By Debbie Gardner
debbieg@thereminder.com
A board certified echocardiography and nuclear cardiology physician at Holyoke Medical Center, Dr. Hari Subramanian brings a wealth of experience to his medical practice. After attending Kilpauk Medical College in India, he did his residency in internal medicine at Abington Memorial Hospital in Abington, PA, and a cardiology fellowship at Hahnemann University Hospital in Philadelphia.
PRIME tapped his heart expertise for insights into heart health in 2018. Here are his answers:
Q: Weight, cholesterol and blood pressure all factor into heart health. Do the American College of Cardiology’s new standard of 130/80 – not 140/90 – as high blood pressure change the picture of when heart disease begins?
“It does not change the picture as to when heart disease begins. The new guidelines have been put in place mainly to emphasize the fact the previously considered blood pressures in the pre-hypertensive range – i.e less than 140mmHg – also play a major role in the development of cardiovascular disease.
“It was felt that with the old ‘pre-hypertension’ diagnosis, both patients and providers were not actively modifying their lifestyle, or if necessary using drug therapy that would favorably modify the disease process. With the new guideline lowering the normal blood pressure to 120/80mmHg and using a category of ‘elevated blood pressure’ as 120-129/80 mmHg and anything above that as hypertension, it is expected to improve overall hypertension control.”
Q: Heart attacks kill more women than breast cancer, yet most women don’t recognize the symptoms. How do heart attack signs differ between men and women?
“Women may have variable symptoms with regard to heart disease. They may or may not have chest pain as the primary problem. Other common presentations include shortness of breath, upper abdominal pain, back pain, arm or jaw pain, fatigue etc. Men on the other hand typically have chest pain with heart attacks.”
Q: Everyone knows the four big heart disease risk factors – smoking, weight, cholesterol and high blood pressure. Are there other risk factors that are under an individual’s control?
“Diabetes is another one to add to that list. Otherwise, your list above seems complete.
“However, there are things everyone can do to improve their heart health. Here are three steps to help you establish a heart-healthy lifestyle:
1. Stop smoking. Smoking is by far the leading preventable cause of death and disability in the United States, and one of its primary targets is the heart. The American Heart Association estimates that cigarette smoking results in a two-to three-fold increased risk of dying of coronary heart disease.
“The reason: Smoking robs the heart of oxygen-rich blood and magnifies the effects of other risk factors, such as blood pressure, blood cholesterol levels and physical inactivity. Q: uitting isn’t easy, but working with your doctor is key. He or she can help design a smoking cessation plan that may or may not include medications aimed at reducing your cravings, making it easier to kick the habit for good.
“Holyoke Medical Center also offers free Quit Smoking workshops every week. To learn more, call 413.534.2789 or email: SmokeFree@HolyokeHealth.com.
2. Exercise 30 minutes most days of the week That’s the basic goal. But finding 30 minutes a day to exercise isn’t easy. Don’t worry — you can break that up into more manageable bits of time. Walk your dog for 10 minutes before work, then take another 10-minute walk on your lunch break, and then ride a bike around the block with your family after work. There’s your 30 minutes.
3. Maintain a healthy weight. How do you know what constitutes a healthy weight? Doctors typically use two measures: body-mass index (BMI) and weight circumference. BMI is a ratio of your height and weight. It’s determined through a complex math formula, but your doctor or one of the many online calculators can determine yours. The goal is to keep your BMI below 25. Waist circumference may be an even better predictor of heart health. Women should keep their waist below 35 inches and men below 40 inches to lower risk for heart disease. Step No. 1 is to learn your BMI and waist numbers. Then, if they’re too high, ask your doctor to recommend the best way to bring them back to where they belong.”
