Your Health

Matters of the heart

What you need to know to reduce your risk for cardiac illness.

Winnipeg Health Region
Wave, Summer 2011

Dr. Davinder Jassal is a cardiologist and researcher with the Winnipeg Health Region's Cardiac Sciences program at St. Boniface Hospital. In addition to treating patients, Jassal also conducts heart-related research designed to enhance care for cardiac patients. He recently took time out to talk about heart issues with Wave.

Is heart disease a big problem in Manitoba?

Yes. Heart disease is the leading cause of morbidity and mortality in Manitoba. Every seven minutes in Canada, someone dies of a heart attack or a stroke. The Winnipeg Health Region's Cardiac Sciences Program at St. Boniface Hospital sees about 50,000 people a year for heart-related issues.

What is heart disease? How many types are there?

Cardiovascular disease is a class of diseases that involve the heart and/or blood vessels. Heart disease can involve the coronary arteries (heart attack), the cardiac pump (heart failure), the valves (heart murmurs), the pericardium (fluid around the heart), and the electrical system (pacemakers and defibrillators). Blood vessel disease can involve the carotid arteries (TIA and stroke) and the lower extremities.

Does heart disease have a root cause?

Although heart disease can manifest itself in different ways, it usually stems from one basic problem - a narrowing of the arteries, which in turn restricts the flow of blood to the heart.

Who is at risk for developing heart disease?

While heart disease can strike anyone at any age, it tends to be more prevalent in older, sedentary smokers who may also have other health issues, such as high blood pressure, diabetes, high cholesterol or stress.

What are the symptoms of heart disease?

For heart attacks, symptoms include chest/ jaw pain, shortness of breath, nausea, vomiting, and sweating. For heart failure, symptoms include shortness of breath and leg swelling. For stroke, symptoms include slurred speech, paralysis or numbness of face/arm/leg, dizziness and loss of vision.

How much heart disease is attributable to lifestyle and how much to genetics?

This is a difficult question to answer. Heart disease can be caused by many factors, including genetics (family history of premature coronary artery disease) and lifestyle issues (diabetes, high blood pressure, high cholesterol, and smoking). Many people with heart disease will have both lifestyle and genetic risks factors.

What I can say for sure is that there is an increase in the number of patients with heart disease in their 30s and 40s. Many of these patients have a history of heart disease in their families. But I think it's also fair to say that in many cases, the risk factor for these patients has been increased because they also smoke, eat the wrong foods and aren't as active as they should be. Put another way, if you have a family history of heart disease, chances are you can reduce your risk - or at least postpone the onset of heart disease - by eating a balanced diet, exercising regularly and not smoking. The odds of reducing your risk are even better if you do all these things and have no family history of heart disease.

I have an older friend who works in an office and doesn't get much exercise during the winter. But come summer, he is out playing tennis for an hour at a time, twice a week. Is this good for his heart?

Let me answer your question this way. Cardiologists in Winnipeg know that a heavy snowfall generally results in a surge of emergency department visits from middle-aged males who experience chest pains after shovelling snow for an hour. So, yes, a "weekend warrior" who engages in strenuous activities without proper conditioning can experience heart problems such as a heart attack, especially if they are already a prime candidate for heart disease. What I like to tell people is that you should always condition yourself. Avoid the temptation to over-exert yourself playing tennis on the first warm day of spring, but take the steps to increase your conditioning so that you can play tennis safely all summer long.

You sometimes hear about high-performance athletes developing heart problems. Can you damage your heart by working out too much? What can a person do to make sure they get some exercise without straining their heart?

Good question. Here in the Winnipeg Health Region, we have been doing quite a bit of research on people participating in the Manitoba Marathon. What we have found is that with appropriate training, there is no permanent damage to the heart from strenuous physical activity, such as running. But again, the key is proper training.

Is it possible to reverse the effects of heart disease? If so, how?

Not really. Once you have a build-up of plaque in your arteries, chances are the best you can do is work to stabilize the condition. The same is true for people who have a heart attack. Once you have a heart attack, there is some damage to the heart muscle. Although we have developed a number of lifestyle and pharmacological methods to treat heart attacks, once they have occurred, there is no reversing the damage to the heart. That's why prevention is so important.

What can a person do to reduce their risk of developing heart disease?

A person can significantly reduce their risk of heart disease by simply taking care of themselves. Quitting smoking is huge. The Heart and Stroke Foundation, for example, points out that within one year of butting out, your risk of suffering a smoking-related heart attack is cut in half. Being active is also important. Exercise gets the blood flowing, which helps prevent plaque from forming in the arteries.

Adults should perform 150 minutes of vigorous-intensity aerobic physical activity per week, in bouts of 10 minutes or more. To maximize the benefits, physical activity should take place every day of the week. During the winter, I recommend indoor activities like swimming and walking in malls, or at the Reh-Fit Centre or Wellness Institute.

Healthy eating is one of the most important things you can do to improve your general health. Nutritious, balanced meals may reduce your risk of heart disease and stroke. By increasing your intake of heart-healthy nutrients, managing your weight, controlling your blood sugar levels and lowering your cholesterol, you can significantly decrease the rates of heart disease. And, of course, it is also important to keep stress levels low. If you take these steps, chances are you will reduce your risk of developing heart disease and won't have to worry about reversing its effects.

	About Wave Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books. Read the Summer 2011 issue of Wave