Let’s talk about how to keep our hearts healthy and a free screening offered by University Hospitals that determines your future heart attack risk.
My expert for this month’s Healthy Actions column is Dr. Emil Hayek, a UH cardiologist with an office in Hudson. The following is based on an interview with Hayek, as well as information from UH.
Q: What general tips do you have to be heart healthy?
A: Heart disease is in part preventable. There are some genetic factors that people cannot help. Some individuals grow up in families where immediate family members have had heart attacks at a young age. But there are factors that can be controlled, such as a person’s diet and activity level.
Q: What’s a heart-healthy diet?
A: There’s unfortunately not a perfect diet. Many of the things we were told before are now known to be wrong. In recent years, we’ve been told to cut fat at the expense of carbohydrates, which turns out are just as bad for you.
There’s a sensible way to eat. I tell patients that one extreme is going to fast food on a regular basis. Fast-produced foods are not healthy for you, period. The most heart-healthy diet is a vegetarian or vegan diet.
There’s somewhere in the middle eating a lot of fruits and vegetables. If you're going to eat meats, eat leaner cuts like chicken and pork and not every day. Eat whole grains, try to stay away from simple sugars and simple carbs. These are things that just turn into sugars when you eat them such as white breads or pastas. Ultimately, the more natural your food is, the better off it is. That should be fruits, vegetables and whole grains and beans and other sources of protein that are healthy sources of protein like fish as opposed to steak.
Q: What about exercise?
A: We encourage at least 30 minutes of exercise as many days a week as you can fit in. If you can exercise five days a week, that's terrific. If you go beyond that, that's even better. But certainly the key is it doesn’t have to be anything fancy.
As a cardiologist, I'll take anything when it comes to preventing heart disease. To get somebody to do 10,000 steps a day or a 2-mile walk, that’s fantastic.
Q: Can you explain UH’s free Coronary Calcium Score test?
A: This X-ray test called the cardiac CT imaging for coronary artery calcium scoring, or the calcium score, has been growing in popularity in recent years.
This test has been shown by many studies to predict future risk of heart attack. It is done without an intravenous line or the use of any X-ray contrast material. It takes five to 10 minutes to complete.
Q: What is it looking for?
A: It measures the amount of calcium that has accumulated in the walls of the coronary arteries and provides your physician what is termed a “coronary artery calcium score.” A score of zero means that no calcium is seen. This finding is associated with a very low risk (less than 1%) of a heart attack over the next 10 years.
When a calcium score is 1 to 99 or 100 to 399, this means that some hardening of the arteries is present, and will indicate how intensively prevention strategies should be used to control your modifiable heart disease risk factors. When a calcium score is found to be 400 or greater, this is a warning that extensive hardening of the arteries is present and aggressive prevention strategies should be used.
Q: Who should get this screening?
A: UH recommends screening for men older than 45 and women older than 55 with no history of coronary heart disease and at least one factor, such as: high blood cholesterol, low HDL (good cholesterol), high blood pressure, cigarette smoking, Type 2 diabetes or a family history of heart disease at age 55 or younger in men and 65 or younger in women.
However, I individualize the decision for younger patients depending on other factors such as family history of premature coronary artery disease or the level of cholesterol elevation. I also tend to screen women at similar ages to men if they are diabetic. The age cutoffs by gender are based on the general consensus that women develop heart disease approximately 10 years later than men. I do screen women in their 40s based on risk factors and a desire on the patient’s part to be aggressive with screening.
The screening can also be helpful for those being treated for high cholesterol or even those on the border of medication treatment to see if calcified plaque already there? Things you did when you were in your 20s and 30s starts developing that plaque that ultimately leads to blockages and heart attacks and strokes.
A patient can also pass a stress test and think everything is fine, but there could still be a possibility that there is a high level of calcified plaque in their arteries.
The test detects which arteries in the three major coronaries it exists, and quantifies how much.
Q: How does UH offer this for free?
A: Heart disease is the No. 1 health threat to men and women and we recognize the importance of understanding personal risk when it comes to heart attacks. Calcium scoring is typically not covered by insurance, but UH has decided to give this gift to the community. UH has created an efficient model of care that allows us to offer this test with no charge. (I have confirmed that Cleveland Clinic Akron General charges $100 out of pocket and Summa charges $199. Western Reserve Hospital does not offer the test at this time.)
Q: How do I schedule it and do I have to go to Cleveland?
A: You can get more information at www.tinyurl.com/UHCalciumscore or call 877-604-6371 once your doctor has agreed to order the test to schedule. It is available for free to any patents who have an order from their physician, regardless of whether the patient or physician is affiliated with UH.
You will need to register with UH. You can also get an invitation to your email to sign up for UH's electronic records portal to get your results, which will also be sent to your doctor.
There are several locations in the Akron region, including Fairlawn, Twinsburg, Medina and Ravenna.
Betty Lin-Fisher can be reached at 330-996-3724 or firstname.lastname@example.org. Follow her @blinfisherABJ on Twitter or www.facebook.com/BettyLinFisherABJ and see all her stories at www.ohio.com/topics/linfisher