Unconventional Heart Health

Four unexpected contributors to heart disease

As we welcome Heart Health month we look at ways to keep the "old ticker" healthy. Heart disease in the District is very serious business. In 2010, heart disease was the cause of 28% of the total deaths in the city making it the number one cause of death.

Poor diet, stress and lack of exercise are well-known causes of cardiovascular disease. But there are others that are often overlooked.


Mental health experts and physicians agree that your mental health can greatly affect your physical state. Such is the case with depression and heart disease. Depression is an intense feeling of sadness, worthlessness or helplessness that can last for several days or even months. According to the Health and Human Services Office of Minority Health, African Americans are 20% more likely to experience serious mental health problems than the general population. Where is the connection to heart disease? Depression makes it difficult for people to concentrate on wellness. The hopelessness and sadness takes away their self-value and will to survive. As a result, eating habits are poor and exercise becomes negligible. Some people with depression smoke as a coping mechanism which is a major risk factor for heart disease.


According to the DC Department of Health 2014 Cardiovascular Disease Report, the prevalence of diabetes among adult black residents rose from 11.7 percent in 2005 to 13.4 percent in 2010. An elevated risk of diabetes means an elevated risk of heart disease. Why? In many cases, type 2 diabetes is a result of lack of a healthy diet regimen and little to no physical activity which leads to obesity. Dr. Reginald L. Robinson, a Cardiologist with MedStar Heart & Vascular Institute, says that the two are closely linked. "If you have diabetes, you have heart disease until proven otherwise. Diabetes is what we call a cardiac equivalent. A lot of people think of diabetes as this separate thing. But it's not just about the diabetes. It's also the effects of diabetes. Diabetes is the leading cause of stroke, heart attacks, amputation, and ending up on dialysis."  Dr. Robinson says the effects of diabetes complications can affect the cardiovascular system.  "If you know someone who has had an amputation from diabetes they are three to four times more likely to have a heart attack, especially if they have suffered from a blood vessel disease. The blood vessel is one big tree. So if you have a disease in one part of the tree you're going to have it everywhere else."


Not being able to sleep and heart disease may sound like two completely unrelated woes, but there is a link between the two. There is an increased work demand on the heart after a person wakes up. People who wake up frequently from sleeping problems such as obstructive sleep apnea often have hypertension, a risk factor for heart disease. Dr. Robinson explains how a person's weight can exacerbate the issue.  "Sleep apnea is connected to obesity. You see people with large necks. Typically they snore. When they snore the oxygen level goes down which produces adrenaline that wakes them up. That adrenaline will cause palpitation and skipped beats and blood pressure issues." Addressing sleep problems and breathing issues can lower the risk for heart disease.

A "Broken Heart"

Ever heard of someone dying from a broken heart? That's not exactly conjecture. Takotsubo cardiomyopathy is a heart attack brought on by highly stressful events such as a death in the family, a violent event, or a sudden surprise which can produce excessive adrenaline, leading to a small chance of causing a heart attack. This kind of heart attack appears more often in women. An unhealthy lifestyle compounded with stress can spell trouble.

Making It Better

The upswing to this is that cardiovascular disease can be reversed. It starts with an honest conversation with your primary care physician. Some risk factors like race, family history or age cannot be changed. Other risk factors like cholesterol, diet, exercise and smoking can be changed. Also sodium reduction can have a big effect on health outcomes overall. Dr. Robinson suggests making a few simple changes. "Diet and exercise are important. Portion control is the key. I tell a lot of my patients to find the diet that works best for you. I tend to like the ones similar to the South Beach diet. I tell people to get away from the simple carbohydrates in their diets. They convert to sugar which converts to fat. Move to more colors, brown rice instead of white rice. You've got to eat to live, not live to eat."

Focusing on wellness instead of on reducing the chance of a heart attack may make the journey more enjoyable. Increased wellness also addresses more than one ailment at a time. The DC Cardiovascular Health Program supports the Million Hearts™ campaign. Their website contains lots of resources from healthy eating plans to scripts on how to speak to your health care provider about managing blood pressure. There are many local resources that are available to assist people in their journey to wellness. Trusted Health Plan's Outreach Center on Minnesota Avenue offers healthy cooking demonstrations to help members find easy, healthy ways to swap bad ingredients for good ones. The University of the District of Columbia CAUSES (College of Agriculture, Urban Sustainability and Environmental Sciences) offers a free six-week workshop called  Expanded Food and Nutrition Education Program (EFNEP).  The workshop offers tips on nutrition, daily meal planning, food safety, hands-on cooking, and equipment care. Want to move more? Check out the Fit DC website and consult with your ward 7 and 8 coaches about how to get out there more. And the Community Wellness Collective inside the Anacostia Arts Center offers workout classes for all skill levels. 

For more information about Million Hearts visit http://millionhearts.hhs.gov. To find out more about Trusted Health Plan's Outreach Center and their classes visit www.trustedhp.com. To find out more about UDC's healthy cooking workshops go to www.udc.edu/causes.

To learn more about cardiac care at MedStar Heart & Vascular Institute, visit www.medstarheartinstitute.org

Candace Y.A. Montague is a health reporter for Capital Community News.

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