Heart disease and substance abuses.

Most people are surprised to learn that there are many similarities between heart disease and substance abuse. Heart disease develops due to both genetic and environmental factors. A genetic disposition to heart disease is based on one's family history of heart disease. Other risk factors that can't be changed include increasing age and gender. Four out of five people who die of coronary heart disease are 65 or older; men have a greater risk of a heart attack than women do, and they have attacks earlier in life. Yet there are a number of lifestyle changes that can be made to reduce the risk for heart disease such as stopping smoking, losing weight, exercising more, and taking prescribed medications. Stress and drinking too much alcohol can also contribute to increasing one's risk for heart disease.

Substance abuse, a generic term often used to describe addictive disorders, also develops due to both genetic and environmental factors. Children growing up in families where one parent has a substance abuse problem are four to five times more likely to develop a substance abuse problem than children in families without a family history of substance abuse.

Environmental factors can greatly contribute to developing substance abuse problems. Exposure to trauma, such as physical and sexual abuse, increases one's risk of developing a drug or alcohol problem. Having a psychiatric disorder increases one's risk. Having friends who use drugs is another obvious risk factor. Children, who smoke cigarettes and drink alcohol, particularly during early adolescence, are at greater risk of developing more serious alcohol problems and moving on to illicit drug use.

Much has been said about the beneficial aspects of drinking alcohol, particularly red wine, in reducing one's risk for heart disease. That may be true for people limiting themselves to one to two glasses of wine with dinner, but it is not true for people who drink heavily. One drink is defined as 12 ounces of beer or 5 ounces of wine or 1.5 ounces of liquor. Very often people have many more drinks than they realize. Filling a 16-ounce glass halfway with vodka is eight drinks, not one, no matter what mixer you use! People consuming five or more drinks a day are four times as likely to have a stroke than those who do not drink. Chronic alcohol abuse is the single most important cause of illness and death from liver disease. Sixty-five percent of pancreatitis cases are alcohol-related. Having 3 to 4 drinks per day increases your risk for hypertension 50% compared to nondrinkers, while consuming 6 to 7 drinks a day increases the risk by 100%. Stimulants, such as cocaine and methamphetamine, can also adversely affect the heart, by causing rapid and irregular heartbeats, heart attacks and strokes.

Both heart disease and substance abuse are chronic diseases. They can be treated and managed, but not cured.

Treatment for substance abuse and heart disease is similar in many respects. They both require significant lifestyle changes and a long-term commitment. A person with heart disease may need to change their diet, lose weight, stop smoking, exercise, see the doctor regularly, and take prescribed medications. Similarly, a person recovering from a substance abuse disorder may identify how to manage cravings to use, learn other ways of coping, address long-standing issues, take medications, attend treatment programs and/or self-help meetings and make new friends. Research shows that people with substance abuse problems have the best results if they can maintain these initial changes through involvement in treatment and recovery activities for nine to twelve months. Treatment for less than 90 days usually results in limited long-term gains. Lifestyle and habit changes take a long time to become a routine part of one's life. This is true for cardiac rehabilitation and substance abuse treatment.

While prevention is the best cure, it is important to realize that treatment is available and effective for both heart disease and substance abuse. People often wait too long to address both diseases, but it is never too late to make changes in one's life and lifestyle. The first step is to talk about the problem and make concrete plans to change. These lifestyle changes require the support of family, friends, and treatment professionals. These changes are not easy, but the consequences of doing nothing are dire, and may even result in death.

For further information about the contents of this article please, contact Ken Bachrach Ph.D., Clinical Director for Tarzana Treatment Centers. His e-mail address is [e-mail]. If you would like to learn about the ways in which Tarzana Treatment Centers can assist you, including a free assessment please call our Assessment and Retrieval Department at (800) 996 I051 or visit www.tarzanatc.org.

Newer Technologies Provide Care

The Cardiac Catheterization team at Encino-Tarzana Regional Medical Center provides a local example of medical professionals utilizing the latest technology in treating cardiac patients. Drug-eluting stents, which may not be appropriate for everyone, are among the newer procedures being offered to patients at the Institute.

The drug-eluting stent is showing promise in preventing restenosis (reblockage of coronary arteries), a not so uncommon occurrence for many cardiac patients. Interestingly, restenosis, rather than being a recurrence of coronary artery disease, is actually the body's response to what has been called the "controlled injury" of angioplasty and was characterized by growth of smooth muscle cells--roughly analogous to a scar forming over an injury.

Drug-eluting stents incorporate pharmacological advances, using the body's circulatory system as a "highway" to deliver ongoing therapy. The drug-eluting being used at the institute is a small spring-like metal stent that is coated with the drug sirolimus and also includes a polymer coating that controls the timed release of the drug inside the vessel during a period of time. "The rate of reblockage or restenosis here at Tarzana is generally low. The hope is that this new stent will prevent even those few cases from coming back," says Cardiologist Richard Cain, MD.

The drug-eluting stent is just one of the many interventional procedures performed by the Cardiac Cath Team. In addition to stents, other procedures include angiography, angioplasty, atherectomy, intravascular ultrasound (IVUS), electrophysiology (EP) studies and radiofrequency ablation. The modern facility includes two catheterization/EP labs, and a peripheral angiogram lab.

"The use of these new drug-eluting stents is in line with our philosophy here at Encino-Tarzana Regional Medical Center," says Dr. Cain, " which is to provide the latest cutting edge technology and to be the leader for cardiac care in the San Fernando Valley."

Information for this article was provided by Encino-Tarzana Regional Medical Center.