Readers Digest Special Heart Disease Report: I Just Didnt Think I Was At Risk-Heart Diseases
"I Just Didn't Think I Was At Risk"Even former President Bill Clinton, treated by some of the best doctors in America when he was in the White House, didn't know he was a heart attack waiting to happen. How could that be, and what does it say for the rest of us? Determining heart-attack risk is a tricky thing: Each of us has a different susceptibility to cardiovascular disease. Some people will live to be 100 on burgers and milk shakes, while a few vegetarian marathon runners will have heart attacks at 35. Your fitness level and what you eat play a role, of course, and so do genes and gender. But gender helps only for a while. Women have fewer heart attacks than men before they reach menopause. They catch up within a few years, however, and heart disease is an equal- opportunity killer after that. Nearly a quarter of the population -- 64 million Americans -- have cardiovascular disease. And here's the shocker: As much as 40 percent of those who have a heart attack have no symptoms at all.One obstacle to diagnosis is denial. In a TV interview with Diane Sawyer after his bypass procedure, Clinton said that before his surgery, he had been experiencing tightness in his chest after exercising. "I'd have to stop and catch my breath," he said. But he thought he was just tired, working too much, and out of shape. He was convinced it was nothing serious. Sadly, this is a common story. It never occurred to Dennis Higgins, 56, a freelance product designer in New York City, that he was at risk for a heart attack, either, but it should have. He'd "lived a wild, crazy life," as he describes it, including smoking since he was 12, drinking a lot, eating a diet high in saturated fat and not exercising regularly. At six-foot-two and 238 pounds, he was overweight. He also had a catastrophic family history: Five of his mother's six brothers, and two of their sons, had all died before age 60 of heart-related problems. "I knew all that," says Higgins, "but I just didn't think I was at risk." He had no symptoms, he says, except for some occasional shortness of breath, usually in the middle of the night. But one day he logged on to a website where an interactive tool calculated that he was going to die at age 68. That did it. "I said, 'Oh, my God!' I have two children, five and six, and I want to be around for them," says Higgins. So he went to a doctor for the first time in 30 years and, after several tests, learned that he had two arteries with blockages. The treatment? Two stents to hold open the arteries, several medications including a statin and a blood thinner -- and a total change in lifestyle. The Future of Heart Disease PreventionIf Higgins hadn't happened upon that website, he might never have gone to his doctor. But even those who do go might not know their risk. Cholesterol scores can't always tell us who will be at risk. Screening tests catch only half of the population. For patients with symptoms, angiograms (in which a catheter is threaded through an artery into the heart for a look around) can provide good information on plaque buildup, blockages and heart damage -- after the fact. Still, these tests are too expensive and invasive to be used in patients with no symptoms.And there are millions more like Higgins. In fact, John Postley, MD, an internist on the faculty of Columbia University Medical Center in New York City, says that blood vessels may start to show signs of lifestyle damage at an alarmingly young age. One study reports that the arteries of obese nine-year-olds are measurably stiffer than those of their peers. With the proper diet and exercise, their arteries can return to normal. By our mid-30s, the stiffening often progresses to hardening of the arteries, characterized by the buildup of plaque, which, if ruptured, can result in a heart attack -- within hours. But all plaque may not be equally dangerous. Calcified plaque is considered relatively stable and can indicate healing after a rupture has occurred. Fatty plaque is more susceptible to the cracking and clotting that lead to heart attacks. But most tests cannot detect this kind of plaque. And therein lies the problem: Until recently, doctors simply didn't have the tools to diagnose heart disease in time to prevent heart attacks. Now, a new generation of noninvasive technology may change that. By looking directly into a patient's arterial walls using CT scanning, high-resolution ultrasound and MRI, doctors can see plaque building up years before it gets to the critical stage. Because risk factors can be as hard to read as tea leaves, Postley believes in proactively using the new diagnostic tools to predict and prevent arterial damage. The results? While we may not have a crystal ball to prevent heart disease, we may someday have the ability to eliminate most killer heart attacks well before they happen. 3 Tests to Stop Your Heart Attack Before It Starts CT scans Ultrasound MRI |
