News is mixed regarding heart disease

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— For more than a century, cardiovascular disease has been the No. 1 killer of Americans. CVD is listed as the primary cause or contributing cause in 70 percent of all deaths in this country.

Cardiovascular diseases affect the heart and blood vessels. Included in the category are high blood pressure, coronary heart disease (blockage of coronary arteries), myocardial infarction (heart attack), angina pectoris, congestive heart failure (weakened heart muscle, primarily from coronary heart disease), stroke and congenital cardiovascular defects (birth defects of the heart).

Unfortunately, coronary heart disease has been provided with fertile ground to grow. The biggest boost to coronary disease came with the spread of cigarette smoking among the armed forces during World War II. Tobacco, compounded by ever-decreasing levels of physical activity and ever-increasing amounts of saturated fats and calories in our diet, has led to a coronary-prone population.

If you read medical news there is a lot of upbeat information related to CVD. The bigger picture is not as clearly optimistic.

The improved survival of coronary patients would be more admirable if we were curing or preventing coronary disease. Actually, the decrease in coronary deaths is due primarily to improved critical hospital care, heart surgery and drugs.

There is both optimism and concern about the future. Research on gene therapy, new drugs and new surgeries is promising. Because coronary disease is now the leading cause of death in every industrialized country in the world and many of the developing countries, there is a worldwide effort through the World Health Organization to combat it. There is universal agreement that the most effective approach to both the treatment and prevention of heart disease is eat right, exercise and don't smoke.

Starting with the Surgeon General's first report on the harmful effects of smoking in 1964, there has been a dramatic decrease in cigarette smoking by adult males. Along with this positive change there has been a major decrease in males dying of heart disease and lung cancer.

Unfortunately, females have "come a long way, baby" and have almost closed the gender gap with males when it comes to smoking cigarettes. Females have now passed males in coronary heart disease death rates. The most recent 2001 unpublished mortality data from the Centers for Disease Control shows a drop in life expectancy for females and a gain in for males. While this combined change only amounts to about three months of life, it is an unprecedented change in historical trends.

These trends are even more disturbing when you consider teen smoking is at its highest level since 1970 and the highest level ever for young females. With youth obesity also at its highest level in recorded history, there is a great deal of public health concern about the future incidence of cardiac disease, diabetes, high blood pressure and other related conditions.

Individuals can do six important things to prevent cardiovascular disease.

First, don't smoke. Next, do mild to moderate aerobic exercise such as walking, cycling, jogging or cross-country skiing for a minimum of 30 minutes, four days per week.

Eat less total and saturated fat. Decrease higher-fat dairy products such as milk with more than 1 percent fat, cheese, ice cream and sour cream. Also limit red meat to two days per week.

Get your cholesterol checked and make sure your numbers are within the national guidelines. Check with your health care provider to determine your safe level because the guidelines vary depending on other risk factors. Follow dietary and exercise recommendations and start medication if indicated.

Get your blood pressure checked. If it is elevated, get on a program of lifestyle modification and medication if indicated. Finally, decrease your stress level.

Dan Smilkstein, M.D., is a family practice physician at Steamboat Medical Group and is Yampa Valley Medical Center's director of community education and health promotion.

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