treatment you'll want to know about. The pod drops the first Wednesday of the month. I'm Rasa Kay. You can always listen to all of the informative Dabora doctor interviews at DaboraHealthReport.com. Schedule an appointment at demandabora.org.
KYW Newsradio's Rasa Kaye talks to Deborah Heart and Lung Center cardiologist, Dr. Sheena Rastogi about preventing heart disease through the holidays and beyond.