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Start to take heart: healthy living key to good heart health.

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Figuratively, the heart is the most essential part of anything: the heart of the matter, the heart of the story, the heart of a company, to name a few. And literally, the heart is vital to bodily function, yet many people's lifestyles reflect habits and practices that damage their body's most essential organ.

Among Alaskans, heart disease is the second-leading cause of preventable death and stroke is No. 4.

Janice Gray, RN nurse consultant I and program manager for Take Heart Alaska's Heart Disease and Stroke Prevention Program, said, "Work site health promotion programs can effectively help your employees get healthier and avoid getting sick."

Of course, you can't be the health police, hovering over employees and nitpicking their choices. However, your influence at the workplace is important and can help your business' bottom line.

Gray said that high-quality heart health programs indicate a cost saving of $2 to $4 per each dollar invested.

"Work site health programs help recruit and retain employees," she added.

Before initiating a heart-healthy company culture, it is important to understand what contributes to and detracts from heart health. The experts agree that avoiding tobacco and controlling weight are the two pillars of good heart health.

SMOKING NO. 1 RISK

"Smoking cigarettes is the number one risk factor for developing blocked coronary arteries," said Stephen Jones, heart surgeon for Alaska Cardiothoracic Surgery in Anchorage. "It's old news and not glamorous, but it can't be over-emphasized."

Stan Watkins, a physician with the Alaska Heart Institute LLC in Anchorage agrees that "if you smoke, quitting smoking is the easiest and most bang for the buck for improving heart health."

So why is smoking so bad for the ticker? Jones explained that smoking causes irregularities in the way lipids are deposited in the arterial walls. Exposure to tobacco can cause those lipids to rupture or collapse and thus block an artery's blood flow to the heart causing a coronary incident such as a heart attack.

"We see patients who have quit smoking 10 or 15 years ago who still have damage from smoking," Jones said. "If you quit smoking in your youth, you probably won't end up with acute coronary syndromes, but the sooner one quits, the better one is."

Secondhand smoke is not safe, either.

"Thirty minutes of exposure to secondhand smoke can raise the nonsmoker's risk of heart attack or a cardiac event," said Laura Muller, tobacco control manager for the American Lung Association in Anchorage.

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Quitting smoking has never been easier. New prescription drugs such as Pfizer's Chantix and GlaxoSmithKline's Zyban can help block nicotine receptors in the brain to decrease the pleasure derived by smoking. Along with lifestyle modification and the use of some of the plethora of nicotine gum, mints, patches and other over-the-counter anti-smoking products, a quitter has a much greater chance of becoming a non-smoker.

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In addition to quitting smoking, people can use drugs to help improve blood flow to the heart. Upon their doctor's advice, taking lipid-lowering drugs such as Pfizer's Lipitor and a daily baby aspirin may help people with high levels. Some alternative health practitioners also recommend taking niacin supplements as well.

OBESITY NO. 2 RISK

Obesity represents the second most important issue for harming heart health.

"Excess weight demands excess work on the heart to supply blood," Jones said. "Our hearts are like the engine on a car. If it's overloaded, it has to work harder."

At 65 percent, obesity rates in Alaska are slightly higher than the national average and are increasing, according to The Burden of Heart Disease and Stroke in Alaska: Mortality, Morbidity and Risk Factors updated December 2009.

As the number of morbidly obese people increases, those who are moderately overweight may become more comfortable with their excess pounds, Jones fears.

"More people are thought of as normal because they're not as big as the huge guys," he said.

To accurately assess one's weight, it's important to measure against the norms indicated by the medical community, not other people.

In most cases, excess weight is caused by poor diet and lack of exercise, the third and fourth factors related to heart health. Poor diet contributes to high cholesterol levels, excessive salt intake, and a lack of nutritious foods.

"I think we tend to look for the magic bullet of 'if I eat this food or don't eat that food that's the answer,'" said Leslie Kleinfeld, owner of Fit for Health in Anchorage.

TESTS TO HELP

As a general rule, Kleinfeld advises clients eat unprocessed, more natural foods and engage in exercise periodically all day.

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Watkins encourages patients to have their cholesterol checked annually and have their C-reactive protein (CRP) measured.

"It's a measurement of inflammation in the blood," he said. "Beyond the risk of high cholesterol and hypertension, elevated CRP carries a higher risk for heart attack."

More than 40 percent of people with heart disease have no measurable factors related to heart disease.

For this reason, Watkins recommends that patients who have a family history of heart disease but no other factors should have a calcium score test taken.

"If you have calcium buildup in heart arteries," he explained, "you have plaque buildup. The extent of calcification is an indicator of your likelihood of heart attack."

CHANGING HABITS

Medication such as AstraZeneca's Crestor can help lower CRP "for people with normal cholesterol but elevated CRP," Watkins said.

It seems like a new weight loss diet is born every day; however, GlaxoSmithKline's alli product is a FDA-approved over-the-counter medication that works by blocking the absorption of 25 percent of a person's fat intake. Because fat is more calorically dense than protein or carbohydrates, alli can help its users decrease their caloric intake.

The pharmaceutical company supports alli users with a diet and exercise program found at www.myalli.com.

"It all comes back to balance," Kleinfeld said. "It's a big picture approach, but these are all things we're personally able to do. It's always in our control. We have to change our awareness and lifestyle habits to have a healthy heart."

Most of the heart-healthy habits are widely known and Gray believes that Alaskans are hearing the message, but "habits are hard to change.... Getting support at work at home and from friends can make all the difference in becoming healthier.

Tips for Heart Health

So what can you, as an employer do to encourage heart-healthy living among your employees? Try the following tips:

1. Offer a health insurance benefit that's proactive in nature with coverage for health screenings, for example.

2. Make the workplace a no-tobacco zone (contact the American Lung Association Anchorage at 907-276-5864 for help in writing a policy).

3. Post the toll-free number for the Alaska Quit Line, 888-842-QUIT, so employees can obtain free support and nicotine replacement products.

4. Host a heart health fair open to the public to make available screenings and information relevant to heart health (bonus: it's terrific PR for your company).

5. Let employees work a flexible schedule that can allow them to pursue exercise and lower their stress level.

6. When ordering lunch for the staff, pick a place with heart-friendly options.

7. Start a lunchtime walking program.

8. Offer healthful snacks in the break room and conference room such as fruit and low-fat baked pretzels.

9. Post heart health tips in public areas around the workplace and include them in paychecks and in the company newsletter. The Metropolitan Height/Weight chart (http://www.bcbst.com/mpmanual/hw.htm) and information from www.mypyramid.gov are good places to start.

Is it a Heart Attack?

Signs, symptoms and what to do.

Am I having a heart attack? Watch for the following signs and remember, the longer you delay treatment, the more heart muscle is dying. Know the warning signs and symptoms of a heart attack.

Reported by Men and Women

* Discomfort, fullness, tightness, squeezing or pressure in the center of the chest that lasts more than a few minutes or goes away and comes back.

* Pressure or pain that spreads to upper back, shoulder, neck, jaw, or arms.

* Dizziness or nausea.

* Clammy sweats, heart flutters or paleness.

Reported Most Often by Women

* Overwhelming or unexplained fatigue.

* Shortness of breath or difficulty breathing.

* Stomach or abdominal pain or indigestion.

* Unexplained feelings of anxiety or weakness, especially with exertion.

Four things to do if you are having heart attack signs or symptoms.

* Call 9-1-1.

* Tell the medical staff that you are having heart attack symptoms.

* Chew and swallow one regular full-strength aspirin.

* When you arrive at the hospital or clinic, insist on a thorough cardiac evaluation.

Reducing Heart Attack Risk

You can reduce your risk of having a heart attack--even if you already have coronary heart disease or have had a previous heart attack, according to the National Heart, Lung and Blood Institute of the National Institutes of Health, within the U.S. Department of Health and Human Services. The NHLBI reports the key is to take steps to prevent or control your heart disease risk factors, and offers six steps that will reduce your risk of having a heart attack.

* Stop smoking.

* Lower high blood pressure.

* Reduce high blood cholesterol.

* Aim for a healthy weight.

* Be physically active each day.

* Manage diabetes.

Healthy Numbers

Do you know your healthy heart numbers? Gray listed the following health statistics as important factors in maintaining a healthy heart.

* Blood Pressure 120/80 or less

* Total Cholesterol less than 200

* LDL (bad cholesterol) less than 100

* HDL (good cholesterol) greater than 40

* Triglycerides less than 150

* Fasting Glucose 70-100

* Waist Circumference: women 35 inches or less, men 40 inches or less

Goals for a Health Heart

* Do moderate aerobic exercise 150 minutes a week or 30 minutes a day.

* Do strengthening exercises two days a week.

* Eat nine servings of fruits and vegetables each day.
Chronic Disease Deaths, Alaska,
Per 100,000 Population

Cause of Death Death Age-Adjusted Rate

All Causes 3,466 756.4
Cancer 857 181.9
Lung Cancer 257 54.0
Breast Cancer (Females Only) 47 17.6
Diseases of the Heart 627 147.9
Coronary Heart Disease (Ischemic) 367 85.5
Cerebrovascular Disease (Stroke) 169 43.6
Diabetes 93 22.4
Diabetes (any mention) 276 64.4

Source: Alaska Bureau of Vital Statistics, 2008
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Title Annotation:HEALTH & MEDICINE
Comment:Start to take heart: healthy living key to good heart health.(HEALTH & MEDICINE)
Author:Sergeant, Deborah Jeanne
Publication:Alaska Business Monthly
Geographic Code:1U9AK
Date:Apr 1, 2010
Words:1718
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