HCN News & Notes

Baystate Preventive Cardiologist Details Ways to Lower Heart-disease Risk

SPRINGFIELD — Americans are losing the battle in preventing heart disease.

“In the past five years, we have seen a reversal of a nearly half-century decline in heart disease and stroke, which was a major burden in the 1950s, but began to steadily decline until about 2015,” said preventive cardiologist Dr. Quinn Pack of Baystate Medical Center’s Heart & Vascular Program.

So, what happened?

“In one word, obesity, which leads to diabetes, which leads to heart disease,” Pack said.

February is American Heart Month, a time to work closely with one’s primary-care physician to modify risk factors through lifestyle changes and, when those aren’t enough, by taking medications prescribed by a doctor to help control risks.

Lifestyle, age, family history, and pre-existing health conditions can increase one’s risk for heart disease. Nearly half of all Americans have at least one of three key risk factors for heart disease: high blood pressure, high cholesterol, and smoking.

While some risk factors for heart disease cannot be controlled, such as age and family history, other factors can be managed to lessen one’s chances of developing heart disease.

Dr. Pack noted there are six “big ones” to control on the way to adopting a healthy heart. First off, he is not a fan of smoking, and always addresses this bad habit first with patients.

“Smoking cessation may be hard, but is a more satisfying risk factor to treat because once you stop, unless you relapse, then that’s it — you’re done,” he said. “That’s different than diet and physical activity, which require effort every day of your life.”

There are also new factors to consider on the smoking front: vaping and marijuana.

“Last year, there were tragic reports of death and lung disease linked to vaping,” he said. “Several patients were hospitalized at Baystate; fortunately, none of them died. Scientists don’t have the answers yet, and may not for another 10 years, on how vaping might lead to lung and heart damage. As for e-cigarettes as a pathway to stop smoking and end your addiction to nicotine, I am not convinced that they are the solution.”

While he considers smoking to be “enemy number one,” Pack’s other five major risk factors to control include high cholesterol, uncontrolled blood-pressure problems, physical inactivity, obesity, and diabetes.

“The more risk factors you have, the greater your chance of developing coronary artery disease,” he noted. “But the good news is that 80% of heart disease is preventable. You can prevent or delay heart disease by beginning to turn your life around with healthy habits today.”

While hypertension or high blood pressure is most often associated with the risk of stroke, it is also a major risk factor for heart disease and heart failure.

“We now have years of discovery behind us in high blood pressure and cholesterol. There are also medications today that are effective and have minimal side effects. So there is no reason other than patient disengagement to not having your blood pressure or cholesterol under control,” said Pack, who noted that patients should talk with their primary-care doctor to learn if they fall under new guidelines for cholesterol lowering statins and hypertensive medications.

Meanwhile, physical activity is “the polypill of preventive cardiology,” he said. “If you exercise every day for at least 30 minutes, just like taking a medication every day, you will have substantial benefits by lowering your risk of heart disease and lowering your blood pressure and cholesterol.”

Meanwhile, he considers obesity and being overweight as “bad polypills.”

“Weight is a major risk factor for high blood pressure, high cholesterol, and diabetes,” he added. “It is also responsible for chronic obstructive sleep apnea, lower back pain, joint pain, and can lead to depression, a decrease in energy, and some cancers. We also know that those who are obese are at a much higher risk to develop cardiovascular disease, especially heart failure and coronary heart disease.”