Despite great advances in prevention and treatment, heart disease is still the leading cause of death in the United States, according to the American Heart Association. Early detection and a heart-healthy lifestyle are key to avoiding a heart attack or stroke.
Nicholas Phreaner, MD, is a board-certified cardiologist who serves as medical director of the cardiology clinics at UC San Diego Health. He specializes in treating and preventing general cardiovascular conditions, such as atherosclerotic heart disease, congestive heart failure and irregular heartbeat (arrhythmia). We asked him to share insights about detecting and preventing heart disease.
What are the early warning signs of heart disease?
Talk to your doctor if you're walking or exerting yourself and just don't feel like you can do the things you used to do, or if you're getting breathless and have tightness or discomfort in the chest. These can happen well before a heart attack or other heart problems occur. If you notice these signs in a family member, a child or an elderly parent, encourage them to be evaluated by their doctor.
Can heart disease in women present differently than in men?
Yes, heart disease can have different signs in women than in men. Often, it's not the typical feeling of an elephant sitting on your chest that signals a heart attack. It can be sharp pain, discomfort or tightness that occurs in the jaw or shoulder and not just in the chest itself.
What role does family history play in heart disease prevention?
Heart disease can run in families, so it's important to talk to your parents and any siblings to understand what you may be at risk for. The good thing is we can intervene well before it becomes a problem. If your grandparents or parents had heart disease, it doesn't necessarily mean you will develop it in your lifetime.
We can get aggressive about treating high cholesterol or high blood pressure and improving your lifestyle to prevent heart disease. We now know so much more about heart disease, genetics and medical therapy as well. Getting checked out early and started on treatment as needed can prevent a lot of heart problems down the road.
What tests can detect heart disease or measure heart health?
We have many good tools these days, including blood tests for cholesterol and monitoring to control blood pressure. And if you’re at risk for heart disease, there’s a really good test called a coronary calcium score. This test can check your heart and detect plaque well before it causes a major blockage or a heart attack.
If your cholesterol or blood pressure readings are borderline and you’re debating whether to start medicine for it, ask your doctor about a calcium score. This test is done here at UC San Diego Health (check to see if your insurance covers it) to help assess your heart health and see how aggressively we need to move forward to help prevent problems like a heart attack or stroke.
What lifestyle changes can be made to prevent heart disease?
A lot of the key lifestyle changes we can make revolve around the foods we eat and how active we are. It's so important to stay active in our lives, and this can really be anything that you enjoy because then you'll do it more often. This could be walking at a park with a friend, taking a dance class, surfing or playing a sport, but you really need to try to raise your heart rate. Aim to exercise at moderate intensity for about 30 minutes most days of the week.
It’s also important to eat healthy, nutritious foods that are prepared at home and are not processed. Eat lots of fruits and vegetables, and cut down on alcohol or tobacco products. These lifestyle changes are key to heart health over a lifetime. It's really a good idea to develop these habits earlier in life so they become part of your routine.
Leading the Way in Heart Care
As an academic medical center, we're researching new ways to improve your cardiovascular care at UC San Diego Health. No matter how common or rare your condition is, you'll have access to highly trained doctors with the experience to treat it.