Study finds more risk factors in heart attack patients.
Every year nearly three-quarters of a million Americans have a heart attack. Age and a family history of heart disease are two risk factors you can’t control, but the rest — like smoking, obesity and inactivity, among others — can be fixed. “It’s hard to say a percentage, but I would say about half of all heart attacks are preventable as long as risk factors are identified,” says Vivek Sailam, MD, a cardiologist with Our Lady of Lourdes Medical Center in Camden, New Jersey.
Despite the fact that so many heart attacks can be prevented with lifestyle changes, a March 2016 study from Cleveland Clinic found that the average person suffering from a heart attack was younger, more obese and had more risk factors in 2014 than in 1995, the period in which the study took place.
A Changing Patient Profile
The study found that the average age for the most serious kind of heart attack — known as ST-elevation myocardial infarction, or STEMI — at Cleveland Clinic dropped from 64 at the beginning of the study period to 60 by the end. The percentage of people with diabetes jumped from 24% to 31%. In 2014, more than three-quarters of those studied had high blood pressure, as opposed to only 55% in 1995. And, though smoking rates among adults in the U.S. have steadily trended downward since the 60s, the hospital saw an increase in smoking rates among heart attack patients, from 28% to 46%.
Cleveland Clinic’s findings mimic Dr. Sailam’s observations. “Unfortunately, in the past 10 years or so I’ve been seeing a steady increase in patients younger than 50 who have significant risk factors: morbid obesity, diabetes, high cholesterol, high blood pressure, and tobacco use,” he said.
Sailam blames the increase in risk factors among people having heart attacks, in part, on poor lifestyle choices: smoking, eating too much, eating the wrong kinds of foods and not exercising. “It’s absolutely lifestyle mediated,” he says. “You see consumption of food from chain restaurants has increased dramatically, and portion sizes are up exponentially. Patients are sedentary, not exercising.”
In addition to reducing the risk of heart attack, the American College of Cardiology recommends diet and exercise for the management of obesity, high blood pressure, high blood sugar and high cholesterol.
It’s good news that the risk factors for heart attack are partially preventable. The first step in heart attack prevention is identifying potential risk factors, says Sailam. “If you have risk factors, you want to get them evaluated and treated. You don’t want to wait until something happens,” he says. “Be proactive. A lot of folks ignore risk factors, and I meet them in the ER while they’re having a heart attack.”
Sailam’s advice is to cut portions and get more exercise. “Pretend it’s the 80s and cut your portions in half,” he says. “For a lot of people, a normal meal to them would be normal for three people in the 80s.” He estimates many of his patients eat upward of 4,000 calories a day, well above even the highest of the United States Department of Agriculture’s (USDA) daily estimates; most people need between 1,600 and 3,000 calories per day.
The Centers for Disease Control and Prevention (CDC) recommends 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. Sailam says that may not be realistic for many people, but it’s critical to do something intensive.
“The basic thing I recommend is 50% aerobic and 50% resistance training a few times a week,” says Sailam. “If that’s only 40 minutes total that’s fine, but it has to be intensive.”