Transcription:
How Old is Your Heart?

Melanie Cole (Host):  Do you know how old your heart is?  If it’s older than you, based on conditions such as high cholesterol and high blood pressure you’re at a higher risk for heart disease and stroke.  My guest today is Dr. Brandi Patterson.  She’s board certified in cardiovascular medicine and internal medicine.  Her specialties include women’s heart health at the UVA Health System.  Welcome to the show, Dr. Patterson.  Tell us a little bit about the factors that make your heart age faster.

Dr. Brandi Patterson (Guest):  Thank you for having me on Melanie today.  So, some of the factors that make our heart age faster are things like smoking.  Smoking really tends to make plaque build-up in our arteries, not only in our hearts, but also in the carotid arteries leading to the brain as well as the arteries in our legs at a much faster rate, much more aggressively.  It really leads to early onset heart attacks and strokes and peripheral arterial disease.  I have actually seen this in my practice in very young women in their early to mid-twenties who have smoked a pack or two or three a day for ten years and they’ve already come in with heart attacks and they’ve already come in with strokes.  So, smoking really increases the age of your heart very quickly as does diabetes, especially uncontrolled diabetes as well as high blood pressure, cholesterol that’s uncontrolled, poor diet and physical inactivity. 

Melanie:  How can you learn how old your heart is?

Dr. Patterson:  It’s actually a great tool that ClubRedUVA.com has online.  So, you can go onto ClubRedUVA.com and take the heart age calculator test.  It’s designed to give you an overall idea of the health of your heart and, basically, a general idea of how your personal lifestyle related factors may have affected your heart.  Now, I have to put in a disclaimer here.  The calculator is meant to be used for people ages 30-74 years old who have no history of cardiovascular disease, meaning you have not had a heart attack, you have no history of a stroke, peripheral arterial disease or heart failure.  It is a good method for determining if you’ve made great lifestyle choices, you can visually see this on a calculator in front of you that by making good lifestyle choices, your heart age may be the same as your chronological age or even younger.  So, you may actually be younger at heart but if you’ve made poor lifestyle choices your heart may age at a much faster rate because of those lifestyle choices.  It puts this on a screen for you so you can visualize it and you can see.  I think it has a very powerful impact when you can see that you’re 30 years old but your heart is actually 65 or 70.  The bottom line for that is that, if you’re a 30-year-old man or a 30-year-old woman and your heart age is 65 or 70, you are at higher risk for having a heart attack or stroke.

Melanie:  Wow.  So, if you do have that higher risk, if you have an older heart than your actual age, can you reverse the process?  Can you make it young again and reduce your risk?

Dr. Patterson:  Yes.  You know, you can.  Fortunately, it’s not impossible to turn back the hands of time when it comes to your heart.  So, everyone deserves to be young at heart and you can start making changes in your lifestyle choices as soon as you can to reduce your heart age.  What I advise my patients is a really simple tool – use you’re A, B, C’s – aspirin, “A” for aspirin when appropriate, “B” for blood pressure control, “C” for cholesterol management, “S” for smoking cessation.  By exercising regularly, watching your diet, and not smoking, people really can do a lot to reduce their risk of heart disease and make their hearts younger.  In fact, more than 75% of heart disease cases can be prevented by making the right lifestyle changes.

Melanie:  Wow.  So, obviously, there’s some genetic component because you always get that question, “Did anyone in your family have a stroke or heart attack before the age of something?”  Dr. Patterson, what is the age when it’s considered a genetic component?  Is there an age when it’s not?

Dr. Patterson:  Yes. So, if you have a male relative that’s in his 60’s and a female relative in her late 50’s or mid-50’s that has a cardiac condition, then it really becomes concerning to us.  While any cardiovascular disease at any age is a concern and we want to know about any family history of heart disease, the younger people are when they get their disease the more precautions or the more aggressively, we like to treat the patients that have the earlier onset heart disease in their family.  So, for instance, for an example, if you have a mother that had the onset of heart failure when she was 45 years of age and a father that had a heart attack when he was 60 years of age, those two ages are very concerning to us.  The fact that there are two first degree relatives involved is very important to us.  That’s not to say that siblings aren’t important.  Siblings are very important, too, but, really, it’s the first degree relatives that we really need to know the most information about cardiovascular disease.  If you have a family history that extends beyond your mother and father, meaning your grandparents had heart failure or heart attack in their 30’s or 40’s and their grandparents had heart attacks in their 30’s and 40’s, obviously, that’s a very concerning trend that we also need to know about.  The more information we can get the better.

Melanie:  Well, certainly that’s true.  Do you take into account if somebody says, “I had a grandfather who had a heart attack but it was 1932” and maybe they didn’t know as much.  Do we still take that into effect?

Dr. Patterson:  Yes.  I would, personally.  I would, personally, and I agree that medicine has really advanced since then and the things that we can do now for folks with heart disease is really much more advanced than we had in the past.  The testing that’s used now to detect cardiovascular disease is much more advanced. However, again, I think the more knowledge that your doctor has about your family history, the better.

Melanie:  Dr. Patterson, when do you feel that stress testing and testing to see if you have peripheral artery disease or any kinds of build-up, when do those come into play?

Dr. Patterson:  I think it comes into play when you know what the risk factors are for the patient as well as, obviously, if the patient is having any symptoms.  For example, for peripheral arterial disease a symptom would be when they are walking a block, they start to get severe cramping in the legs, the calf muscles, the thigh muscles, the buttocks, either or.  When they stop, that pain gets better.  If somebody came to me with that symptom and let’s just say they have a smoking history, I would be very concerned about aggressive plaque formation in the arteries in the legs.  It’s really, Melanie, a combination of risk factors plus symptoms and with that, again, of course, family history, knowing when to test the patient depending on those three items – family history, risk factors and symptoms.

Melanie:  Now, we certainly know women, Dr. Patterson, we are the caregivers of society and if we don’t put our own masks on first we can’t put the masks on of our loved ones.  We don’t always, as you know, pay attention to our own symptoms as much as we do to everybody else’s, running around going “What did you just feel?  What did you just feel?”  What do you want women to know about heart disease and our risk and our different symptoms?

Dr. Patterson:  Well, I think you need another segment for that!  There’s a lot to talk about with that topic.  I think the bottom line is that women need to know how prevalent cardiovascular disease is--it’s not just a man’s disease.  Today is actually “wear red” day for women with heart disease and it’s a very important day.  It increases awareness for women that heart disease is a major risk--that one in three--and some form of cardiovascular disease affects one in three women.  Now, I think we all know someone in our life – a mother, a sister, a grandmother that has had some type of heart disease.  While we all have these female family members--if not family members, then friends--with heart disease, and we rarely think it’s going to happen to us.  I think the important part of this is that, again, it goes back to your risk factors. You need to know what your risk factors are for having cardiovascular disease.  That is diabetes, smoking, high blood pressure, high cholesterol, diet, physical inactivity or physical activity and your family history.  So, knowing these things about yourself, what is your risk for having heart disease?  Has your mother had problems in her 30’s, 40’s, and 50’s?  What was your grandmother’s cardiovascular history like? I think the more that women are knowledgeable about their own risks and understand that those risks place them at an increased chance of having not only heart attack but also potentially valve disease, rhythm disease or heart failure, I think the better we are able at recognizing symptoms in ourselves.  Symptoms of heart disease can really be much different in a woman than a man.  We don’t have to have the elephant sitting on the chest.  I actually saw a woman the other day in the clinic who had pinpoint needle pricks in her chest – that was the symptom--prior to her stent placement.  It could be as mundane as just being fatigued and that’s really difficult because, my gosh, if we don’t get a good night’s sleep and we’re fatigued the next day is our heart or the fact that we haven’t’ slept?  I think having an awareness of how your body normally functions, how you normally feel, is this fatigue, is it lasting 24 hours or is it lasting a week even though you’ve gotten enough sleep the next couple of nights?  If it’s lasted a week and you’ve gotten enough sleep over the last couple of nights, boy, something may be wrong and it may actually be your heart.  Shortness of breath, discomfort in the stomach, abdominal pain, nausea, vomiting, numbness and tingling in the hands, the arm, the jaw.  Again, I think it’s important to know your risk factors.  I think it’s important to know that women’s symptoms are different than men’s and I think it’s important to know the prevalence.  It’s very common for women to have some form of cardiovascular disease.

Melanie:  In just the last few minutes, what great information, Dr. Patterson.  We sure covered a lot in this time.  Why should patients choose the UVA Heart and Vascular Center for their heart care?

Dr. Patterson:  UVA has expertise in all areas in cardiovascular disease from cardiovascular disease prevention to heart replacement in both the American College of Cardiology and The Society of Thoracic Surgeons clinical data registries.  UVA’s heart program actually ranks in the top 10%.  This is based on measures that really matter like survival from heart attacks.  I, personally, think that’s why patients should choose the UVA Heart and Vascular Center for their heart care.

Melanie:  Thank you so much.  What great information.  For more information on Club Red and the UVA Heart and Vascular Center you can go to UVAhealth.com.  That’s UVAhealth.com.  You’re listening to UVA Health Systems Radio.  I’m Melanie Cole.  Thanks so much for listening.