Fighting Back

Louisiana ranks among the worst states for heart-related deaths. A look at what local hospitals are doing — and what you can do — to change that.

February not only falls during the time of year where everyone is battling to keep their resolutions, it is also National Heart Awareness Month, making this the perfect time to take a serious look at lifestyle choices and make changes, big and small, that can lead to a lifetime of heart health.

According to the American Heart Association, heart disease is the leading cause of death for men and women in the United States, and stroke is the fifth-leading cause of death in the country. This month is set aside to raise awareness about heart disease and education about prevention and the dangers of heart disease to everyone.

Every year one in four deaths is caused by heart disease; the most common type of heart disease is coronary heart disease, which often presents as a heart attack. Americans suffer 1.5 million heart attacks and strokes each year, and every day, 2,200 people die from cardiovascular diseases—that’s nearly 800,000 Americans each year, or one in every three deaths.

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While 40 years ago, people living in the northern part of the country had the highest rates of death from heart disease, that title has now moved south..

The percentage of counties with the highest heart-disease mortality fell in the North (from 48 to 4 percent) and the Midwest (from 17 to 6 percent), but increased in the South (from 24 to 38 percent). Counties with the slowest declines in heart-disease mortality (9.2 to 49.6 percent) were mainly in the Alabama, Mississippi, Louisiana, Arkansas, Oklahoma and parts of Texas. Counties with the fastest declines (64.1 to 83.4 percent) were largely in the northern part of the United States, as well as Florida and South Carolina.

In Louisiana, heart disease ranked as the one of the top three causes of death in 2013 according to the Department of Health and Hospitals and the CDC, who reported that 193,000 people died in Louisiana due to heart disease in 2013.

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“Traditionally Louisiana ranks highest in the country when it comes to heart disease and heart-related deaths, and I think so much of this can be directly related to our culture and education,” says Dr. Paul Stahls, a cardiologist at St. Tammany Parish Hospital. “As of 2012, the state ranked fifth in the country for heart disease. That is better, but we have a long way to go to achieve heart health in our state. Our culture is such that it revolves around food, good food, and eating and drinking. You can’t help but have a good time here. But, we are now seeing a trend that people are not smoking as much in the metro areas as compared to years past. Unfortunately, that trend is not carrying over to the more rural areas.”

With heart disease being such a concern in Louisiana, New Orleans and the surrounding area is lucky to have some of the top heart facilities in the country in a close proximity. These facilities are pioneers in their fields, developing innovative treatments to improve healthcare as well as prevention protocols designed to educate the community about how to live a healthy lifestyle.

“More than 5.7 million people live with heart failure in America,” says Dr. Sapna Desai, advanced heart failure cardiologist at Ochsner Health Systems. “In the early stages, the disease can be managed with a combination of medication and a healthier lifestyle. As time progresses, however, treatment becomes more complex. Patients from around the world have sought care from the nationally renowned team at Ochsner. Here, in the largest program for advanced heart failure treatment in the Gulf South, patients receive the latest treatment options and personal care.”

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Last year, Ochsner implanted the first HeartMate3 device in the Gulf South region. This new advancement is a mechanical circulatory support that is under clinical trial at the John Ochsner Heart and Vascular Institute (JOHVI). From Louisiana to Tampa, JOHVI, is the only provider to offer and perform the HeartMate3 implant and one of only 25 centers in the country actively participating in the Momentum 3 trial.

“The HeartMate3 is an implantable mechanical device that helps circulate blood throughout the body,” Desai says. “Sometimes called a heart pump, the device is designed to supplement the pumping function of the heart for patients too weak to pump blood adequately on their own. The HeartMate3 also enhances the ease of surgical placement due to its compact size. We are the only center in the state that is working with this device. To date, we have 13 patients utilizing the HeartMate3’s innovative technology.”

 



Last year Ochsner implanted the first HeartMate3 — a mechanical circulatory support — in the Gulf South Region. The technology is under clinical trial at the John Ochsner Heart and Vascular Institute (JOHVI).


Desai says the type of patient that would benefit from the HeartMate3 runs the gamut, from someone who is short of breath to an ICU patient. “This machine can drastically improve a patient’s quality of life and can serve as a bridge to a heart transplant or as a way to regain an active lifestyle,” Desai adds. “It is a benefit to have a hospital in our backyard with this type of technology available for patients. It is so much easier for patients — they don’t have to travel out of state and incur the extra costs. It makes such a big difference.”

The ability to monitor patients for heart failure and arrhythmia has also made great strides in recent years. “Pacemakers have come such a long way,” Stahls says. “In the past, once a pacemaker was inserted a patient could not get an MRI, but new advancements in pacemakers have made it so that patients now have the freedom to have an MRI if needed. They are no longer restricted. Also, there have been advances in the ability to open chronically occluded blood vessels that would traditionally require a bypass surgery. New techniques allow doctors to retrograde from another vessel to open a clogged spot. The patient bypasses open-heart surgery altogether. These techniques are constantly evolving as technology advances.”

Touro is also offering new and innovative diagnostics and treatments including cardiac imaging tests such as echocardiography, nuclear imaging and cardiac CT, which can be used to evaluate various cardiac conditions.

“Early screening for heart disease and risk factors is very important in identifying common heart conditions to help lower the risk of developing heart disease or having a heart attack,” Falco says. “Coronary artery disease and heart failure are two common heart problems in the general population. Years ago, no one worried about heart disease before the age of 50 or 60, and although it is still more common in older age groups, much younger people are also at risk. Coronary artery disease is not uncommonly seen in 30-year-olds. Heart failure, depending on the underlying problem leading to this problem, can be seen in even younger patients. You are never too young to start paying attention to your heart health.”

The Centers for Disease Control state that together, heart disease and stroke, along with other cardiovascular disease, are among the most widespread and costly health problems facing the nation today, accounting for approximately $320 billion in health care expenditures and related expenses annually. Fortunately, they are also among the most preventable.

“In order to improve heart health, people need to be aware that heart disease is a real threat to both men and women, says Dr. Viviana Falco, a cardiologist at Touro Crescent City Cardiovascular Associates. “Many women perceive heart disease as something that only affects men, but everyone needs to recognize the risk factors for heart disease, which include smoking, diabetes, high cholesterol and high blood pressure, in addition to family history.” Touro hosts several events over the year to assist in these efforts, including heart health seminars and screenings for blood pressure and cholesterol. “Once there is an understanding of what puts someone at risk for heart disease, then you can work at lowering your risk,” Falco says.

High blood pressure, high LDL cholesterol, and smoking are key risk factors for heart disease. About half of Americans (49 percent) have at least one of these three risk factors. Several other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including: diabetes, overweight and obesity, poor diet, physical inactivity and excessive alcohol use.

“It is so important to maintain a healthy lifestyle in order to keep your heart healthy, Stahls says. “We all already know the way to do that —watch your diet and where your calories are coming from, be active and eat those high protein foods. It is so easy to not eat healthy, especially in South Louisiana, but just eating healthy 80 to 85 percent of the time is achievable and you can splurge the other 15 to 20 percent of the time if you have to and not feel like you are missing out. Set realistic goals so that you can achieve them – your life could depend on it. Think of food as good medicine and keep it simple.”

 “The American Heart Association recommends exercising five to seven days a week,” Stahls says. “The exercise can be something as easy as taking a walk, but the key is to elevate your heart rate for at least 30 minutes to get the most cardiovascular benefit. It is also paramount that you lose any excess weight you may be carrying around. Extra weight puts strain on your heart: It has to work even harder than it should when you are overweight. Also, no one knows for sure if they are genetically predisposed to heart disease, so I would recommend to prepare for the worst and don’t take any chances — go ahead and take the necessary precautions by eating healthy and exercising, and by all means stop smoking.”
 


Heart Healthy Habits

High cholesterol, high blood pressure, obesity, diabetes, tobacco use, unhealthy diet, physical inactivity and secondhand smoke are all risk factors associated with heart disease.

The good news is that heart disease can often be prevented by making healthy choices and managing existing health conditions. Good habits according to the American Heart Association include:

• Select fat-free, 1% fat and low-fat dairy products.

• Use spices to season food instead of salt.

• Choose heart-healthy fats over saturated fats and trans fats.

• Cut back on beverages and foods with added sugars.

• Purchase and consume foods lower in sodium/salt.

• Limit foods that are high in dietary cholesterol. Try to eat less than 300 mg of cholesterol each day.

• Choose more whole grains, legumes, fresh produce and low-fat dairy products.

• Choose lean meat and poultry.

• Include fish in your diet.

• Lose weight if you are overweight.

• Practice portion control at all meals.

• Become physically active for 30 to 60 minutes a day.

• Manage stress.

• Control your cholesterol and blood pressure.

• Stop smoking.

• Drink alcohol in moderation.

 


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