"It takes no holiday," Dr. R.G. Krishnan recently told a packed house at Monongahela Valley Hospital during a program on Innovations in the Treatment of Cardiac Disease.
Since 1900, cardiovascular disease has been the No. 1 killer in the United States every year except 1918. That year, influenza and flu killed more people.
Coronary artery disease is one of the most common and serious effects of aging, as fatty deposits build up in the blood vessel walls and narrow the passageway for the movement of blood.
However, the process actually starts at birth and is accelerated by fatty foods, weight gain, smoking, high blood pressure, emotional stress and lack of exercise - all of which are controllable risk factors.
"Seventy-five percent of the risk factors are controllable," said Krishnan, who is board certified in cardiology and internal medicine and serves as president of the medical staff at MVH.
Even though coronary artery disease may restrict blood to the heart, you may not feel any effects - until the situation worsens. If the coronary arteries can't supply enough blood to meet the oxygen demands of your heart, the result may be chest pain called angina.
Some people may not be aware they have coronary artery disease until they develop symptoms of congestive heart failure: extreme fatigue with exertion, shortness of breath and swelling in their feet and ankles.
A heart attack occurs when an artery to your heart muscle becomes completely blocked and the part of the heart muscles fed by that artery dies. Sometimes, the signs and symptoms of a heart attack happen suddenly, but they also can develop slowly, over hours, days and even weeks before a heart attack occurs.
In addition, not everyone having a heart attack experiences the typical symptoms, particularly women. If you've already had a heart attack, your symptoms may not be the same for another one. The more signs and symptoms you have, the more likely it is that you're having a heart attack.
"Once you have a blockage in the heart, you're more prone to blockage in the carotid artery and leg," Krishnan said. "It's like fixing a pothole with a Band-Aid. It's not fixing the problem."
Many people are able to manage coronary artery disease with lifestyle changes and medications. And there's one program, which is offered by MVH, that actually claims to reverse heart disease: The Ornish program, developed by Dr. Dean Ornish.
The program is a lifestyles modification program that enables participants to reverse many of the root causes of coronary artery disease. The program has four components: exercise, stress management, a low-fat, whole-foods nutrition plan and group support.
Since the program was introduced in 2002 at MVH, more than 100 people have participated. Of that group, no participants have died or undergone a heart transplant, and none has suffered a heart attack or undergone bypass surgery or angioplasty.
Even though medical advances have extended the quantity of life, as one member of the Dean Ornish staff pointed out, the quality of life sometimes continues to suffer. The Ornish program increases the quality as well, according to Krishnan.
A 41-year-old Monongahela man won't argue with that.
When he graduated from high school, he weighed about 200 pounds. He continued to gain weight, and by 2008, he weighed 340 pounds.
"I was grossly overweight and out of shape," he told the audience, noting that he had high blood pressure and diabetes, and his cholesterol was more than 300. The only green vegetable he ate was spinach, and that was only when it was in wedding soup.
It was no surprise, then, that he suffered a massive heart attack. He received a stent and underwent cardiac rehabilitation.
Then, he reverted to his old habits.
In September 2009, he entered the Ornish program and graduated.
"I can honestly say this program saved my life," he said. He has lost 70 pounds, and his blood pressure is a healthy 118 over 72.
"I learned to adapt," he said. "The program is based on pleasure, not pain. It gives you the freedom to explore all fruits and vegetables and whole grains. It's about doing something good for yourself."
Krishnan, who serves as director of the Ornish program, said 75 percent of participants show significant progress with the program.
If viable tissue remains after a heart attack, "you can improve muscle mass with the Dr. Dean Ornish Program," Krishnan said. "It decreases the chance of heart attack by 87 percent."
-----
By the numbers
In the United States, Pennsylvania ranks:
16th in heart disease
20th in obesity
7th in diabetes
West Virginia ranks:
1st in heart disease
2nd in obesity
3rd in diabetes
Source: Monongahela Valley Hospital
Symptoms
The following may be indications you are having a heart attack:
n Chest pain or angina that persists;
n Upper body discomfort in one or both arms, the back, neck, jaw or stomach;
n Shortness of breath, which may often occur with or before chest discomfort;
n Nausea, vomiting, lightheadedness or fainting, or breaking out in a cold sweat.
