Heart attacks occur when plaque, which grows quietly in the wall of a coronary artery, suddenly becomes unstable. This causes a clot to form, which blocks blood flow. This happens to 1.5 million Americans every year, one-third of whom will die.

Most heart attacks can be prevented. How is this possible?

The short answer to prevention is to use a combination of sophisticated testing, medication, diet, exercise and stress management to turn known risk factors into non-risk factors. The list of risk factors that we can change is short.

It includes:

• High blood pressure (above 130/80)

• Smoking

• Diabetes (fasting blood sugar above 100, Hemoglobin A1c above 6.0)

• Abnormal lipids (cholesterol above 200, LDL above 100, HDL below 40, triglycerides above 150

• Overweight (body mass index above 30)

• Lack of regular exercise (less than 3 hours per week)

• Stress, which is not as easy to measure, but can do devastating damage.

There are several things you can do to reduce your risks.

They include:

Step 1 – Identify your risk factors

Step 2 – Do a complete battery of blood work checking cholesterol, LDL, HDL, triglycerides, glucose and in some individuals test Hemoglobin A1c, high sensitivity CRP, and advanced lipid testing.

Step 3 – Consider getting a calcium score. This is a CT scan that non-invasively lets you know if you have any plaque in your coronary arteries.

Step 4 – If you have any symptoms of coronary artery blockage (chest discomfort, shortness of breath, decrease in exercise capacity), you should have a stress test.

Step 5 – Create your plan for intervention.

In 1995, Edna Silva, RN, and I created a program called the Heart Series. Our mission statement is to decrease the incidence of heart disease in Tucson. Participants, who have already had a heart attack, bypass, stent or those who have never had an event share the same goal of avoiding hospitalization and further interventions.

We meet weekly for 12 weeks, learning skills that are needed to create a comprehensive prevention plan. If you are interested learning more about the Heart Series, call Edna at 544-3720 or visit www.heartseries.org.

Charles Katzenberg, MD, practices preventive cardiology.

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