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by Eric G. Tangalos, MD, AGSF and Win-Kuang
Shen, MD, Mayo Clinic
Heart disease is the nation's number one
cause of death among older adults. The disease takes many
forms in its effect on the human body, such as heart attack,
heart failure, and sudden death. Although the risk of dying
from many of these conditions has been reduced, it is necessary
for older adults to be aware of heart disease and its warning
signs.
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Q. As I get older,
what is my risk of heart disease?
A. On
average, men age 65 and over have a 25% chance of developing
heart disease over ten years. However, if no additional risk
factors are present, such as diabetes, high blood pressure,
high cholesterol, or smoking (or if these conditions are controlled
by medications), the chance of developing heart disease is
11% over ten years. Women of the same age, on average, have
a 13% chance of developing heart disease over ten years. The
risk is only 8% over ten years if no other risk factors are
present.
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Q. What is cholesterol? Should I be concerned
if my cholesterol level is high?
A. Cholesterol
is a soft, waxy substance found among the fats in the bloodstream
and in all your body's cells. Cholesterol is produced by the body,
but also comes to us from animal products we eat, such as meats,
poultry, fish, eggs, butter, cheese and whole milk. Low-density
lipoprotein, or LDL, is known as the "bad" cholesterol.
Too much LDL cholesterol can clog the arteries to your heart and
increase your risk of heart attack. High-density lipoprotein,
or HDL, is known as the "good" cholesterol. There is
strong evidence that we should reduce our LDL cholesterol when
it is abnormally high.
Q. What is coronary
artery disease?
A. Coronary
artery disease is the hardening of the vessels that supply blood
to the muscles of the heart. The hardening is most often caused
by a buildup of plaque (deposits of fat-like substances) in the
arteries. This condition reduces the blood supply to the heart
and can cause a heart attack. When permanent damage occurs to
the heart muscle it is called a myocardial infarction (MI).
Q. What are the symptoms
of a heart attack?
A. Common
warning signs of a heart attack include:
• An uncomfortable pressure, fullness,
squeezing or pain in the center of the chest that lasts more than
a few minutes, or goes away and comes back;
• Pain that spreads to the shoulders,
neck or arms;
• Chest discomfort with lightheadedness,
fainting, sweating, nausea or shortness of breath.
Less common warning signs of heart attack include:
back or shoulder pain; stomach or abdominal pain; nausea or dizziness
(without chest pain); shortness of breath and difficulty breathing
(without chest pain); unexplained anxiety, weakness or fatigue;
and palpitations, cold sweat or paleness. Chest pain associated
with the heart is often called angina or angina pectoris.
Q. Should I take aspirin
to reduce my risk for a heart attack?
A. Aspirin
diminishes the clotting action of blood platelets, which in turn
protects arteries already narrowed by accumulated plaque. The
decision to take aspirin to prevent a heart attack should be made
with your physician so that he or she can weigh your risk of heart
disease against the potential for adverse reactions to prolonged
aspirin use.
Q. What is heart failure?
A. Heart failure
is a condition in which the heart cannot pump enough blood to
meet the body's needs. This condition occurs when the heart muscle
has been damaged by a past heart attack or other conditions, such
as high blood pressure or diseased heart valves. People with heart
failure cannot exert themselves because they become short of breath
and tired. Other common signs of heart failure are swollen legs
or ankles and weight gain due to a buildup of fluid in the body.
Q. My doctor tells
me I have high blood pressure. What steps can I take to reduce it?
A. To help
control mild to moderate high blood pressure, your doctor may
prescribe dietary and lifestyle changes such as: reducing your
salt intake; eating more fruit, vegetables, and fat-free and low-fat
dairy products; reducing alcohol consumption; incorporating exercise
into your daily activities; and maintaining a healthy weight.
In some cases, lifestyle changes are not enough to bring blood
pressure down and your doctor must prescribe medication to help
control your blood pressure.
Q. What does it mean
if I get lightheaded when I stand up in the morning?
A. Having
low blood pressure can cause a dizzy feeling upon rising. As we
age, blood vessels become less responsive to change in position
and the body takes longer to adjust to gravity. To help alleviate
this feeling and to avoid a possible fall, take your time when
getting up so that your system can adjust to an upright position.
Certain medications can also cause a lightheaded feeling. You
should speak with your doctor to determine the exact cause of
your feeling.
Q. Why does my heart
occasionally skip a beat and sometimes beat really fast?
A. Occasional
missed heartbeats are fairly common, even in young people. When
the heart takes up a persistent irregular rhythm it may be a sign
of atrial fibrillation or another more serious abnormality. If
the rhythm disturbance is accompanied by symptoms of weakness,
fatigue, dizziness, chest pain or tightness, fainting or shortness
of breath, seek medical attention immediately.
For more information about heart disease, contact
the following organizations:
The American Heart Association
7272 Greenville Avenue
Dallas, Texas 75231-4596
Phone: (800) AHA-USA1
www.americanheart.org
Heart Failure Society of America
Box 358
420 Delaware Street S.E.
Minneapolis, Minnesota 55455
Phone: (612) 626-3864
Fax: (612) 624-2174
www.hfsa.org
National Heart, Lung and Blood Institute
NHLBI Information Center
P.O. Box 30105
Bethesda, MD 20824-0105
Phone: (301) 592-8573
Fax: (301) 592-8563
Email: NHLBIinfo@rover.nhlbi.nih.gov
Website: www.nhlbi.nih.gov
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