Five things to know about heart disease

James Beckerman, M.D., FACC
Cardiologist, Providence St. Vincent Medical Center
Providence St. Vincent Heart Clinic-Cardiology

Published February 2011

 1. Heart disease is an equal-opportunity epidemic
As the No. 1 killer in the United States and increasingly in the developing world, heart disease is one of the most preventable causes of death. It’s also the most costly cause of hospitalizations.

Some ethnic populations, such as people of African or South Asian descent, may be at greater risk than others, but more than 80 percent of heart disease cases can be prevented through targeting risk factors, such as smoking, diabetes, elevated cholesterol and high blood pressure.

2. Women can experience heart disease differently 
People may associate heart disease and heart attacks with the sudden onset of clutching chest pain. Yet studies show that women, more than men, might experience more subtle symptoms, such as shortness of breath, nausea, back pain or even significant fatigue. New symptoms or a change in symptoms is a good reason to seek medical attention.

3. Quitting smoking now will reduce heart-disease risk
Many smokers believe that quitting tobacco after many years of smoking isn’t worth the effort; that the damage has been done.

But studies suggest that quitting smoking and eliminating nicotine exposure can reduce the risk of heart disease to that of a nonsmoker after only two years.

4. Coronary stents do not prevent heart attacks
Many patients and even some doctors believe that placing an elective coronary stent will reduce the risk of future heart attacks and death. But results of study after study have shown that while stents can improve symptoms, they often do not prevent future heart attacks or even death. This is because heart attacks and fatal events are typically caused by ruptured plaque in unsuspected coronary arteries – that is, where blockages are less than the 70 percent threshold that cardiologists use when deciding to place a stent.

However, lifestyle changes, such as quitting smoking, exercising and eating right, can reduce risk. A wealth of data shows that statins and blood pressure medications reduce risk, too.

5. Sex after a heart attack is probably OK
One of the greatest concerns after a cardiac event is that sexual activity will significantly increase the risk of another heart attack. The good news is that this is rare. Cardiologists consider sexual activity to be in a similar risk category as moderate exercise, and it is typically safe six weeks after a heart attack.

However, symptoms, such as chest pain or shortness of breath, should prompt an evaluation. As I’ve written before, most patients will not bring up this issue with their physician – it’s our job to start the conversation.

Clinical articles by James Beckerman, M.D.