How to minimize the risk of a heart attack
By a significant margin, heart disease claims the most lives in Allegheny County.
That’s also true of the U.S. overall, but the county stands out: Its fatalities from heart disease outpaced the national rate by some 42% since 2018, according to figures from the Centers for Disease Control and Prevention.
More than 15,500 Allegheny County residents died from cardiac ailments in that time, CDC reporting shows. For perspective on the leading cause of death — and how to minimize heart risks — the Post-Gazette spoke with Dr. Amber Johnson, an assistant professor of medicine at the University of Pittsburgh.
Dr. Johnson, a cardiologist, is a fellow of the American College of Cardiology. She said many physicians are moving more toward a prevention mindset around heart disease.
“We can prevent the development of heart disease. For example, by decreasing the rates of smoking, we could be helping people to prevent heart disease,” Dr. Johnson said. Her message: “By leading more of a healthy lifestyle, we can decrease the burden of disease in the future.”
This interview has been edited for clarity and brevity.
Are there particular pressures on health that make the risk of heart disease more pronounced in Allegheny County?
Nationally speaking, contributors to poor heart health include not managing the risk factors for cardiovascular disease. Those factors in Allegheny County, compared with other places, probably have more to do with lifestyle. Our rates of cigarette smoking and obesity are higher. And we tend to leads more of a sedentary lifestyle compared with some other parts of the country. In some areas, it’s more common to be active yearround — hiking, walking and biking. We tend to do that less here.
Do most deaths from heart disease involve heart attacks?
When we talk about heart disease, we commonly are talking
about heart attacks. But different types of heart disease can include coronary artery disease, hypertension and heart failure. Lifestyle factors contribute to heart attacks and to the other types of heart problems.
Are most heart attacks predictable?
Usually, they are predictable. Certain symptoms may appear leading up to a heart attack. One early-warning sign is a feeling of heaviness in the chest — known as angina — when you’re walking up steps, climbing a hill or otherwise exerting yourself.
Sometimes people can have a silent heart attack, which means they have damage to the heart muscle but don’t know about it. The damage can create weakness in the heart muscle that prevents normal function.
If you’re with someone who seems to be having a heart attack, what’s the best thing to do?
Call 911 and have the person rest in a safe place while you’re waiting for help. Heart attacks often come on during physical exertion, so have the person stop what they’re doing and sit down. When medics arrive, they may administer medications. They’ll probably take the person to the hospital right away.
What can each of us do, individually, to keep from facing a heart attack?
It’s all about leading a healthy lifestyle. Diet and exercise are the main things we can do to prevent the development of heart disease. The heart-healthy diet includes lots of fresh fruits and vegetables — really, a plant-based diet is ideal. Other heart-healthy staples include whole grains. Foods that are low in fat and low in cholesterol are key.
When it comes to exercise, the American Heart Association recommends 150 minutes of physical activity each week. I usually tell my patients they can divide that up however they’d like — just as long as they incorporate the activity into their routines. It can be walking, swimming, biking — whatever it takes to get heart and respiratory rates up.
Other important lifestyle habits include not smoking. If you drink, do so in moderation. And if you have risk factors like diabetes, high blood pressure or high cholesterol, make sure those conditions are under control.
What are the other health benefits of these prevention efforts?
They can help manage hypertension, high cholesterol, high blood pressure — conditions that lead to heart disease. If you lose weight, you may no longer need to be on medication for high blood pressure. If you eat a healthier diet, you may need less insulin for your diabetes.
A heart-healthy lifestyle also contributes to easing other chronic conditions. It can help reduce anxiety and depression. Having a heart-healthy diet can help with chronic diseases like chronic obstructive pulmonary disease and other forms of chronic lung disease. So many other factors can improve when someone leads a healthy lifestyle.
On a community level, what should southwestern Pennsylvanians be doing to reduce the incidence of heart disease?
Leading a heart-healthy lifestyle is often difficult to achieve unless you have the means to do so. It’s a matter of inequity and injustice that a lot of people who are at highest risk of developing heart disease are least able to afford a heart-healthy lifestyle.
I think it’s unjust that fresh fruits and vegetables are not attainable for a lot of communities. I mentioned tobacco use, which is a choice for people who smoke. But then there are second-hand smoke and air pollution, which we know also contribute to the development of heart disease. We need to be making sure that we have clean air to breathe and healthy environments to live in.