Older Adult Class Helps Retired Teacher ‘Take Charge’

Carol Wojtalik

By Dana Bright

For over four years now, Older Adult Programs at Rush has offered “Take Charge of Your Health,” an educational workshop for adults and older adults living with ongoing, chronic health conditions, such as diabetes, heart disease, asthma and high blood pressure.

During six weekly interactive sessions with trained facilitators, participants come together with others going through similar experiences to learn skills and information aimed at helping them become more confident and in control of managing their health conditions and overall health as a whole. Every so often, we have a participant who shows such enthusiasm for the program and comfort with the material that we ask her/him to go on to become a trained workshop facilitator.

Several years ago, we had the great fortune to meet such a person, Carol Wojtalik. The program had a significant impact on Carol’s life as a participant, and she has gone on to become one of our most active, dedicated facilitators. We recently asked Carol to reflect back on her experience.

Here’s her story:

Where do I begin? I had just retired from a 35-year teaching career and was waiting for an epiphany. It came in an unusual form. I received a letter from Rush Generations inviting me to participate in a program called “Take Charge of Your Health.” My primary care doctor had suggested that I would be interested. Needless to say, my curiosity for learning made me sign up for the program. Continue reading

The Lupus-Heart Disease Link

By Meenakshi Jolly, MD

Lupus, an autoimmune disease, usually affects women who are in their 20s to 40s and have a high risk of early heart disease.

Usually when we think of women with heart disease or at risk of heart disease, we think of someone in an older age group, and possibly in a setting of high blood pressure, diabetes, cholesterol, obesity, smoking or a family history of early age heart disease. These risk factors are called “traditional risk factors.”

Recently, the American Heart Association released 2011 updates on guidelines to prevent heart disease in women, and for the first time included lupus and rheumatoid arthritis as conditions that put women at an increased risk for heart disease. Is this truly a new risk factor?

Lupus is marked by inflammation in various organs, caused by the immune system’s fight against the body’s own cells. If this inflammation remains untreated or uncontrolled, it leads to damage, which becomes irreversible with time. This inflammation and damage can occur in any of the organs/systems of the body. Though some of the inflammation and damage may be visible to a patient or physician, e.g. in the skin or joints, frequently it may not be visible, perceptible or easily measurable. Continue reading

African Americans More Vulnerable to Heart Problems

By Richard Olstein, MD

Despite all the advances the medical community has made in the treatment of coronary heart disease, preventing the occurrence of heart attacks, strokes and other forms of vascular disease remains essential to our fight against this No. 1 killer in America. In this fight, a portion of our community remains particularly susceptible — African Americans.

African Americans have a higher chance of death if they suffer a heart attack compared to Caucasians. According to the U.S. Department of Health and Human Services, in 2007, African American men were 30 percent more likely to die from heart disease compared to Caucasians. The explanations for this disparity have not been discovered. What’s clear is that preventing heart disease is one’s best chance of living a longer and healthier life. The only way to prevent heart disease is to control or prevent the classic risk factors.  These controllable risk factors include high blood pressure, diabetes, high cholesterol and smoking.

High blood pressure, or hypertension, is nearly 1.5 times more common in the African American population. In addition to leading to heart attacks and strokes, hypertension increases your chance of developing heart failure, kidney failure and vision loss. The goal is to reduce your blood pressure to less than 140/90 mmHg. This can sometimes be accomplished with a low salt/sodium diet and exercise, but often requires medications. Medications that are often particularly effective in African Americans include diuretics, or “water pills,” and calcium channel blockers. Continue reading

Managing Chronic Heart Disease: Tips for Patients

By James E. Calvin, MD

Over the last three decades, the management of acute heart disease such as heart attack has come a long way. When I graduated from high school, the mortality rate for a heart attack was in excess of 30 percent. By current statistics, the mortality rate for a ST-segment elevation myocardial infarction (the kind we rush to the cath lab in order to place a stent) is 5 to 7 percent, and for the less severe form, so called non-ST segment elevation myocardial infarction, this mortality is now less than 4 percent.

However, the emergence of chronic heart failure, chronic arrhythmias and lifelong prevention of coronary disease really requires a sustaining partnership between a proactive physician and a well-informed and motivated patient.

A recent study that I presented at an international meeting determined that patients were receiving appropriate recommended therapies for heart failure and taking them as directed only a third of the time. This observation is a stark reality that points out the need to not only enhance physician clinical decision-making but also patient education.

Why Some Patients Don’t Take Medication

Why might patients not take the medication that they have been prescribed? There appear to be lots of reasons. One important reason is the patient’s knowledge about why the medications are important and how they improve patient’s symptoms is not adequate. Continue reading

Tips for Maintaining a Heart-Healthy Lifestyle

Cassie Vanderwall, MS, RD, LD, is a registered dietitian at Rush and a certified personal trainer. Here are some of her suggestions for maintaining a heart-healthy lifestyle.

Why is a heart-healthy lifestyle good for everyone?

Good nutrition and exercise significantly reduces your risk — by 50 percent — of heart disease and stroke, which remains the No. 1 killer of Americans. The Diet and Lifestyle Goals for Cardiovascular Disease Risk Reduction, published by the American Heart Association, are proven lifestyle changes to promote heart health, which leads to lower total and LDL cholesterol levels, decreased triglycerides, reduced blood pressure and blood glucose control.

What does a heart-healthy meal plan include?

Heart-healthy eating includes everything, in moderation. This style of eating focuses on foods that are lower in sodium, healthier fats and proper portion sizes.

What types of fat should I consume on a daily basis?

Heart-healthy fats are those that are fluid at room temperature, such as olive oil, fish oil, and the oils from nuts and seeds. Fats that are solid at room temperature are called saturated fats, and they are known to increase LDL cholesterol and promote cardiovascular disease. If saturated fat is bad, then trans fat is worse. Trans fats have been found to both increase “bad” (LDL) cholesterol and decrease “good” (HDL) cholesterol.

What are omega 3 fatty acids?

Omega 3 fatty acids are unsaturated fats that are found in fish oil, flaxseed oil, walnut oil and many other nuts and seeds. This type of fat has been shown to decrease triglycerides, lower blood pressure, decrease the risk of arrhythmias and decrease the growth of arterial plaque. Eating fatty fish — such as mackerel, lake trout, herring, sardines, albacore tuna and salmon — two times per week will meet this recommendation. Continue reading

Can Stress Cause a Heart Attack?

Can stress cause a heart attack?By Jill Waite Goldberg

Stress can trigger insomnia, exacerbate digestive problems and cause muscle tension that leads to body aches. But can stress cause a heart attack? Or is it just a dire, unsubstantiated warning offered by concerned family and friends along the lines of “You’ll catch pneumonia if you go outside with your hair wet”?

When faced with a stressful situation (known as acute stress) — such as rush-hour traffic or babysitting an ornery grandchild — our bodies release hormones, including cortisol and adrenaline, which help us react to the situation. These hormones increase heart rate and blood pressure, supplying the body with a burst of energy and strength. This creates a “fight or flight” reaction that, when you’re in actual danger, helps you defend yourself or flee. When the “danger” or stressful scenario passes, the body’s relaxation response kicks in and hormone levels return to normal.

Stress and Heart Health

“In a person with a healthy cardiovascular system, this surge shouldn’t be a problem,” says Rami Doukky, MD, a cardiologist at Rush. However, if there is underlying heart disease, the sudden increase in blood pressure and heart rate could contribute to events leading to a heart attack. For example, in people with atherosclerosis, or cholesterol buildup in their arteries, the increase could cause plaque to rupture and block blood flow, which could result in a heart attack. The surge can also expose people with existing heart disease to the risk of an arrhythmia, which is an irregular heartbeat.

“There is no solid evidence that stress can directly cause a heart attack,” says Doukky. “However, chronic stress — the kind of stress that’s due to ongoing situations like a bad relationship or difficult job — can lead to risk factors that affect heart health.”

Chronic stress has been linked to overeating (which can result in obesity), poor sleep habits and tobacco and alcohol use — practices that could translate into high blood pressure, a major risk factor for cardiovascular disease as well as diabetes. For older adults, who are already at a higher risk for heart disease because of progressive atherosclerosis associated with aging, stress may increase their chances of developing heart disease, Doukky says. Continue reading