What is
Cardiology?

Cardiology is the study of cardiovascular illness and the care of all things
related to the heart. Cardiology is classified as an internal medicine
sub-specialty. It includes veins and arteries, and it used to diagnose and treat
conditions like blockages. Cardiologists should not be confused with cardiac
surgeons. Cardiac surgeons go into the chest and perform heart surgeries, while
cardiologists perform tests and procedures like angioplasty.
Cardiology is the discipline that researches, diagnoses and treats heart
injuries and diseases as well as their causes. Cardiologists will treat your
heart problem while staying aware of other conditions, including high blood
pressure, high cholesterol, diabetes and other factors that risk damaging the
heart. Risk factors may include a family history of heart disease, obesity,
cigarette smoking, poor diet and a sedentary lifestyle.
What Does a
Cardiologist Do?
A cardiologist is a physician
who is board certified to diagnose and treat problems of the
cardiovascular system- the heart, arteries, and veins. Cardiology is
classified as an internal medicine subspecialty. Knowledge of internal
medicine and other specialties is required to obtain certification.
Finding A Top Cardiologist
Choosing
a Cardiologist is an important decision. Thus, our goal is to assist you in
making that decision.
First of all, when selecting a Cardiologist, you may want to begin your search
several different ways:
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Ask
family, friends, neighbors and/or co-workers. |
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Contact
your local Chamber of Commerce or Better Business Bureau for reputable
Cardiologists that specialize in the area of medicine that you have a
need for. |
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Contact
your city, county or state medical agencies for names of qualified
Cardiologists. Contact and ask for referrals from medical associations.
Many are listed in this publication. |
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Ask your
family doctor. They are in constant contact with all kinds of health
care professionals and will be able to provide you with recommendations. |
We recommend that
you interview the Cardiologist and ask the following:
How long have you
been in practice?
Is your staff
friendly and accommodating?
What are the
procedures if we need a doctor in the middle of the night or on a
weekend?
Do you have an
associate that covers for you when you are not available?
Do you have more
than one office and if so, how is your time divided between offices?
What kind of
continuing education do you utilize?
Do you accept phone
calls during office hours?
How do you stay
current on the latest drug prescriptions available and medical
testaments?
What types of
insurance coverage do you accept?
How do you handle
billing? Do you require payment at the time of visit?
Discuss your family
medical history and particular problems you are concerned about.
After you have
consulted a few Cardiologists you should have a good idea which one you
felt most comfortable with and best answered your questions.
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How
Cardiologists Were Selected
Consumers' Research Council of
America has compiled a list of Cardiologists throughout the United States by
utilizing a point value system. This method uses a point value for criteria that
we deemed valuable in determining top health care professionals.
The criteria that was used
and assessed a point value is as follows:
Experience:
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Each year the Cardiologist has been in practice
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Training:
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Education
and Continuing Education
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Professional
Associations:
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Membership
in Professional Medical Associations
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Board
Certification:
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Completing an approved residency program and
passing a rigid examination on that specialty
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Simply put, Cardiologists that have accumulated a certain amount
of points qualified for the list. This does not mean that doctors that did not
accumulate enough points are not good Cardiologists; they merely did not qualify
for this list because of the points needed for qualification.
Similar studies have been done with other professions using a survey system.
This type of study would ask fellow professionals who they would recommend. We
found this method to be more of a popularity contest. For instance,
professionals who work in a large office have much more of a chance of being
mentioned as opposed to a professional who has a small private practice. In
addition, many professionals have a financial arrangement for back-and-forth
referrals. For these reasons, we developed the point value system.
Since this is a subjective
call, there is no study that is 100% accurate. As with any profession, there
will be some degree of variance in opinion. If you survey 100 patients of a
particular Cardiologist on their level of satisfaction, you will undoubtedly
hear that some are very satisfied, some moderately satisfied and some
dissatisfied. This is really quite normal.
We feel that a point value
system takes out the personal and emotional factor and deals with factual
criteria. We have made certain assumptions. For example, we feel that the more
years in practice is better than less years in practice; more education is
better than less education, being board certified is better than not being
certified, etc.
The Top Cardiologist list that we have compiled is current as of a certain date
and other doctors may have qualified since that date. Nonetheless, we feel that
the list of top Cardiologists is a good starting point for you to find a
qualified specialist.
No fees, donations,
sponsorships or advertising are accepted from any individuals, professionals,
corporations or associations. This policy is strictly adhered to, ensuring an
unbiased selection.
Coronary Angioplasty
Coronary Angioplasty (AN-jee-oh-plas-tee) is a medical procedure used to
restore blood flow through a narrowed or blocked artery in the heart.
The arteries of the heart (the coronary arteries) can become narrowed
and blocked due to buildup of a material called plaque on their inner
walls. This narrowing reduces the flow of blood through the artery and
can lead, over time, to coronary artery disease and heart attack. In
angioplasty, a thin tube with a balloon or other device on the end is
first threaded through a blood vessel in the arm or groin (upper thigh)
up to the site of a narrowing or blockage in a coronary artery. Once in
place, the balloon is then inflated to push the plaque outward against
the wall of the artery, widening the artery and restoring the flow of
blood through it. Coronary bypass surgery is very successful in
relieving angina. This surgical procedure is highly invasive which
requires the opening of the chest, routing the blood through a heart
lung machine, transplanting new vessels and stopping and restarting the
heart. Bypass surgery requires taking large blood vessels from the
patient's legs, stomach or chest and grafting them to the front and back
of the blocked arteries.
The illustration shows the placement of a stent in a coronary artery with plaque
buildup. The coronary artery is located on the surface of the heart. Figure A
shows the deflated balloon catheter and closed stent inserted into the narrowed
coronary artery. In Figure B, the balloon is inflated, expanding the stent and
compressing the plaque to restore the size of the artery. Figure C shows normal
blood flow restored in the stent-widened artery.
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Angioplasty is used to:
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Relieve chest pain caused by reduced blood flow to the heart.
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Minimize damage to the heart muscle during a heart attack. This damage occurs
when blood flow is totally cut off to an area of the heart |
Angioplasty was first used in 1977. A tiny balloon was used to open or widen
narrowed arteries. Since then, new devices and medicines have improved the
procedure and made it appropriate for more people.
The improvements include:
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Stents. A stent is a tiny mesh tube that looks like a small spring. The
stent is inserted in the area where the artery is narrowed to keep it open.
Some stents are "coated" with medication to help prevent the
artery from closing again. Stents are used in most angioplasties except when
an artery is too small for a stent to fit.
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When a stent is used, in 2 out of 10 people the artery will close again within
the first 6 months.
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When a stent is not used, in 4 out of 10 people the artery will close again
within the first 6 months.
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Plaque removers. Many kinds of plaque removers exist. They are used to cut
away plaque that narrows the inside of the arteries.
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Laser. A laser is used to dissolve or vaporize plaque. First approved in
1992, laser devices are used in many major U.S. medical centers.
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Today, angioplasty is performed on more than 1 million people a year in the
United States.
The procedure is best done:
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By doctors who do at least 75 angioplasties a year
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In hospitals that do at least 400 angioplasties a year
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Research on angioplasty continues to:
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Increase its safety
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Prevent the artery from closing again
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Make it an option for more people
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What Happens After Coronary Angioplasty?
Angioplasty is not a cure for coronary artery disease (CAD). You should
discuss with your doctor what led to CAD and the need for angioplasty. Select
the links below for more information on how to slow the development of CAD and
how to lower your chance of having a heart attack:
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Preventing coronary artery disease
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Living with angina
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Life after a heart attack
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Going Home
When you are ready to leave the hospital, you will receive instructions to
follow at home, including:
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How much activity or exercise you can do.
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When you should follow up with your doctor.
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What medicines you should take.
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What you should look for daily when checking for signs of infection around
the area where the tube was inserted, such as:
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Redness
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Swelling
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Drainage
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When you should call your doctor, for example:
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If you have a fever or signs of infection
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If you have pain or bleeding where the tube was inserted
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When you should call 911. For example, if you have any chest pain.
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Your doctor will prescribe medicine to prevent blood clots from forming. It is
very important that you take the medicine as directed. The medicine can
prevent the stent from becoming blocked.
Types of medicine may include:
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Anticoagulants
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Antiplatelet drugs, such as aspirin and clopidogrel (Plavix)
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Most people can return to work and other normal activities about 1 week after
angioplasty.
Cardiac Rehabilitation
Your doctor may recommend that you participate in a cardiac rehabilitation
(rehab) program. Cardiac rehab provides medical guidance and support to help
you return to work or daily activities. "Recovering From Heart Problems
Through Cardiac Rehabilitation: Patient Guide" from the U.S. Agency for
Healthcare Research and Quality gives more information on cardiac
rehabilitation.
Coronary Artery Bypass Graft Surgery
Coronary bypass surgery
is very successful in relieving angina. This surgical procedure is
highly invasive which requires the opening of the chest, routing the
blood through a heart lung machine, transplanting new vessels and
stopping and restarting the heart. Bypass surgery requires taking large
blood vessels from the patients legs, stomach or chest and grafting them
to the front and back of the blocked arteries.
During
a bypass procedure the heart-lung machine takes over the functions of
the heart and lungs. This is done so the heart can be carefully stopped and the
surgeon can work in a blood-free environment. The heart-lung machine
keeps oxygen-rich blood flowing through the body. It receives the blood
and removes the carbon dioxide and other waste products, warms and/or
cools the blood and adds oxygen as it pumps the blood through the
patient's body. At the conclusion of the bypass surgery, the heart is
restarted and the heart-lung machine is disconnected.
New advances in bypass
surgery are continuing. A minimally invasive bypass surgery technique is
being tested with promising results. This new procedure requires the
surgeon to work on the front of the heart through a four inch incision
while it is beating slowly. Another type is that the heart is stopped
and a surgeon uses a fiberoptic scope that is passed through a 4 ½ inch
incision and the surgeon works on all sides of the heart by viewing a
video image. This less invasive procedure would be less expensive and
requires a much shorter hospital stay.
Cardiac
Catheterization
Cardiac catheterization (KATH-e-ter-i-ZA-shun) is a medical procedure used to
diagnose and treat certain heart conditions. A long, thin, flexible tube called
a catheter is put into a blood vessel in the arm, upper thigh (groin), or neck
and threaded up into the heart. Through the catheter, doctors can perform
diagnostic tests and treatments on the heart. Cardiac catheterization is usually
performed in a hospital by heart doctors (called cardiologists) that specialize
in the treatment of heart diseases.
To diagnose some heart conditions, doctors may put a special dye into
the catheter to make the inside of the heart and blood vessels show up
on x rays. Doctors may take samples of blood and heart muscle through
the tube. They can also treat certain heart problems during this
procedure.
Why Is Cardiac Catheterization Done?
Often a doctor does a cardiac catheterization to find out why a patient
is having chest pain. The procedure can reveal blocked or narrowed
places in the heart’s arteries that can cause this pain. During the
cardiac catheterization, a doctor might be able to open up the blocked
arteries by doing another procedure called angioplasty
(AN-jee-oh-plas-tee).
Most people who have heart attacks have arteries that are partly or
completely blocked. That is why doctors often do cardiac
catheterizations after patients have heart attacks. The procedure can
tell them if there are blocked arteries that can be treated with
angioplasty or surgery.
Another reason doctors may do cardiac catheterizations is to see the
overall shape of the heart and the four large spaces (heart chambers)
inside it. That way they can:
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Find any likely problems in people about to have open heart surgery
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See heart abnormalities in children or adults
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Sometimes doctors do cardiac catheterizations to see how well the tissue
flaps (valves) at the openings and exits of the heart chambers are
working. To do this, the doctor will measure blood flow and oxygen
levels in different parts of the heart. Cardiac catheterizations are
also done to check the functioning of artificial heart valves.
Doctors may also perform cardiac catheterizations so they can do minor
surgery on the heart. For example, doctors may do the procedure to
remove (biopsy) a small piece of heart tissue to see if there is an
infection or tumor, or they might repair holes in the heart or other
heart defects.
What are the risks with Cardiac Catheterization?
Cardiac catheterization is a common medical procedure that rarely causes serious
problems.
But complications can include:
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Bleeding, infection, and pain where the tube (catheter) was inserted
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Damage to blood vessels
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An allergic reaction to the dye used
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Other less common complications of the procedure include:
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An irregular heartbeat.
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Damage to the kidneys caused by the dye used.
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Blood clots that can trigger strokes, heart attacks, or other serious
problems.
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Low blood pressure.
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A buildup of blood or fluid in the sac that surrounds the heart. This fluid
can prevent the heart from beating properly.
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As with any procedure involving the heart, complications can sometimes, although
rarely, be fatal.
The risk of complications with cardiac catheterization is higher in:
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People with diabetes
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People with kidney disease
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Older people (ages 75 and older)
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Women
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People having emergency catheterization for serious heart symptoms
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What Happens During a Cardiac Catheterization?
During
a cardiac catheterization, you are kept on your back and awake. That way you can
follow your doctor’s instructions during the procedure. You are given a drug
to help you relax. This drug may make you sleepy.
Your doctor or nurse will numb the area
where the small plastic tube (catheter) will enter the blood vessel through a
small cut or needle in the arm, upper thigh (groin), or neck. The doctor then
threads the tube through the vessel and into the large spaces (chambers) of the
heart. Special x-ray movies are taken of the tube as it is threaded up into the
heart. This helps the doctor see where to put the tube.
Once the catheter is at the right spot,
your doctor can use it to conduct several tests or treatments. Often, special
dye is put in the tube to make the inside of the heart’s arteries and other
structures show up on an x ray. Your doctor may use a procedure called
angioplasty to open up the blocked arteries. He or she may also take blood
samples from different parts of the heart or do minor heart surgery.
Once your doctor does all of the needed
tests or treatments, the catheter will be taken out. The opening in the blood
vessel that the tube went through will then be closed up and bandaged. A small
sandbag or other type of weight may be put on top of the bandage to apply more
pressure. This will help prevent major bleeding from the site.
What Happens After a Cardiac Catheterization?
After a cardiac catheterization, you
will be moved to a special care area where you will stay for several hours or
overnight. While you recover in this area, your movement will be limited to
avoid bleeding from where the tube (catheter) was inserted. Nurses will check
your heart rate and blood pressure regularly. They will also check to see if
there is any bleeding from the tube insertion site.
Eventually, a small bruise will appear
where the tube was put in. That area may feel sore or tender for about a week.
Be sure to let your doctor know if:
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You have a constant or large amount of blood at the site that cannot be
stopped with a small bandage.
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You have any unusual pain, swelling, redness, or other signs of infection at
or near the insertion site.
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Your doctor may tell you to avoid certain
activities, such as heavy lifting, for a short time after the procedure.
Key Points
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Cardiac catheterization is a procedure in which a thin tube (catheter) is put
into a blood vessel in the arm, upper thigh (groin), or neck and threaded up
into the heart to do tests or treatments on the heart.
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Cardiac catheterizations often are done after a heart attack or to find out why
a patient is having chest pain.
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Cardiac catheterization is a common medical procedure that rarely causes
serious complications. The risk of complications is higher in people with
diabetes and kidney disease, and in older people and women.
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Before having a cardiac catheterization, it is a good idea to meet with your
doctor to learn about the procedure and how to prepare for it.
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You may have to stop taking certain medicines before the procedure.
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Patients are not usually allowed to drive the same day
as the procedure. If you don’t have to stay overnight after the procedure,
you should arrange for a ride to and from the hospital.
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You are kept awake during a cardiac catheterization. Afterwards, you will be
moved to a special care area where you will stay for several hours or overnight.
During this time, your movement will be limited to avoid bleeding from the site
where the tube was inserted.
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The area where the tube was put in may feel sore for about a week. You need to
let your doctor know if you have an excessive bleeding from that area or signs
of infection. You may have to avoid doing certain activities, such as heavy
lifting, for a short time after the procedure.
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All
About Angina
What Is Angina?
Angina (an-JI-nuh or AN-juh-nuh) is
chest pain or discomfort that occurs when your heart muscle does not get enough
blood. Angina may feel like pressure or a squeezing pain in your chest. The pain
may also occur in your shoulders, arms, neck, jaw, or back. It may also feel
like indigestion.
Angina is a symptom of Coronary
Artery Disease (CAD), the most common type of heart disease. CAD occurs when
plaque builds up in the coronary arteries. This buildup of plaque is called
Atherosclerosis. As plaque builds up, the coronary arteries become narrow and
stiff. Blood flow to the heart is reduced. This decreases the oxygen supply to
the heart muscle.
Sometimes,
other types of heart disease or uncontrolled high blood pressure can cause
angina.
Some plaque is hard and stable and
leads to narrowed and hardened arteries. Other plaque is soft and is more likely
to break open and cause blood clots. The buildup of plaque on the inner walls of
the arteries can cause angina in two ways:
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By
narrowing the artery to the point where the flow of blood is greatly reduced
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By
forming blood clots that partially or totally block the artery
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Types of Angina
The three types of angina are stable,
unstable, and variant (Prinzmetal's). It is very important to know the
differences among the types.
Stable angina is the most common type. It
occurs when the heart is working harder than usual. There is a regular pattern
to stable angina. After several episodes, you learn to recognize the pattern and
can predict when it will occur.
The pain usually goes away in a few minutes after you rest or take your
angina medicine.
Stable angina is not a heart attack but makes it more likely that you will
have a heart attack in the future.
Physical exertion is the most
common cause of pain and discomfort from stable angina.
Severely narrowed arteries may allow enough blood to
reach the heart when the demand for oxygen is low (such as when you are
sitting). But with exertion, like walking up a hill or climbing stairs, the
heart works harder and needs more oxygen. Other causes include:
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Emotional stress
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Exposure to very hot or cold temperature
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Heavy meals
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Smoking
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Unstable angina is a very dangerous
condition that requires emergency treatment. It is a sign that a heart attack
could occur soon. Unlike stable angina, it does not follow a pattern. It can
occur without physical exertion and is not relieved by rest or medicine.
Unstable angina is caused by blood clots that partially or totally block an
artery. If plaque in an artery ruptures or breaks open, blood clots may form.
This creates a larger blockage. The clot may grow large enough to completely
block the artery and cause a heart attack. Blood clots may form, partly
dissolve, and later form again. Chest pain can occur each time a clot blocks an
artery.
Variant angina is
rare, and usually occurs
at rest. The pain can be severe and usually occurs between midnight and early
morning. It is relieved by medicine.
Variant angina is caused by a spasm in a coronary
artery. The spasm causes the walls of the artery to tighten. This narrows the
artery, causing the blood flow to the heart to slow or stop. Variant angina may
occur in people with and without CAD. Other causes of spasms in the
arteries that supply the heart with blood are:
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Exposure to cold
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Emotional stress
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Medications (vasoconstrictors) that constrict or narrow blood vessels
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Cigarette smoking
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Cocaine use
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Not all chest pain or discomfort is
angina. Chest pain or discomfort can be caused by a heart attack, lung problems
(such as an infection or a blood clot), heartburn, or a panic attack. However,
all chest pain should be checked by a doctor.

The illustration shows a normal artery with normal blood flow (Figure A) and an
artery containing plaque buildup (Figure B).
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Other Names for Angina
Who Is At Risk for Angina?
More than 6 million people in the United States have angina.
People with coronary artery disease or who have had a heart attack are more
likely to have angina.
Unstable angina occurs more often in older adults.
Variant angina is rare. It accounts for only about 2 out of 100 cases of
angina. People with variant angina are often younger than those with other forms
of angina.
What Are the Signs and Symptoms of Angina?
Pain and discomfort are the main symptoms of angina. These symptoms:
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Are
often described as pressure, squeezing, burning, or tightness in the chest
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Usually start in the chest behind the breastbone
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May
also occur in the arms, shoulders, neck, jaw, throat, or back
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May
feel like indigestion
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Some people say that angina discomfort
is hard to describe or that they can't tell exactly where the pain is coming
from. Symptoms such as nausea, fatigue, shortness of breath, sweating,
light-headedness, or weakness may also occur.
Symptoms vary based on the type of angina.
Stable Angina
The pain or discomfort:
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Occurs when the heart must work harder, usually during physical exertion
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Is
expected, and episodes of pain tend to be alike
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Usually lasts a short time (5 minutes or less)
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Is
relieved by rest or angina medicine
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May
feel like gas or indigestion
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May
feel like chest pain that spreads to the arms, back, or other areas
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Unstable Angina
The pain or discomfort:
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Often occurs at rest, while sleeping at night, or with little physical exertion
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Is
unexpected
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Is
more severe and lasts longer (as long as 30 minutes) than episodes of stable
angina
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Is
usually not relieved with rest or angina medicine
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May
get continuously worse
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May
signal that a heart attack is impending
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Variant Angina
The pain or discomfort:
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Usually occurs at rest and during the night or early morning hours
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Tends to be severe
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Is
relieved by angina medicine
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Chest pain that lasts longer than a few minutes and is
not relieved by rest or angina medicine may mean you are having—or are about
to have—a heart attack. Call 9–1–1 right away.
How Is Angina Diagnosed?
To find out if you have angina, your doctor will:
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Do
a physical exam
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Ask
about your symptoms
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Ask
about your risk factors and your family history of coronary artery disease (CAD)
or other heart disease
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Sometimes, your doctor can diagnose angina by noting your symptoms and how
they occur. Your doctor may order one or more tests to help make a diagnosis of
angina. The tests your doctor may order include:
EKG
(electrocardiogram). This test measures the rate and regularity of your
heartbeat. Some people with angina have a normal EKG.
Stress Test. Some heart problems are easier to diagnose when your heart is
working harder and beating faster than when it's at rest. During stress testing,
you exercise (or are given medicine if you are unable to exercise) to make your
heart work harder and beat faster while heart tests are performed.
During exercise stress testing, your blood pressure and EKG readings are
monitored while you walk or run on a treadmill or pedal a bicycle. Other heart
tests, such as nuclear heart scanning or echocardiography, also can be done at
the same time. These would be ordered if your doctor needs more information than
the exercise stress test can provide about how well your heart is working.
If
you are unable to exercise, a medicine can be injected through an intravenous
line (IV) into your bloodstream to make your heart work harder and beat faster,
as if you are exercising on a treadmill or bicycle. Nuclear heart scanning or
echocardiography is then usually done.
During nuclear heart scanning, radioactive tracer is injected into your
bloodstream, and a special camera shows the flow of blood through your heart and
arteries. Echocardiography uses sound waves to show blood flow through the
chambers and valves of your heart and to show the strength of your heart muscle.
Your doctor also may order two newer
tests along with stress testing if more information is needed about how well
your heart works. These new tests are magnetic resonance imaging (MRI) and
positron emission tomography (PET) scanning of the heart. MRI shows detailed
images of the structures and beating of your heart, which may help your doctor
better assess if parts of your heart are weak or damaged. PET scanning shows the
level of chemical activity in different areas of your heart. This can help your
doctor determine if enough blood is flowing to the areas of your heart. A PET
scan can show decreased blood flow caused by disease or damaged muscles that may
not be detected by other scanning methods.
Chest x ray. A chest x ray takes a picture of the organs and structures inside
your chest. These include your heart, lungs, and blood vessels.
Nuclear heart scan. This
test provides your doctor with moving pictures of the blood passing through your
heart's chambers and arteries and shows the level of blood flood to the heart
muscle. A small amount of a radioactive tracer is injected into your bloodstream
through a vein, usually in your arm. A special camera is placed in front of your
chest to show where the tracer lights up in healthy heart muscle and where it
doesn't light up (in heart muscle that has been damaged or has a blocked
artery). There are different types of nuclear heart scans. Most scans have two
phases—taking pictures of the heart at rest and while it is beating faster
(called a stress test), although sometimes only a rest scan is done. Many heart
problems show up more clearly when your heart is stressed than when it is at
rest. By comparing the nuclear heart scan of your heart at rest to your heart at
"stress," your doctor can determine if your heart is functioning
normally or not.
Echocardiogram. This test uses sound waves to create a moving picture of
your heart. Echocardiogram provides information about the size and shape of your
heart and how well your heart chambers and valves are functioning. The test also
can identify areas of poor blood flow to the heart, areas of heart muscle that
are not contracting normally, and previous injury to the heart muscle caused by
poor blood flow.
There are several different types of echocardiograms, including a stress
echocardiogram. During this test, an echocardiogram is done both before and
after your heart is stressed either by having you exercise or by injecting a
medicine into your bloodstream that makes your heart beat faster and work
harder. A stress echocardiogram is usually done to find out if you have
decreased blood flow to your heart (coronary artery disease).
Cardiac catheterization. A thin flexible tube (catheter) is passed through
an artery in the groin (upper leg) or arm to reach the coronary arteries. Your
doctor can determine pressure and blood flow in the heart's chambers, collect
blood samples from the heart, and examine the arteries of the heart by x ray.
Coronary Angiography. This test is done during cardiac catheterization. A
dye that can be seen by x ray is injected through the catheter into the coronary
arteries. Your doctor can see the flow of blood through your heart and the
location of blockages.
Your doctor may also order blood tests, such as:
|
|
A fasting lipoprotein profile to check your cholesterol levels.
|
|
|
Fasting glucose test to check your blood sugar level.
|
|
|
C-reactive protein (CRP) test. This blood test measures CRP, a protein in
the blood that shows the presence of inflammation. Inflammation is the body's
response to injury. High levels of CRP may be a risk factor for CAD.
|
|
|
A test to check for low hemoglobin in your blood.
Hemoglobin is the part of
red blood cells that carries oxygen to all parts of your body.
|
How Is Angina Treated?
Treatment for angina includes lifestyle
changes, medicine, special procedures, and cardiac rehabilitation. The main
goals of treatment are to:
|
|
Reduce the frequency and severity of symptoms
|
|
|
Prevent or lower the risk of heart attack and death
|
Lifestyle changes and medicine may be
the only treatments needed if your symptoms are mild and are not getting worse.
Unstable angina is an emergency condition that requires treatment in the
hospital.
Lifestyle Changes
The first thing that you need to do is change your living habits to avoid
bringing on an episode of angina.
|
|
Slow down or take rest breaks, if angina comes on with exertion.
|
|
|
Avoid large meals and rich foods that leave you feeling stuffed, if angina
comes on after a heavy meal.
|
|
|
Try to avoid situations that make you upset or stressed, if angina comes on
with stress. Learn techniques to handle stress that can't be avoided.
|
You can also make other lifestyle changes, for example:
|
|
Eat a healthy diet to prevent or reduce high blood pressure, high blood
cholesterol, and obesity
|
|
|
Quit smoking, If you smoke
|
|
|
Be physically active, as directed by your doctor
|
|
|
Lose weight, if you are overweight or obese.
|
|
|
Follow your doctor's orders and take all medicines as directed, especially
if you have diabetes
|
Medications
Nitrates
are the most commonly used medicines to treat angina. Fast-acting preparations
are taken when angina occurs or is expected to occur. Nitrates relax and widen
blood vessels, allowing more blood to flow to the heart while reducing its
workload.
You can use nitrates in different forms to:
|
|
Relieve an episode that is occurring by using the medicine when the pain
begins
|
|
|
Prevent an episode from occurring by using the medicine just before pain or
discomfort is expected to occur
|
|
|
Reduce the number of episodes that occur by using the medicine regularly on
a long-term basis
|
Nitroglycerin is the most commonly used
nitrate for angina. Nitroglycerin that dissolves under your tongue or between
your cheeks and gum is used to relieve an angina episode. Nitroglycerin in the
form of pills and skin patches is used to prevent attacks of angina. These forms
of nitroglycerin act too slowly to relieve pain during an angina attack.
Other medicines can be used to treat angina:
|
|
Beta blockers slow the heart rate and lower blood pressure. They can delay
or prevent the onset of angina.
|
|
|
Calcium channel blockers relax blood vessels so that more blood flows to
the heart, reducing pain from angina. Calcium channel blockers also lower blood
pressure.
|
|
|
ACE (angiotensin-converting enzyme) inhibitors lower blood pressure and
reduce the strain on the heart. They also reduce the risk of a future heart
attack and heart failure.
|
People who have angina may also use:
|
|
Medicines to lower cholesterol levels.
|
|
|
Medicines to lower high blood pressure.
|
|
|
Oral antiplatelet (an-ty-PLAYT-lit) medicines (such as aspirin and
clopidigrel), taken daily, to stop platelets from clumping together to form
blood clots. Platelets are small blood cells that circulate through your blood
vessels and help stop bleeding by sticking together to seal small cuts or breaks
in tiny blood vessels. Antiplatelet medicines may not be appropriate for some
people because they increase the risk of bleeding. Discuss the benefits and
risks with your doctor before starting therapy with aspirin or the other
antiplatelet medicines.
|
|
|
Glycoprotein IIb-IIIa inhibitors are potent antiplatelet medicines that
prevent clots from forming in your arteries. They are given intravenously in
hospitals for the treatment of angina or during and after angioplasty.
|
|
|
Anticoagulants (an-ty-ko-AG-u-lants) to prevent clots from forming in your
arteries and blocking blood flow.
|
Special Procedures
When medicines and other treatments do not control angina, special (invasive)
procedures may be needed. Two commonly used procedures are:
|
|
Angioplasty. This procedure opens blocked or narrowed coronary arteries. It
can improve blood flow to your heart, relieve chest pain, and possibly prevent a
heart attack. Sometimes a stent is placed in the artery to keep it propped open
after the procedure.
|
|
|
Coronary artery bypass surgery. This procedure uses arteries or veins from
other areas in your body to bypass your blocked coronary arteries. Bypass
surgery improves blood flow to your heart, relieves chest pain, and can prevent
a heart attack.
|
Cardiac Rehabilitation
Your doctor may prescribe cardiac rehabilitation (rehab) for angina or after
bypass surgery, angioplasty, or a heart attack.
The cardiac rehab team may include:
|
|
Doctors
|
|
|
|
Your family doctor
|
|
|
A heart specialist
|
|
|
A surgeon
|
|
|
Nurses
|
|
|
Exercise specialists
|
|
|
Physical therapists and
occupational therapists
|
|
|
Dietitians
|
|
|
Psychologists or other
behavioral therapists
|
Rehab has two parts:
|
|
Exercise training. This helps you learn how to exercise safely, strengthen
your muscles, and improve your stamina. Your exercise plan will be based on your
individual ability, needs, and interests.
|
|
|
Education, counseling, and training. This helps you understand your heart
condition and find ways to reduce your risk of future heart problems. The
cardiac rehab team will help you learn how to cope with the stress of adjusting
to a new lifestyle and to deal with your fears about the future.
|
How Can Angina Be Prevented?
You can prevent or lower your risk for heart disease and angina by making
lifestyle changes and getting treatment for related conditions.
Make Lifestyle Changes
|
|
Eat a healthy diet to prevent or reduce high blood pressure, high blood
cholesterol, and obesity.
|
|
|
Quit smoking, if you smoke
|
|
|
Be physically active, as directed by your doctor
|
|
|
Lose weight, if you are overweight or obese
|
Treat Related Conditions
In addition to making lifestyle changes, you can help prevent angina and
heart disease by treating related conditions, such as:
|
|
High blood cholesterol. If you have high cholesterol, follow your doctor's
advice about lowering it. Take medications to lower your cholesterol as
directed.
|
|
|
High blood pressure. If you have high blood pressure, follow your doctor's
advice about keeping your blood pressure under control. Take blood pressure
medications as directed.
|
|
|
Diabetes (high blood sugar). If you have diabetes, follow your doctor's
advice about keeping your blood sugar levels under control. Take medicines as
directed.
|
|
|
Overweight or obesity. If you are overweight or obese, talk to your doctor
about how to lose weight safely.
|
Living With Angina
Angina is not a heart attack, but it does mean that you are at greater risk
of having a heart attack than someone who does not have angina. The risk is even
higher if you have unstable angina. For these reasons, it is important that you
know:
|
|
The usual pattern of your angina, if you have it on a regular basis
|
|
|
About your medicine
|
|
|
How to control your angina
|
|
|
The limits of your physical activity
|
|
|
How and when to seek medical attention
|
Know the Pattern of Your Angina
Stable angina usually occurs in a pattern. You should know:
|
|
What causes the pain to occur
|
|
|
What it feels like
|
|
|
How long it usually lasts
|
|
|
Whether it is relieved by rest or medicine
|
After several episodes, you will learn to recognize when you are having
angina. It is important for you to notice if the pattern starts to change.
Changes in the pattern to look for may include:
|
|
Occurring more often
|
|
|
Lasting longer
|
|
|
Being more severe
|
|
|
Occurring without exertion
|
|
|
Not going away with rest or medicine
|
These changes in the pattern may be a sign that your symptoms are getting
worse or becoming unstable. You should seek medical attention. Unstable angina
suggests that you are at high risk for a heart attack very soon.
Know Your Medicines
You should know what medicines you are taking, the purpose of each, how and
when to take them, and possible side effects. It is very important that you know
exactly when and how to take fast-acting nitroglycerin or other nitrates to
relieve chest pain. They should be taken:
|
|
Immediately when pain begins or before stressful activity
|
|
|
Three times spaced 5 minutes apart if pain does not go away
|
|
|
Always sit down before taking nitroglycerin.
|
|
|
Long-acting nitrate preparations should be used regularly as prescribed by
your doctor.
|
Men with impotence (erectile dysfunction) who take sildenafil (Viagra®)
should talk with their doctor. Taking sildenafil and nitroglycerin or other
nitrates within 24 hours of each other can cause serious problems.
Ask your doctor about your other medicines. Also, see the Treatment section
to read descriptions of the medicines that you are taking.
Know How To Control Your Angina
|
 |
|
After several episodes, you will know the level of activity, stress, and
other things that can bring on your angina. By knowing this, you can take steps
to prevent or lessen the severity of episodes.
|
Physical exertion. Know
what level of activity brings on your angina and try to stop and rest before
chest pain starts. For example, if walking up a flight of stairs leads to chest
pain, then stop halfway and rest before continuing. When chest pain occurs
during exertion, stop and rest or take your angina medicine. The pain should go
away in a few minutes. If the pain does not go away or lasts longer than usual,
call 9–1–1 and get emergency care.
|
|
Emotional stress. Anger, arguing, and worrying are examples of emotional
stress that can bring on an angina episode. Try to avoid or limit exposure to
situations that cause these emotions. Exercise and relaxation can help relieve
stress. Alcohol and drug use play a part in causing stress and do not relieve
it. If stress is a problem for you, talk with your doctor about getting
counseling to help you deal with stress.
|
|
Eating large meals. If this leads to chest pain, eat smaller meals. Also,
avoid eating rich foods.
|
|
Know the Limits of Your Physical Activity
Most people with stable angina can
continue their normal activities. This includes work, hobbies, and sexual
relations. However, if you engage in very strenuous activity or have a stressful
job, you may need to discuss this with your doctor.
Know How and When To Seek Medical Attention
If you have angina, you are at high risk of having a heart attack. Therefore,
it is very important that you and your family know how and when to seek medical
attention. Talk to your doctor about making an emergency action plan. The plan
should include:
|
|
The signs and symptoms of a heart attack
|
|
|
Instructions for the prompt use of aspirin and nitroglycerin
|
|
|
How to access emergency medical services in your community
|
|
|
The location of the nearest hospital that offers 24-hour emergency heart
care
|
Be sure to discuss your emergency plan
with your family members. Take action quickly if your chest pain becomes severe,
lasts longer, or is not relieved by rest or medicine.
Sometimes, it may be difficult to tell
the difference between unstable angina and a heart attack. Most heart attack
victims wait 2 hours or more after their symptoms begin before they seek medical
help. This delay can result in death or lasting heart damage.
Key Points
|
|
Angina is chest pain or discomfort that occurs when your heart muscle does
not get enough blood. Angina may feel like pressure or a squeezing pain in your
chest. The pain may also occur in your shoulders, arms, neck, jaw, or back.
|
|
|
Most people with angina have coronary artery disease, with narrowed
arteries due to atherosclerosis. When arteries are narrowed, blood flow to the
heart is reduced.
|
|
|
More than 6 million people in the United States have angina.
|
|
|
The most common types of angina are stable angina and unstable angina. A
less common type of angina is called variant angina.
|
|
|
Stable angina is chest pain or discomfort that occurs when the heart is
working harder than usual. Pain from stable angina goes away when you rest or
take your angina medicine. Angina medicine, such as nitroglycerin, helps widen
and relax the arteries so that more blood can flow to the heart.
|
|
|
Unstable angina is a very dangerous condition that requires emergency
treatment. Unstable angina is a sign that a heart attack could occur soon.
Unstable angina can occur without physical exertion. It is not relieved by rest
or medicine.
|
|
|
Variant angina is caused by a spasm in a coronary artery. The spasm causes
the walls of the artery to tighten. This narrowing of the artery slows or stops
blood flow to the heart.
|
|
|
Doctors diagnose angina based on your health history,
your family’s health history, a physical exam, and the results of various
tests.
|
|
|
Angina is usually treated with medicines such as nitrates (nitroglycerin).
People with angina may need to take other medicines to lower their blood
pressure or cholesterol. They also may take medicine to prevent blood clots.
|
|
|
|
To prevent and treat angina, it is important to make changes to improve
your health. Get regular physical activity, maintain a healthy weight, don't
smoke, and eat a healthy diet that is low in saturated fat and cholesterol. A
cardiac rehab program can be helpful for many people with angina.
|
|
|
When medicines and lifestyle changes do not control angina, special
procedures may be needed. Angioplasty and coronary artery bypass surgery are two
common procedures used to treat angina.
|
|
|
If you have angina, it is important to know the pattern of your angina,
about your medicine, how to control your angina, and the limits on your physical
activity. You should know how and when to seek medical help.
|
Minimally
Invasive Heart Surgery
Recent advances in
surgical techniques and equipment allow surgeons to perform Coronary
Artery Bypass Surgery in a less traumatic way. Minimally Invasive
Coronary Artery Surgery is also called Limited Access Coronary Artery
Surgery. It is as an alternative to the standard methods of Coronary
Artery Bypass Graft Surgery. Unlike conventional surgery, which utilizes
a 10-12" incision and requires the patient to be placed on the
heart-lung machine, new minimally invasive surgery may avoid placing the
patient on the machine, and can be performed through a 3-5"
incision placed between the ribs, or may be done with several small
incisions. Like conventional surgery, the surgery is done to reroute, or
bypass, blood around coronary arteries clogged by fatty buildups of
plaque and improve the supply of blood and oxygen to the heart.
Minimally Invasive Coronary
Artery Bypass—also called MIDCAB—is
used to avoid the heart-lung machine. It's done while your heart is
still beating and is intended for use when only one or two arteries will
be bypassed. MIDCAB uses a combination of small holes, or ports, in your
chest and a small incision made directly over the coronary artery to be
bypassed. The heart surgeon usually detaches an artery from inside the
chest wall and re-attaches it to the clogged coronary artery farthest
from the occlusion. The surgeon views and performs the attachment
directly, so the artery to be bypassed must be right under the incision.
Minimally Invasive Bypass
Surgery has the same beneficial results as conventional bypass surgery.
It restores adequate blood flow and normal delivery of oxygen and
nutrients to the heart. This type of surgery has additional advantages,
including the ability of the surgeon to work on a beating heart or
through smaller incisions.
|
|
The
procedure is performed in only two to three hours, compared to three
to six hours for a traditional bypass.
|
|
|
The
recovery time is dramatically reduced from months to days or a week.
Complications associated with the heart-lung machine are avoided.
|
|
|
Due
to less time under anesthesia, patients are moved out of intensive
care more quickly.
|
|
|
Patients
tend to experience less pain and discomfort.
|
|
|
There
is a 25-40% savings of the cost of conventional surgery.
|
|
|
Lower
infection rate: A smaller incision
means less exposure and handling of tissue, which may reduce the
chances of infection.
|
This
surgery is available to more patients.
Many patients are poor
candidates for traditional bypass surgery because their illness is too
widespread or their heart is too weak. Some patients are able to receive
this life-saving surgery through minimally invasive techniques.
Risks
Performing
surgery on a beating heart is more difficult than working on a heart
that has been stopped with the help of the heart-lung machine. In
addition, the stress on the heart during the procedure may lead to more
heart muscle damage, lower blood pressure, irregular heartbeat and
potential brain injury if blood flow to the brain is reduced for too
long during surgery. In some cases—usually less than 10 percent—it
is necessary to convert to conventional methods on an emergency basis.
Weight Control
 Weight
control is an important part of our culture. We are reminded daily in our
society that being overweight is not "in" or fashionable. Just look at
TV or any type of media advertising and you will soon see that being thin and in
good shape is what is popular.
Your primary goal
should be to have a healthy body. Healthy bodies come in different shapes and
sizes. Weight control is just a part of having a healthy body. Other factors
include your diet, nutrition and the amount and kind of exercising you are
getting. Displayed later on in this chapter is a height/weight chart that will serve as a guideline.
When you see your family doctor, they
will check your height, weight, and blood pressure, blood lipids,
(cholesterol, triglycerides), and blood sugar (for people with
diabetes). All of these involve medical conditions related to weight.
Proper weight control and weight management can help provide for a
healthy body.
Obesity
Obesity is
basically a medical condition that signifies the excess storage of body fat. It
is normal for the body to store fat tissue under the skin and around joints and
organs. Fat is essential for good health because it provides energy when the
body demands it and provides insulation and protection for vital organs. It is
the accumulation of too much fat that poses the health problems of obesity.
These health problems include diabetes, hypertension, stroke, heart disease and
arthritis.
The United States
has one of the highest percentages of obese adults. It is estimated that over
36% of adults in America are obese. Obesity is most common among minorities,
especially minority females. Over 50% of African-American and Mexican-American
women are obese. Over 20% of children between the ages of 6 to 17 fit in the
obese category.
A primary concern
of obesity is the risk of developing disease. Obese people are twice as likely
to develop high blood pressure and over 70% of heart disease cases are linked to
excess body fat. Obese women are twice as likely to develop breast cancer and
40% more likely to develop colon cancer. Close to 80% of Type II or non-insulin
dependent diabetics are obese.
Obesity is partially determined by
genetic makeup. Research has revealed that basal metabolic rate and the
size and number of a person's fat cells help in determining the amount
of weight loss that is possible. When calories from food intake equal
the amount of energy that the body requires to function the weight
remains the same. However, when more calories are consumed than the body
needs, the body will store the extra calories, resulting in weight gain.
Diet
Diets are the most
common treatment for obesity. There seem to be countless diets that are promoted
and it is recommended that your weight control diet be supervised by a your
family doctor. Most health care professionals will recommend a diet that
consists of 1200 - 1500 calories per day. People who are over 40 pounds
overweight may require a more aggressive approach and may be put on a restricted
diet of 500 to 800 calories per day.
There many types of weight loss
medications on the market today but there are also many side effects
that include insomnia, anxiety and irritability. Your family doctor can
evaluate your particular condition, health issues and can
recommend weight-loss medications under the right circumstances. Used
correctly, they can be very effective in the treatment of overweight
people.
Exercise
Exercise
should be an important part of your weight management plan. Calorie reduction
alone is not a complete plan will not result in long-term weight loss. Regular
exercise is a long-term plan for continuing weight reduction. Exercise will also
improve some of the medical conditions associated with obesity which include
high cholesterol levels, high blood pressure and diabetes.
A long-term
exercise plan sometimes requires lifestyle and behavior modification, which can
be hard for many obese people to accept. Successful weight management plans
require strong discipline to control eating urges and to implement exercise
plans. New habits need to be learned and many old bad habits need to changed,
such as food types consumed and unproductive eating habits.
When choosing an
exercise program, the person should consult their family doctor. The exercise
program will be designed around the person's work capacity, which will be
determined by your doctor. Exercise tests using the treadmill or stationary
bicycle are the most common ways to determine and measure work capacity. Once
your work capacity has been determined, an exercise program can be recommended.
The formula will include what your training heart rate should be and how much
intensity should be expended during your workout.
An exercise
program can be the most important part of your weight management program because
it will give you so many other added health benefits. Many studies show a direct
correlation between physical fitness and mental achievement.
Weight Chart
The following
charts provide healthy weight ranges for different body sizes and builds:
WOMEN
Height |
Small Frame |
Medium Frame |
Large Frame |
4' 10" |
102 - 111 |
109 - 121 |
118 - 131 |
4' 11 |
103 - 113 |
111 - 123 |
120 - 134 |
5' 0" |
104 - 115 |
113 - 126 |
122 - 137 |
5' 1" |
106 - 118 |
115 - 129 |
125 - 140 |
5' 2" |
108 - 121 |
118 - 132 |
128 - 143 |
5' 3" |
111 - 124 |
121 - 135 |
131 - 147 |
5' 4" |
114 - 127 |
124 - 138 |
134 - 151 |
5' 5" |
117 - 130 |
127 - 141 |
137 - 155 |
5' 6" |
120 - 133 |
130 - 144 |
140 - 159 |
5' 7" |
123 - 136 |
133 - 144 |
143 - 163 |
5' 8" |
126 - 139 |
136 - 150 |
146 - 167 |
5' 9" |
129 - 142 |
139 - 153 |
149 - 170 |
5' 10" |
132 - 145 |
142 - 156 |
152 - 173 |
5' 11" |
135 -148 |
145 - 159 |
155 - 176 |
6' 0" |
138 - 151 |
148 - 162 |
158 - 176 |
MEN
Height |
Small Frame |
Medium Frame |
Large Frame |
5' 2" |
128 - 134 |
131 - 141 |
138 - 150 |
5' 3" |
130 - 136 |
133 - 143 |
120 - 134 |
5' 4" |
132 - 138 |
135 - 145 |
140 - 153 |
5' 5" |
134 - 140 |
137 - 148 |
144 - 160 |
5' 6" |
136 - 142 |
139 - 151 |
146 - 164 |
5' 7" |
138 - 145 |
142 - 154 |
149 - 168 |
5' 8" |
140 - 148 |
145 - 157 |
152 - 172 |
5' 9" |
142 - 151 |
156 - 160 |
155 - 176 |
5' 10" |
144 - 154 |
151 - 163 |
158 - 180 |
5' 11" |
146 - 157 |
154 - 166 |
161 - 184 |
6' 0" |
149-160 |
157 - 170 |
164 - 188 |
6' 1" |
152-164 |
160 - 174 |
168 - 192 |
6' 2" |
155-168 |
165 - 178 |
172 -197 |
6' 3" |
158-172 |
167 - 182 |
176 - 202 |
6' 4" |
162-176 |
171 - 187 |
181 - 207 |
All About High
Blood Pressure
Everyone has blood pressure.
Without it, blood can't circulate through the body. And
without circulating blood, vital organs—like your brain—can’t get the
oxygen and food that they need to work.
Your blood pressure measurements
consist of two numbers: systolic and diastolic. The systolic
measurement is the pressure of blood against your artery walls when the heart
has just finished pumping. It is the first or top number of a blood pressure
reading. The diastolic measurement is the pressure of blood against the artery
walls between heartbeats, when the heart is relaxed and filling with blood. It
is the second or bottom number in a blood pressure reading.
Generally, when you get your blood
pressure checked, a reading that is less than 140 over 90 indicates that you
don't need to worry. If either or both numbers are equal to or greater than 140
over 90 for an extended period of time, you have high blood pressure, or
hypertension.
Hypertension is dangerous because
it causes the heart to work extra hard. This strain contributes to heart attacks
and stroke. When the heart is forced to work excessively for an extended period
of time, it tends to enlarge. A slightly enlarged heart can function well, but a
significantly enlarged heart cannot. High blood pressure also causes damage to
the arteries, causing arterial disease.
Also, untreated high blood
pressure can damage the delicate lining of the blood vessels. Once damaged, fat
and calcium can easily build up along the artery wall, forming plaque. The blood
vessel becomes narrowed and stiff, and blood flow through the blood vessel is
reduced. Over time, decreased blood flow to certain organs in the body can cause
damage, leading to:
|
1 |
|
Heart
disease, heart attack, and abnormal heartbeat.
|
|
2 |
|
Stroke.
|
|
3 |
|
Kidney
failure.
|
|
4 |
|
Peripheral
arterial disease. |
|
5 |
|
Eye
damage.
|
What causes high blood pressure?
Several factors are known to
increase blood pressure, including obesity, heavy alcohol use, family history,
high salt intake, and aging. An inactive lifestyle, stress, low potassium
intake, low calcium intake, and resistance to insulin may also cause your blood
pressure to rise. Risk factors you can't control include a family history
of high blood pressure, your race (being African-American increases your risk),
and aging.
Getting diagnosed
Because
there are usually no symptoms, diagnosing hypertension can be tricky. The most
common symptoms are headaches, dizziness, and lightheadedness, but these usually
occur only in severe hypertension and are often so mild that they're ignored. If
you are obese and has a family history of hypertension, this should raise a red
flag for hypertension. The only reliable way of diagnosing hypertension is with
regular blood pressure measurements.
Prevention
Doctors usually recommend six
lifestyle changes to help prevent high blood pressure. These six strategies are
especially important for people who have risk factors for high blood pressure
that cannot be changed, including family history, race, and aging.
|
1
|
|
Maintaining
a normal weight, and keeping a
Body Mass Index (BMI) of 18.5-24.9.
|
|
2
|
|
Exercising
for at least 30 minutes a day.
|
|
3
|
|
Reducing
your sodium intake to 2,400 mg per day,
which is about a teaspoon.
|
|
4
|
|
Limiting
the amount of alcohol you drink.
|
|
5
|
|
Getting
3,500 mg of potassium in your diet everyday.
|
|
6
|
|
Eating a
diet that is rich in fruits, vegetables, and low-fat
dairy products, with reduced amounts of saturated and total fats.
|
Treatments
The remedy for
high blood pressure depends on the severity of the disease and whether you have
other health problems, such as heart failure or diabetes, or you are pregnant.
Your doctor may want you to try lifestyle changes first, including losing
weight, increasing activity, and eating a balanced diet. If your blood pressure
is above a certain level, your doctor may prescribe medication along with the
lifestyle changes.
Some people may only need lifestyle changes to control their high blood
pressure, while others need medication as well. Either way, treating high blood
pressure usually is a lifelong process.
About
Cholesterol
Cholesterol is a
white-colored waxy substance found in cell membranes and is required for the
body to help produce other cell membranes and a variety of hormones. The
majority of cholesterol is produced by the liver, and the cholesterol levels
found in our blood are affected by the types of foods we eat. Excessive amounts
of cholesterol can build up in the arterial walls over time, thus causing
hardening and narrowing of the blood vessels. When this occurs it increases the
risk of heart disease by reducing the flow of blood.
Causes of high
cholesterol include:
|
A diet
too high in saturated fats
|
|
A
genetic trait of high cholesterol
|
|
Improper
liver function
|
|
Hormonal
problems
|
Certain foods
contain high amounts of cholesterol, and people who are concerned about reducing
their cholesterol intake should avoid the following foods:
|
Fatty
Meats
|
|
Full-fat
dairy products
|
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Shrimp
|
|
Cream,
butter, cheese, ice cream, milk
|
|
Vegetable
fats, shortening and some margarines
|
|
Sausage,
salami and other similar meats
|
|
Cakes,
muffins, biscuits
|
|
Salted
nuts, crackers
|
|
Pastry,
croissants
|
Others can be beneficial in striving to reduce cholesterol levels. These foods
include the following:
|
High
fiber foods
|
|
Whole
grain bread, cereals, brown rice and whole grain pasta
|
|
Vegetable
skin items, i.e.: potatoes (with skin on)
|
|
Whole
grain rolled oats, oat bran
|
|
Fruits
and vegetables |
|
Lean
meats , skinned poultry and fish
|
Most people can
reduce cholesterol by 10 to 20% by watching their diet. In many cases this is
not enough and therefore other remedies are necessary. Medication may be
required and research has shown that new drugs can be very effective in reducing
cholesterol levels.
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