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The Killer in You

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Heart disease takes more lives than the flu, but the good news is that you can prevent it

The year 1918 was a bad one in American history. It was the year of a horrific influenza pandemic that killed millions, which made 1918 also notable in that it is the only year in more than a century in which heart disease was not the number one cause of death in the United States. So while a recent strain of influenza, the H1N1 virus (also known as the swine flu), remains a cause for concern, the attention it has received seems outsized in proportion to the consistent, much more pervasive public health problem of heart disease.

“When most people talk about heart disease, they’re thinking of atherosclerosis. That’s the buildup of fats in the arteries called plaque. It’s what leads to heart attacks and often to strokes,” says Dr. Richard Milani, the vice chairman of the Department of Cardiology at Ochsner Health System. “There are other types of heart disease, but that’s the most common. It’s what’s killing the most people.”

For a refresher on biology, the heart’s sole function is to pump blood around the body. If the heart’s the pump, then the arteries are the tubes. When plaque accumulates in the insides of the arteries, the passages become narrower. Heart attacks occur when a passage supplying blood to the heart muscle itself becomes blocked, and a stroke occurs when plaque clogs up the passageways providing blood to areas of the brain.

According to Dr. Milani, key warning signs can let you know that a heart attack may be imminent. “An unexplained shortness of breath is an important warning sign,” he says. “You might also experience discomfort or pain in the chest or upper belly. These symptoms typically come with exertion and are relieved with rest. If someone is experiencing these pains and they’re ongoing, it’s not indigestion. Pay attention to it, and get it checked out quickly.”

Certain risk factors increase an individual’s likelihood of heart disease, including diabetes, smoking, high blood pressure and a history of heart disease in the family. A patient’s cholesterol profile is an important factor, too. A risky cholesterol profile means that a person has too much bad cholesterol and not enough good cholesterol. The bad cholesterol results from a diet high in saturated fats and trans fats. Meanwhile, the good cholesterol, called HDL, isn’t strongly linked to diet but instead to exercise and weight. Exercise and a weight-loss program will raise HDL levels, while smoking will lower them.

“We recommend the consumption of good fats, found in fish and seafoods and the use of olive and canola oils in cooking,” says Dr. Milani. “A heart-healthy diet doesn’t mean eliminating meat altogether, but it should include fruits or vegetables with every meal.”

While New Orleans is not known for its healthy lifestyle, Dr. Milani swears our famous cuisine lends itself to a healthy diet if you want it to.

“There’s a million good things to eat in New Orleans. We have so many fresh, local foods. You don’t have to eat the bad things,” he says. “When I go to a restaurant, I usually get the fish of day, and tons of good vegetables come with it. I don’t go away unhappy, I’ll tell you that.”

Indeed, Dr. Milani practices what he preaches. “Everyone wants to eat at our house, even all my kids’ friends. And if my kids are at someone’s house where something unhealthy is being served, they’ll wait until they come home to eat.” He adds, “Eating healthy is only hard if it doesn’t taste good. But everything we recommend tastes good.”

America’s problem with obesity hasn’t gone away, and obesity is a risk factor in heart disease, but Dr. Milani sees some encouraging trends nationwide. Many Americans are paying more attention to their diet than they used to, while at the same time people are smoking less. On the flip side, the baby boomer generation is aging, which portends an increase in heart disease.

“You don’t have to die of a heart attack. It’s not a natural process of aging,” Dr. Milani says. “The issue is that when people have more years for plaque to build up in their arteries, it starts to catch up with them when they’re older. But you can be 90 years old with clean arteries.”

The crux of the matter is that, as deadly as it is, heart disease is preventable. February is American Heart Month, as designated by a congressional code since 1963, and a number of public activities are happening in the New Orleans area to raise awareness about heart disease and to help nip it in the bud.