Triglycerides any one? Signs of a heart attack waiting to happen and how to prevent it.

Image courtesy of freevector.com

It really isn't about hamburgers...  it's about all the contributing factors that lead to heart disease.

Ultimately, the question isn't whether to eat it, it's how much! When discussing heart disease, obesity plays perhaps the most important role.  If we as a society are used to ingesting 1,500 calories for lunch well... no wonder our country is pretty bad shape when discussing the causes and risk factors of heart disease! Do we REALLY need the extra butter on the bun?

In February, Dr. DeMaria’s presentation talked about the most common heart afflictions, the risk factors and the new technology being developed to diagnose, treat and, most importantly, prevent heart disease.

Today, 1.4 million people per year have a heart attack; 800,000 people have strokes.  As a matter of fact, he estimated that in the time it took us to eat lunch during his presentation (20 minutes), around 60 Americans had already lost their lives from heart disease.  The sad truth is that cardiovascular disease claims a victim in this country EVERY 30 SECONDS.

Even though questions remain about the onset of heart disease, what we know very well are the predisposing causes and risk factors.  What this means is that the likelihood of developing heart disease is going to increase depending on the predominance of one’s risk factors. Some of the risk factors are things we can control, while some we can’t modify; a family history of heart disease, gender or age being the three most relevant ones.

The factors we can control to avoid the likelihood of getting heart disease are very well known.  And once again, going back to basics:

Our cholesterol levels
Our blood pressure
Our triglycerides
Cigarette smoking
A poor  diet
Lack of exercise
• Diabetes
Obesity

Obesity is perhaps the most relevant factor for heart disease in the US today.  Most of the states reflect over 25% of obesity rates, and studies have shown every single state’s obesity rates have steadily increased over the past three decades. So has our risk for heart disease and stroke.   

Our behavior can and will make us ill. Period.  Modifying our behavior will result in the reduction of cardiovascular and stroke incidents to the tune of 70 to 75%, according to Dr. DeMaria.  Understanding the puzzle of LDL, HDL and triglycerides, and their functions in our body is one of the most important pieces of information we can have regarding our health. The more significant part of the equation is controlling the risk factors that ultimately have the potential for heart disease. 

Dr. DeMaria: “In Cardiology, we are always looking for the future”. The common sense things you can start doing today to delay the risk of heart disease, plus the most innovative trends you need to know about its treatment.

No, it wasn’t Star Trek.  It was actually Fantastic Voyage! A glimpse into the future of Cardiology Care. 

When you take a look at the research taking place today it sounds like the producers of Fantastic Voyage were in fact predicting the future of healthcare! 

Dr. DeMaria presented the latest innovations in cardiology, starting with the use of nano-bots smaller than the size of a vessel to shatter the plaque and re-establish and regulate the blood flow of our body.  For those of us there, it did remind us of "Fantastic Voyage"!

We have heard about the strides bioengineers are making in the field of medicine.  Back in 2015, Dr. Coleman discussed patient monitoring through tattoos at one of Howell’s luncheons. The use of sensors to monitor cardiac health is yet another technology currently being developed and tested that is aimed at preventing heart disease.  By analyzing the heart rate and rhythm, accurate treatment –including lifestyle changes—can have a positive effect in personalized medicine (vs. a one-treatment-fits-all approach).  The encouraging news is that it involves the patient directly in his or her care.   

Developing new applications to monitor a patient’s health has definitely taken off.  It will come to a point were one can place a finger on an electronic device such as an Apple watch, and in turn get an electrocardiogram to determine if there is a heart attack in process.   
Some more examples the future of cardiology that presented by Dr. DeMaria include: 
  • As we get older, our heart valves begin to deteriorate. In the past, the solution was limited to surgery.  Today, a heart valve can be replaced with percutaneous intervention without a single incision by inserting a catheter that extends and inserts the new heart valve. 
  • Imaging the heart from an ultrasound into a hologram is yet another technological advancement that allows cardiologists to pinpoint exactly what the patient needs in regards to his or her heart treatment
  • Stem cells have the ability to continuously reproduce.  Though extremely controversial, the notion of identifying the cells that are responsible for regenerating the dead muscle after a heart attack is on its way to becoming a reality; not only for the cardiovascular system, but for many organs in the human body as well.  Research is underway to “trick” the cell into thinking it’s an embryo cell and regenerating dead cells. 
  • Working with body tissue from animals (specifically from pigs), and inserting tissue to areas of the heart to regenerate dead muscle tissue is yet another research effort being conducted to date. 
  • Utilizing a patient's own cells to create an organ in a 3D printer from a specific individual, patient specification.  Dr. De Maria showed the latest research that took a removed aortic valve and compared it to the one made by bio-printing.   
  • Inserting heart pumps capable of circumventing the area of the damaged heart into the aorta most likely will become a reality 
  • Current bio-engineering efforts are leading to the development and manufacturing of mechanical hearts.
  • Artificial intelligence, or as Dr. DeMaria called it, machine learning by teaching computers to think and act based on repeated information from the patient, will expand ‘Computer Aided Diagnosis”

The take away. 

It is estimated that Heart Disease is costing the country around $315 billion dollars a year! You would think that by doing a series of life changes, one can mitigate the ever increasing costs of having heart disease.  

Even though immense strides have taken place to make our heart healthy, the future of medicine will be based on the person.  The new era of cardiology is being introduced and branded as ‘precision medicine’.  The notion that prescribing the same medication in the same dose to everyone is not working that well anymore. 
Precision medicine will depend on a personalized, genetically identified need. According to Dr. DeMaria,  “Medicine in the future will be focused on four ‘P's’:  It will be preventive, with new technology that will have the capacity to predict what disease somebody is susceptible (instead of waiting for the illness); It will be personalized based on a series of genetic background and participatory of the costs.  And so whether a patient’s needs are genetically identified or genomics, this is where medicine is going.” 

The future of cardiology is here...  literally, HERE:  Be There, San Diego! 

A program that is unique in the United States, the Be There San Diego movement is an initiative that brings together ALL of the medical institutions in San Diego County to try and eliminate the threat of heart disease and Stroke. 

Is it working?  ABSOLUTELY!  According to the research presented by Dr. DeMaria (who also Chairs the effort), over 4000 patients have been coached regularly to promote and provoke the required life changes to prevent heart disease and stroke.  In addition, the information of current research is currently being shared in benefit of the patient, and the efforts of the organization have reached so far 80% of their goals. 

A three-prong initiative, BE THERE SAN DIEGO if focused on: 
  • Addressing the risk factors responsible for heart attacks and strokes through education and engagement
  • Aggressively treating risk factors for heart attacks and strokes based on the use of evidence-based medicine and innovative clinical practices 
  • Sharing information to the medical setting to ensure each patient gets treated with the latest information on heart disease and stroke
Perhaps the most important aspect of the project  is the one concerning lifestyle changes to prevent heart disease: A healthy diet!  Do check it out! www.betheresandiego.org.

Still craving that hamburger?  Maybe... a salad? 

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About the Doris A. Howell Foundation: 

The Doris A. Howell Foundation for Women’s Health Research is dedicated to keeping to women we love healthy by making a long-term, positive impact on women’s health.  It is the premier organization advancing women’s health. 

The organization does so by funding scholarships to students researching issues affecting women’s health; providing a forum for medical experts, scientists, doctors, and researchers to convey timely information on topics relevant to women’s health, and by funding research initiatives that improve the health of under-served women and increase awareness and advocacy in the community; bringing women's health research to a full cycle. 

About Dr. Anthony DeMaria: 

DeMaria received his medical degree from Rutgers University, New Jersey College of Medicine and completed a medical residency at the United States Public Health Service Hospital in Staten Island, New York and cardiology fellowship training at the University of California, Davis.  He is the Judith and Jack White Chair in Cardiology and founding director of the Sulpizio Cardiovascular Center at UCSD.  He specializes in cardiac imaging techniques, particularly echocardiography. For 12 years, Dr. DeMaria served as Editor-in-Chief of the Journal of the American College of Cardiology (JACC). An author or co-author of over 700 articles in medical journals, Dr. DeMaria is also listed as one of the Best Heart Doctors in America.

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Summary prepared by Carolyn Northrup with information captured during DeMaria's presentation and information from the following sources: 
https://stateofobesity.org/adult-obesity/
www.betheresandiego.org

Image Courtesy of www.freevector.com



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