40 Year Old Woman’s Heart Attack Attributed to Familial Hypercholesterolemia

A recent story featured on Good Morning America and ABC News relates the story of Blair Wenter, a 44-year-old mother diagnosed with familial hypercholesterolemia — a genetic cholesterol disorder that starts at birth, an issue that was amplified by the fact that genetic testing revealed Blair’s son Christian also had the condition. Blair – at the time a 40-year-old ranch photographer from Frisco, Texas, thought she was too healthy and active to have a heart attack.

Wenter, a lively speaker at last year’s Boca Raton Regional Hospital (BRRH) sponsored ASPC meeting stated, “When you see a 128-pound, 5-foot 4-inch woman in stilettos, doctors think it’s a hormone issue”. “I was riding horses, chasing children, swimming — I live a very active life. I ran a 10K the week of my heart attack.” Sadly Wenter’s story is not unique.

As is the case with many people stricken with FH, Blair was unaware she had the condition. Familial Hypercholesterolemia, is a genetic cholesterol disorder that leads to premature vascular disease. In the most severe circumstances, very young children can experience life-threatening heart attacks and strokes. Typically however, the disease does not wreak havoc until people reach their 40s and 50s. FH is not as rare as you might imagine. It occurs in one out of every 500 people, but in some populations – like French Canadians and South African Ashkenazi Jews – the number can be as high as one in 67! To make matters worse, the disorder often goes undetected.

In an attempt to thwart the dire consequences of FH, organizations like the FH Foundation, the National Lipid Association and the American Society for Preventive Cardiology are working hard to raise awareness. This Tuesday February 26th at BRRH I will be giving Grand Rounds on FH. Because of her dedication to the FH cause, Katherine Wilemon, the founder and president of the FH Foundation (and an FH patient herself) will be flying in from California to join me. These organizations – and I personally – encourage you to speak to your doctor to see whether you harbor this silent threat. If you do, don’t be afraid; treatment is available for you and your family.

Remember, as a genetic disease FH can impact all members of your immediate and even extended family. Consequently all relatives of a single FH patient should be screened with simple cholesterol tests. Please don’t procrastinate. See your doctor soon to be sure you do not have FH.. These organizations – and I personally – encourage you to speak to your doctor to see whether you harbor this silent threat. If you do, don’t be afraid; treatment is available for you and your family. Remember, as a genetic disease FH can impact all members of your immediate and even extended family. Consequently all relatives of a single FH patient should be screened with simple cholesterol tests. Please don’t procrastinate. See your doctor soon to be sure you do not have FH.

For more information on FH treatment alternatives, including LDL-Apheresis, visit Preventive Cardiology Inc.

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Tips to Improve Your Cardiovascular Health During National Heart Month

There may be no better time to change your ways and focus on improving your heart health than National Heart Month. Here are some simple tips that may help get you on a path to better cardiovascular and overall health.

An irreplaceable component in any healthful lifestyle regimen is exercise.

  • The American Heart Association advocates at least 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise (or any combination of the two). An average of 30 minutes a day, five times a week is an easy target to remember. (Personally I advocate 60 minutes of daily exercise). If you are unable to allocate a solid thirty minutes of your time to exercise you can divide your time into two or three shorter segments of 10 -15 minutes per day.
  • Walking is the simplest aerobic exercise you can undertake to effectively improve your heart health. It’s enjoyable, free, easy, social, relaxing, and even meditative.
  • Racquet sports, basketball, swimming, golf, gardening – or any aerobic pastime that gets you up off the couch – are great ways to improve your cardiovascular health and potentially trim inches off that waistline.
  • If you’ve been sedentary for years, a full 30 minutes of exercise may be too challenging for you. Start with sessions of shorter duration – something is better than nothing – and gradually build up to a full 30 to 60 minutes of activity. Also, if you have been truly sedentary, see your doctor before embarking upon a new exercise regimen.

Adjust your diet
Excess weight can be a killer. Address any overweight and obesity issues you may have. If you currently eat a lot of fast food, sugary sweets or high saturated fat foods you should begin a transition to a more healthful diet. This is a lifestyle change and does not have to occur all at once!

  • Eat a diet that features daily servings of a variety of fruits and vegetables and at least one serving of fatty fish (salmon, tuna, trout) per week.
  • Limit foods and drinks high in sugar, salt, and saturated fat. Avoid unhealthful snacks. Stay away from processed foods to the best of your ability. Avoid simple carbohydrates. Sugar is your enemy.
  • Consider a high quality fish oil pill that has been concentrated and purified to give you 1,000 mg of combined DHA and EPA in a single soft gel.
  • Take a good daily multiple.

Be your own healthcare advocate
In addition to undertaking a regular exercise regimen and eating a healthful diet here are some additional recommendations for leading a more healthful life.

  • Get a check-up. How often you have a check-up can be determined by your age, sex, and overall health.  Have your blood pressure checked, and get screened for hypertension.
  • Talk to your doctor about whether or not taking a daily aspirin to prevent heart attack and stroke is right for you.
  •  Get immunized: Annual flu shots are recommended for adults 50 and older, as well as immunization of adults 65 and older against bacteria that causes pneumonia and related diseases. Children should get immunized for measles, mumps, diphtheria, tetanus, whooping cough, rubella, polio, hepatitis B, etc.
  • Cholesterol screening is imperative. Request an assessment of not only your LDL but your LDL particle number as well.
  • Never smoke; quit smoking if you’ve already started; and avoid second hand smoke.
  • Adults 50 and older should have a routine colorectal-cancer screening. (Genetic issues may dictate earlier screening).
  • Cervical cancer screening for sexually active women and women over 21 years of age.
  • Routine breast-cancer screening for women 50 and older and discussion with women ages 40 to 49 to set an age to begin screening. (Genetic issues may dictate earlier screening).
  • Calcium-supplements can be especially beneficial for adolescent girls and women.
  • Get an eye exam, particularly diabetics and adults 65 and older.
  • Manage your stress. Meditation, deep breathing, and simple exercise will help you do so.
  • Get routine dermatologic exams.
  • Get enough sleep. If you have a sleep disorder, please discuss this with your physician.
  • Always remember that you and your doctor are partners in the quest to keep you healthy and active for years to come. Find a doctor who is proactive and with whom you are completely comfortable. He or she should be instrumental in helping guide you throughout your life.

Visit vitalremedymd.com for more preventive healthcare solutions.

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It’s National Heart Month Again

February is National Heart Month. It seems like just yesterday when I last spoke about this. Given the passing of a full year of research and education it is fair to ask whether we’ve made any significant strides against heart attack and stroke (CVD). The qualified answer is yes. I say qualified because although the strides I cite are impressive, we are still far from removing CVD from its place as the leading cause of death in the western world. And so we must continue to do more – woman on beachexercise more; eat better; lose weight; diminish stress… Still, great things have occurred and they should be noted. In the world of cholesterol two novel cholesterol lowering medications were approved: Lomitapide and Mipomerson. Both are intended for patients with the very serious genetic lipid disorder Familial Hypercholesterolemia, so their applications will be limited. Still, they mark a leap in our understanding and management of cholesterol problems, a leap that will likely translate into more research and concomitant applications with much broader clinical utility. We have also made strides in treating atrial fibrillation, a common rhythm disturbance saddled with the associated risk of stroke. Three new blood thinning medications have been approved and they too represent true “game changers”. New devices have hit the market, instruments for less invasively treating valve disorders, blocked arteries, holes in the heart, rhythm disturbances, and aneurysms. New blood tests have made their way to the prevention scene, enabling doctors to predict more accurately who may or may go on to sustain a life-threatening cardiovascular event in the more proximate future. And imaging has evolved – we can now view one’s coronary arteries with far less radiation than is delivered by most stress tests, and just slightly more radiation than is experienced during a mammogram!

And so we should be happy. Doctors, scientists, and philanthropists have helped diminish our risk of dying from disorders of the heart, brain, and vasculature. But there are strategies we cannot forget. TLC, or therapeutic lifestyle changes, still represents our single best defense against these diseases. And TLC simply put means living better lives. It means exercising, eating properly, maintaining an optimal weight, seeing your doctor regularly, taking your medications appropriately, and in short doing your part to stay healthy. There is no escaping the fact that no matter how much we learn and grow as doctors and scientists we still need the genuine and full engagement of our patients to achieve optimal health and maximally reduce risk. Optimal health demands a team, and the captain of that team will always be the individual patient.

So this National Heart Month I want to encourage you to take charge of yourself. Personal responsibility seems to be a theme of 2013. In the case of CVD it is no different. Do yourself and your loved ones a favor and do what you can to fight CVD. It is a plainly defeatable foe.

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