HEART HEALTH

In honour of Valentine’s Day and February being “Heart Health Month”, we thought it was a great time to review some basic information on how we can all improve our cardiac health.  What better gift could you possibly give those who care about you than your own good health?

Cardiovascular disease refers to a disease process that effects the circulatory system which includes the heart and blood vessels; the blood vessels may affect the lungs, brain, kidneys or other vital parts of the body. Cardiovascular disease is the leading cause of death in adult men and women according to the Public Health Agency of Canada and the American Heart Association.

FACTS

There are six major types of cardiovascular disease, these include:

Peripheral vascular disease: PVD is a condition of the blood vessels that leads to narrowing and hardening of the arteries that supply the legs and feet.  The narrowing of the blood vessels leads to decreased blood flow, which can injure nerves and other tissues. 

Congenital heart disease: CHD occurs at birth; a congenital heart defect happens when the heart or the blood vessels near the heart don't develop normally before birth.

Ischemic heart disease: IHD develops when cholesterol accumulates on the walls of the arteries that supply blood to the heart. Eventually, deposits called plaques may form. These deposits narrow the arteries and eventually block the flow of blood; this decrease in blood flow reduces the amount of oxygen supplied to the heart muscle and leads to recurring chest pain or discomfort. 

Cerebrovascular disease: CVD refers to a group of conditions that affect the circulation of blood to the brain, causing limited or no blood flow to affected areas of the brain.  Atherosclerosis is one of the conditions that can cause CVD. During this process, high cholesterol levels coupled with inflammation in areas of the arteries in the brain can cause the cholesterol to build up in the vessel in the form of a thick, waxy plaque. This plaque can limit, or completely obstruct, blood flow to the brain, causing a stroke (CVA), transient ischemic attacks (TIA), or dementia, which may lead to a variety of other health complications.

Heart failure: (CHF) occurs when the heart isn't able to pump blood normally. As a result, there is not enough blood flow to provide the body's organs with oxygen and nutrients. The term "heart failure" does not mean that the heart stops beating completely, but that the heart is not working efficiently.

Rheumatic heart disease: (RHD) refers to the chronic heart valve damage that can occur after a person has had an episode of acute rheumatic fever. This valve damage can eventually lead to heart failure. Rheumatic heart disease affects children and young people living in conditions of poverty, poor sanitation and overcrowding. Practically eliminated in wealthy countries, it is still common in Africa, Asia and the Pacific.

PREVENTION

Your best defense is controlling the risk factors that could lead to PVD, IHD, CVD & CHF heart disease, such as high blood pressure, high cholesterol, diabetes, smoking, chronic stress, excessive alcohol consumption, physical inactivity and being overweight.  Lifestyle changes are the most practical way to reduce the risk factors and the sooner these changes are made, the better. You will also benefit from vitamin supplements including antioxidants and vitamins C & E.

Congenital heart defects generally cannot be prevented, but before and during pregnancy you can lower your risk of having a baby with heart defects.  If you are thinking of becoming pregnant and you or your partner has a congenital heart defect, ask your doctor about genetic counseling, this may help you find out if you have an increased chance of having a child with a heart defect.

The best way to deal with rheumatic heart disease is to prevent it. Aggressive treatment of strep throat (with antibiotics) and of rheumatic fever (should it occur) can help to limit rheumatic heart disease.

TESTING

The best way to identify heart disease is to have regular physicals with your family physician; be sure to keep notes of any symptoms you my experience and share them promptly with your doctor.

In the past, the most accurate test to measure atherosclerosis was angiography. Today, non-invasive imaging techniques like CT Scans and carotid ultrasounds are available to measure the health of the arterial wall and even determine the stability of the plaque deposits on the inside of the artery. Although these tests are most often used to diagnose existing strokes, they are also highly effective screening tools.

Heart failure is usually diagnosed if a test shows that the heart is not pumping as well as it should; this is called a decreased ejection fraction. Tests used to measure ejection fraction include: Echocardiogram; Gated SPECT; MRI of heart; Ventriculogram or cardiac blood pooling imaging.

Ankle-brachial index (ABI) is a common test used to diagnose PVD, it compares the blood pressure in your ankle with the blood pressure in your arm. Special ultrasound imaging techniques, such as Doppler ultrasound, can help your doctor evaluate blood flow through your blood vessels and identify blocked or narrowed arteries.

FUN ADVICE

This Valentine’s Day, do something good for your heartthrob and your heart. “Your relationships can affect your overall health, especially your cardiac health,” says Dr. Sameet Kumar, a clinical psychologist with Memorial Health Care System. So treat your Valentine right. Make dinner reservations. Take a romantic stroll. Toast yourselves with a glass of wine. And don’t forget to give that heart-shaped box of dark chocolates to the one you love. Such activities are not only good for your relationship, but they also may be good for your heart, says Dr. Melissa Tracy, medical director of the University of Miami Cardiac Rehabilitation Program.

"A torn jacket is soon mended; but hard words bruise the heart of a child". Henry Wadsworth Longfellow

Excerpts from:

www.heartandstroke.com

www.ncbi.nlm.nih.gov/pubmedhealth

www.phac-aspc.gc.ca/cd-mc/cvd-mcv/cvd-mcv-eng.php

GLAUCOMA AWARENESS

January is also “Glaucoma Awareness Month” so we will dedicate this Blog on the sight-stealing disease in an effort to spread the word.  Glaucoma is a group of eye diseases that gradually steal sight without warning. Although the most common forms primarily affect the middle-aged and the elderly, it can affect people of all ages.  

There are two main types: Primary Open-Angle Glaucoma (POAG) which accounts for about 90% of all Glaucoma cases and has no symptoms, and Angle-Closure Glaucoma where the angle of the canal is blocked by part of the Iris. Less common forms include congenital (from birth) and pigmentary, as well as secondary Glaucoma which can develop when another disease like Diabetes causes or contributes to increased eye pressure, resulting in optic nerve damage and vision loss.

FACTS

Glaucoma remains the LEADING CAUSE OF PREVENTIBLE BLINDNESS with at least 300,000 Canadians affected by this disease - 50% are not even aware they have it!  The CNIB states that blindness costs Canadians over $1 Billion per year.

Glaucoma can develop in one or both eyes.

Not every person with increased eye pressure will develop Glaucoma; some people can tolerate higher levels of eye pressure better than others.

Glaucoma can develop without increased eye pressure; it’s called low-tension or normal-tension Glaucoma.

RISKS

There are some conditions which can increase your risk to develop Glaucoma, these include:

·         A close family member with Glaucoma

·         High Blood Pressure

·         Diabetes

·         People of African or Hispanic decent

·         People over 60

·         High myopia (nearsightedness)

·         Thinness of the cornea

·         Abnormal optic nerve anatomy

·         Steroid use

·         Blunt trauma injury to the eye (often from Baseball or Boxing)

*Please Note: the conditions listed above are only conditions that MAY put you at increased risk to develop Glaucoma, these in no way mean that you will develop any eye health issues. We share this information in an effort to increase the general public’s awareness and knowledge about risks to our health.  If you already have one of the conditions listed above then you’ll want to be sure to have regular eye health exams to identify any eyesight issues as early as possible.

TESTING

There are several ways to test for glaucoma; diagnosis requires a comprehensive examination by a qualified Optometrist or Ophthalmologist.

Glaucoma testing may involve:

o   Measure the pressure inside the eye [“IOP” = IntraOcular Pressure] (Tonometry)

o   Dilated eye exam (Ophthalmoscopy)

o   Visual field test (Perimetry)

o   Measure the thickness of the Cornea (Pachymetry)

o   Viewing where the Iris and Cornea meet (Gonioscopy)

Currently there is no national standard for vision screening of pre-school children across Canada. A British Columbia report that looked at vision screening programs found that only six of 9 provinces administered provincial mass screening programs (Gale and Micco, 1993).

TREATMENT

The keys to managing this disease are early diagnosis, proper treatment and regular eye exams. Although there is no cure for glaucoma, yet, medications and surgery can help you live with the disease and slow its progress. Some forms respond well to Laser treatment, and others can be managed with oral medication and/or eye drops.  Acute, chronic, congenital, and secondary Glaucoma can all be treated successfully with microsurgery.

The appropriate treatment depends upon the type of Glaucoma among other factors, but early detection is vital to slow the progress of the disease.  Without treatment, you will slowly lose your peripheral vision. If the disease remains untreated, you may miss objects to the side and out of the corner of your eye; it’ll seem like you’re looking through a tunnel (known as ‘tunnel vision’).

Treatments may save remaining vision but they do not improve sight already lost from glaucoma.

Before beginning any Glaucoma treatment, tell your eye care professional about any other medicines or supplements that you are taking. Sometimes the drops can interfere with the way other medicines work.

PREVENTION

A recent report suggests that certain wavelengths of light could be bad for the optic nerve. This hasn’t been proven yet but it would be wise to wear sunglasses and a hat on very bright days.

Moderate physical exercise over a 15-year period was associated with a 25% reduced risk to develop Glaucoma; Yoga can be beneficial, but avoid inverted positions such as headstands and shoulder-stands, as these may increase IOP.

A well-balanced diet is also associated with a lower incidence of eye disease; as your Insulin levels rise, it causes your blood pressure, and possibly also your eye pressure, to increase. 

Avoid wearing contact lenses for prolonged periods or straining your eyes by reading too much in low light.

Wear protective eyewear when participating in sports or home improvement projects.

Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness; it is the second leading cause of blindness around the world but with early detection and treatment, you can often protect your eyes against serious vision loss. Have regular eye exams that include testing for Glaucoma: every 2-4 years up to age 45; every 1-2 years age 45-65; and every 6-12 months after age 65. *Anyone with high risk factors should be tested every year or two after age 35.

“No matter how dark things seem to be or actually are, raise your sights and see the possibilities – always see them, for they're always there.” Norman Vincent Peale

Excerpts from:

www.glaucoma.org

www.visionhealth.ca

www.glaucomaresearch.ca

ALZHEIMER AWARENESS

ALZHEIMER AWARENESS

January is ‘Alzheimer Awareness Month’ in Canada so I thought it would be appropriate to focus our first blog of the New Year on Alzheimer’s as it is a disease which has many myths and misconceptions associated with it. Like anything, knowledge is power so it behooves us to learn the facts.

Myths:

o   Alzheimer’s is just a normal part of the aging process; if all of us lived to be 90 or 100 years old, would we all eventually get it.

o   Only old people get Alzheimer’s.

o   If someone in your family has dementia then you’ll get it too.

o   There is nothing you can do once you’re diagnosed with Alzheimer’s.

Facts:

o   Dementia is NOT caused by exposure to aluminum, aspartame, flu shots or tooth filings.

o   A diet like the Mediterranean diet seems to have a protective effect and a diet that has a lot of saturated fat and sugar seems to place you at greater risk.  Diets low in saturated fat and simple carbohydrates might be protective against Alzheimer's disease and improve brain health.

o   People who eat baked or broiled fish every week may reduce their risk of developing mild cognitive impairment and Alzheimer's disease.

o   Survivors of cancer, particularly non-skin cancers, appear to have a reduced risk for Alzheimer's disease.

o   Right now, over 500,000 Canadians have Alzheimer's disease or other dementia.

Although ageing can lead to some mild memory loss, we all get to the store and forget what we went there to buy, or forget where we left the car keys, but ‘senility’ or ‘dementia’ is NOT a normal part of ageing.  Recognising the symptoms and reporting them to our physician can help lead to early diagnosis and treatment.  A recent Canadian study found that almost half of the patients recently diagnosed with Alzheimer’s lived with the symptoms for more than a year before they reported them, sadly this led to delayed treatment and support.

10 Warning Signs of Dementia:

·         Memory loss that affects normal daily activities.

·         Disorientation to person, place or time.

·         Altered mood or behaviour.

·         Difficulty performing familiar tasks.

·         Impaired judgment.

·         Personality changes.

·         Challenges with language.

·         Loss of initiative – loss of interest in activities.

·         Difficulties with abstract thinking.

·         Putting things in inappropriate places (e.g. BlackBerry in the Microwave).

Falls in older adults who are otherwise physically and cognitively healthy might also be an early sign of Alzheimer's disease, according to research presented at the Alzheimer's Association International Conference 2011  (July 17, 2011 | Paris, France).  

"The results of our study indicate the importance of understanding not only the cognitive impairments associated with Alzheimer's disease, but also the motor changes that appear to come before the cognitive changes.  I study falls in older adults, and we know that the fall rate among older adults who have Alzheimer's disease is much higher than in adults who do not" said Dr. Susan Stark, PhD, from Washington University, St. Louis, Missouri.

The Importance of Early Diagnosis:

Other medical conditions can have symptoms similar to dementia and many are treatable; these include vitamin and thyroid deficiencies, infections, constipation, brain tumours, depression, drug interactions or substance abuse.

It is particularly important to identify the type of dementia. Medications are already available to treat some people with Alzheimer's disease, and some people with Lewy body dementia, but those drugs are ineffective in the treatment of Pick's disease (another form of dementia), and may actually worsen its symptoms.

While there have been significant advances in diagnostic testing methods for Alzheimer’s that use brain scans and spinal taps that can detect specific biomarkers of the disease even in its pre-clinical stage, but currently there is still no single or definite test for Alzheimer's, it is diagnosed through a comprehensive assessment by a qualified physician. Diagnosis will include reviewing your complete medical history, mental function assessment, a neurological exam and blood tests (to rule out and possible treat other causes of dementia-like symptoms). If you, or someone you love, have concerns about memory loss or other possible symptoms of dementia, it is important to be evaluated by a physician – the sooner, the better.

Reducing the prevalence of lifestyle-based risk factors, including smoking and physical inactivity, by 25% could potentially prevent up to 3 million cases of Alzheimer's disease (AD) worldwide new research suggests. Presented at the Alzheimer's Association International Conference 2011 and simultaneously published online July 19 in Lancet Neurology, the study suggests, but doesn't prove, that up to 50% of AD cases are potentially attributable to 7 preventable risk factors. These include smoking, physical inactivity, midlife obesity, midlife hypertension, depression, diabetes, and cognitive inactivity.

Experiencing some memory loss does NOT mean you have dementia; talk to your doctor if you have any concerns and remember ‘Knowledge Is power’ so know the facts.

Excerpts from:

http://www.alz.org/

http://www.alzheimer.ca/

http://www.medscape.com/