Medications Alone Won’t Prevent Heart Disease

Heart Pic - 1HYANNIS – Most of us know that daily exercise is a great way to prevent obesity and hypertension, while reducing the risk of heart disease and some cancers.

Numerous studies over the last four decades back this up. But too often, people are looking to medications, instead of exercise, to combat these problems.

In the last two weeks alone, I have read new research and studies that confirm we are straying too far from promoting exercise, especially to prevent cardiovascular disease, but also to help people recover from heart attacks.

In their study, “Regular Physical Activity: Forgotten Benefits,” Steven Lewis, Ph.D and Charles H. Hennekens, M.D., at Florida Atlantic University’s College of Medicine, concluded that lack of physical activity accounts for 22 percent of coronary heart disease, 22 percent of colon cancer, 12 percent of diabetes and hypertension, and 5 percent of breast cancer.

“Unfortunately, most Americans prefer prescription of pills to proscription of harmful lifestyles such as physical inactivity,” Dr. Hennekens wrote.

Men and women who engage in regular physical activity experience statistically significant and clinically important reductions in the risk of dying from coronary heart disease, the leading cause of death in the U.S.

“Brisk walking every day for only 20 minutes, which can be practiced even among the oldest adults, confers a 30 to 40 percent reduced risk of a heart attack,” the authors wrote.

You would think that statistic alone would get us all off the couch to start exercising. Unfortunately, this is not the case.

According to Healthy People 2020, a federal initiative to promote good health, a staggering 36 percent of adults do not engage in any leisure-time physical activity.

Even in patients who have suffered a heart attack, it’s estimated that less than 15 percent actually participate in cardiac rehabilitation following discharge, according to the initiative.

That number may be even lower, according to a study released in September by UCLA’s David Geffen School of Medicine. “Only one in 10 heart failure patients is referred to a cardiac rehabilitation after being hospitalized, despite strong evidence that such exercise programs improve quality of life and reduce the likelihood of future hospitalizations,” study author Dr. Gregg Fonarow wrote.

UCLA researchers relied on a national database of more than 100,000 people with heart failure who were discharged from hospitals between 2005 and 2014 and were eligible for cardiac rehabilitation program.

Dr. Fonarow called those results “startling.” Fortunately, we are doing better than that on the Cape.

At both Falmouth Hospital and Cape Cod Healthcare’s Heart and Vascular Institute in Hyannis, we encourage all of our patients to participate in comprehensive, state-of-the-art cardiac rehabilitation programs. That includes people who have experienced a heart attack, by-pass surgery, heart valve repair or replacement, angina, angioplasty, coronary stenting, chronic heart failure and even heart-lung transplants.

Patients in the 12-week group program use stationary bikes, treadmills, arm exercises and hand weights. Exercise specialists, physiologists and cardiac nurses supervise their workouts and monitor their progress using EKG telemetry.

We help patients understand their risk factors and modify poor behavior. Our nutritionists counsel them on healthy eating and diet. We monitor their medications and offer stress management. I personally offer group and individual counseling.

How important is cardiac rehabilitation? Consider a September study from Germany that reported on nearly 2,000 patients who spent time in the hospital for serious cardiovascular disease.

Of those who underwent cardiac rehabilitation, one in nearly 44 patients died of heart disease during the study period. In contrast, seven times more patients who did not go to rehab died.

These latest studies make me want to work even harder. To be blunt, we have become a society of mouse clickers, not walkers.

In public schools across the country, physical education classes and organized sports are not prioritized. An entire generation of children is not learning how to exercise. That will make them far less likely to participate in exercise as adults, and are more likely to suffer from obesity, hypertension, hyperlipidemia and diabetes.

Our Healthy Parks, Healthy People initiative, a partnership of Cape Cod Healthcare and the Cape Cod National Seashore, is a grass roots movement to combat this trend.

Since launching in July, hundreds of residents, second homeowners and visitors have participated in the walking program, with many obtaining their own HPHP Passports that register each of their walks at the Seashore, including blood pressure readings before and after each walk.

Watch for news coming soon about a winter walking program at the Cape Cod Mall sponsored by Cape Cod Healthcare and the mall.

By Elissa Thompson, M.D., OneCape Health News



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