The Life of Heart Transplant Survivor

The Life of Heart Transplant Survivor

PATIENT STORY

The Life of Heart Transplant Survivor

How a new heart changed one man’s life

The phone rang at my desk. It was Dr. Sullenberger. “Mike, you should come upstairs. There is a patient I want you to meet, David Gray. He has a story you need to hear.” I grabbed my recorder and walked upstairs to the 4th floor of our Corporate Woods location, unsure what to expect. This was the first time I had been called to meet a patient. Dr. Sullenberger introduced me to David Gray, a normal looking man wearing a hoodie sweatshirt and blue jeans. He smiled, we sat down, and David started opening up. He shared his remarkable survival story with the passion that makes you sit up and take notice.

David Gray (left) with Dr. Lance Sullenberger (right)

David Gray is a heart transplant survivor. His life changed forever in the summer of 2010, September 23rd to be exact. He speaks with such detail, you feel like you were in the hospital room when he received the diagnosis from Drs. Jeffrey Uzzilia and Lance Sullenberger that, what he thought were allergies, was in fact, viral cardiomyopathy, a disease of the heart muscle that causes it to become enlarged, thick or rigid. When David says cardiomyopathy, it just rolls right off his tongue. “Then I met Dr. Ian Santoro, my injection fraction was at 34%, it was recommended that I get a defibrillator, I got that. Glad I did because it saved my life. I fell on the floor and it shocked me four times, it brought me back to life!”

It was at that point, that I realized that David is going on his ninth year of telling this story. His journey continued after getting an Implantable Cardioverter Defibrillator (ICD). He blinked a few times, and the smile that was on his face cleared as a more serious tone came over his demeanor. He mentally focused as he shared this part of his story. Five years after receiving his implant, David’s ICD saved his life.

“I had just gotten done mowing the lawn,” David began. He went to sit in his chair in the garage to watch TV to cool off. “I said to my wife, ‘Hey, do you want anything from Stewart’s? I’m going to play the Lotto.” He looked right at me and stated the exact time and date; it was 5:30 pm on May the 30th. “She was like, ‘Naw, I don’t want anything.’ I told her, ‘Don’t leave, something is wrong.’ Next thing I remember, she’s in my ear saying, ‘I’m calling 911! Are you okay?” David recalls getting up and sitting in the chair but doesn’t remember falling to his garage floor, his forehead narrowly missing the snowblower parked nearby.

His defibrillator saved his life.

He sat in the chair in his garage for 20 minutes before going to the store. That’s when he got a call. “They told me that I was in full cardiac arrest and needed to come in right now. That started my summer off,” said David. “Dr. Sullenberger brought me in July of 2015 and said we needed to have a family meeting. I brought my wife and two kids in, I remember saying, ‘Really? I need a heart transplant evaluation! Are you serious?’ I was perfectly healthy my whole life. I thought I was just getting old.” David’s heart condition was degrading. A heart transplant was needed to save his life. We talked about what happens after you get this kind of diagnosis. How mind-boggling the news, terminology, and explanation can all be. The worst part is when you get home with a head full of questions left unanswered, so you get on the computer. “I googled heart transplant surgery — biggest mistake in my life, I didn’t need to know that. And I googled organ donation,” he said.

David rattled off facts so matter of factly, that after speaking with him, I realized was part of his impeccable memory recall. When it comes to organ donation in the United States, “New York is number 50 in the country. We’re at about 25% of per capita registered, we’re on the bottom of the pile. A New Yorker dies every 18 hours waiting for a transplant,” David stated. At the end of January 2016, an Intra Aortic Balloon Pump was inserted through Dave’s shoulder, another temporary solution until his open-heart surgery to implant a left ventricular assist device (LVAD).

“I knew nothing, absolutely zero about the heart or cardiology. Now I know more than I ever wanted to know in life!”

David Gray

Heart Transplant Survivor, Patient of Capital Cardiology Associates

“I smiled, I stayed strong during the entire process,” he recalls. The implant of an artificial heart made it possible for David walk his daughter down the aisle for her wedding, his major goal for that summer. He was able to return home, live a “normal life”, get back to the things that kept him busy, and most importantly, be with his family. Now David waited for a heart donor. Four months later, he got a phone call in late August that changed his life: a heart had been found for him. The next day he underwent surgery and on September 14th, he was discharged from the Westchester Medical Hospital. His body had accepted the new heart.

Today, David Gray lives like most retirees in the Capital Region. He keeps busy with his projects. David makes beer, cans jam and tends to his five beehives. “This year I have 42 pounds of honey!” he exclaimed. He fishes in the summer and hunts in the fall. But there is one thing that makes David quite unique to men his age: he’s survived heart failure, open-heart surgery, and in his mid-50’s, David is a patient advocate. “I have always helped people, it’s just different now,” David said.

He started small, working with support groups online and in person. He volunteers his time with several organ donor groups, New York State Donate Life, the Center for Donation and Transplant at Albany Med, the American Heart Association, “but my number one priority is with Westchester Medical Hospital”, he said, where he visits on a weekly basis. “My new life is that I visit patients. I talk with patients who come through from Capital Cardiology, I spend twelve hours a day down there.” This year he started visiting area high school students, sharing his story with young people.

David Gray walking with his daughter at her wedding

In a 2012 study, researchers found that the average life expectancy in heart transplant recipients was a little over 9 years, although researchers found a “relatively high quality of life even 10 years after surgery.” For David Gray, it’s obvious to anyone who speaks or meets with him for any amount of time that he is making the most of his new heart. He writes to politicians to celebrities and speaks to anyone who will listen about the need for organ donors. Personally, he has thanked everyone involved with his heart transplant, from the first nurse who saw him at the beginning of his diagnosis to the mother of his heart donor. An estimated 2,000 donor hearts become available in the United States each year. There is a tremendous need for donors across the country. Approximately 3,000 people are on a heart transplant waiting list at any given time, according to the University of Michigan. “We need more heroes, that’s all I can say,” David said. Anyone 16 years old or older can enroll in the New York State Donate Life Registry. Learn more by clicking here.

Written by: Michael Arce, Marketing Coordinator, Capital Cardiology Associates Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.
Study Links Weight History With Congestive Heart Failure

Study Links Weight History With Congestive Heart Failure

PATIENT EDUCATION

Study Links
Weight History
With Congestive
Heart Failure

Why patients are being
diagnosed with heart failure
at 50 years old and what you
can do to lower your risk

One in five people worldwide run the risk of developing congestive heart failure, and this prevalence increases with age. At its base, congestive heart failure implies that your heart, which is a pump, cannot adequately provide the circulatory support required to maintain profusion to all of your organs. As there is no cure for the ailment, patients can only monitor their health closely with lifestyle changes or medication to prevent their heart function from deteriorating irreversibly.

On top of their being no cure for congestive heart failure, the condition is one of the most common infirmities affecting adults over 40 years old with more than 200,000 cases being diagnosed in the US every year. “Unfortunately what we are seeing more common these days are patients in their 50’s and 60’s with congestive heart failure,” states Dr. Connor Healey, a board-certified cardiologist with Capital Cardiology Associates. And for younger patients who receive the diagnosis, “The real scary thing is the overall expected lifespan is five years.”

Some people present no congestive heart failure symptoms. For others, they can experience shortness of breath when doing a light activity like walking around the supermarket, dizziness, fatigue, fluid retention (causing swelling in the lower extremities), sudden weight gain, and changes in their heartbeat. To diagnosis congestive heart failure your doctor will order a series of tests beginning with a blood test, echocardiogram, electrocardiogram x-rays, CT scan, stress test — all designed to show your heart’s function.

Causes

“The problem with congestive heart failure is that it covers such a wide swath of sub diseases,” states Dr. Healey. While you can’t prevent heart disease, for young adults looking to minimize their risk of developing heart attack, stroke, and heart disease that means avoiding lifestyle choices like excessive alcohol use, cigarette smoking, poor dieting, minimal to little physical activity/exercise, and poor sleeping habits. “The heart is an organ; it can’t live forever, it will exhibit age-related changes in your life,” he says. You should also have a regular conversation with your primary care provider, who can map out an individual assessment of risk and prevention plan. “The best thing you can do is to avoid getting congestive heart disease in the first place.”

Types of Congestive Heart Failure

Congestive heart failure is traditionally into two different aspects: systolic and diastolic.

Systolic congestive heart failure implies that the pumping of the heart is weak. As Dr. Healey explains, “We refer to that by the injection fraction which is a useful piece of information for patients to know and to ask their doctor, ‘What is my ejection fraction?'” Ejection fraction (EF) refers to how much blood in the heart, per pump, exits the heart and travels through the body. Most times, EF refers to the amount of blood being pumped out of the left ventricle, the heart’s main pumping chamber, each time it contracts.

Ejection fraction is expressed as a percentage. “A normal value is between 55 and 70%,” says Dr. Healey. “That might not be a great score on an exam but for an EF that is pretty good. Anything less around 40-50% is systolic congestive heart failure.” Your EF can go up and down, based on your heart condition and how well your treatment works.

The other group is diastolic heart failure which means the lower left chamber of the heart (left ventricle) is not able to fill correctly with blood during the diastolic phase, reducing the amount of blood pumped out to the body. “This is a normal EF, but the heart doesn’t function quite as well because it is stiff,” notes Dr. Healey. Over time, this causes blood to build up inside the left atrium, and then in the lungs, leading to lymphatic congestion and symptoms of heart failure. “This is generally related to inflammation and fibrosis which can be caused by any number of factors.”

The American College of Cardiology along with the American Heart Association have collaborated to categorize the four stages of heart failure (HF).

Stage A

The American Heart Association describes Stage A as, “At high risk for HF but without structural heart disease or symptoms of HF.” This diagnosis is typically for patients with hypertension, diabetes, or obesity. “If you have risk factors without actually congestive heart failure, we still label you as Stage A because we want you to be aware of how serious this diagnosis is and to prevent you from progressing to that next stage which is having congestive heart failure,” said Dr. Healey. The risk factors for Stage A include atrial fibrillation (A-Fib), hypertension, coronary artery disease (which involves diet, cholesterol, exercise), and sleep apnea. “AFib is a big risk for diastolic congestive heart failure because if you have a stiff heart, and now you are losing the coordination that occurs with AFib, now you have an inefficient heart with chambers squeezing at inappropriate times, leaving the remaining chambers to try to pick up the slack.”

Your doctor will talk with you about embracing a heart-healthy lifestyle as part of our treatment goals and may prescribe medications (like a statin) to treat vascular disease, diabetes, or high cholesterol.

Stage B

Stage B is outlined as, “Structural heart disease but without signs or symptoms of HF.” Most people with Stage B heart failure have an echocardiogram (echo) that shows an ejection fraction (EF) of 40% or less. “We’ve made the diagnosis after an ultra-sound of your heart which is generally the way we make the diagnosis along with clinical symptoms,” describes Dr. Healey. “You have parameters that suggest your heart is not functioning properly; it’s either weak or inefficient. Again, you’re not symptomatic, so we have time to intervene before it becomes a point where it’s affecting your life.”

Stage C

Patients diagnosed with Stage C have heart failure. “Stage C is the bulk of patients which is symptomatic,” commented Dr. Healey. They will be prescribed many medications to relieve their symptoms. They are placed on low sodium diets. They could also have pacemakers implanted or be put on implantable cardiac defibrillator (ICD) therapy.

Stage D

“Stage D is the end stage of heart failure,” begins Dr. Healey. “Typically that’s systolic congestive heart failure where your pump is completely inadequate. Essentially, you cannot get up and walk more than 20 feet without getting a significant shortage of breath where you have to stop.” Treatment options at this stage include heart transplant, surgery, and research therapies.

Watching Your Weight

A report published in November of 2018 examined a patient’s risk of heart disease compared to their weight history. From the age of 20-40, participants had their weight and body mass index (BMI) score recorded. The team found a 34% increased likelihood of heart disease for every 5 BMI points. “Weight has such a negative impact on many cardiac functions. Most notably I would say, congestive heart failure,” said Dr. Healey. The study authors concluded that “control of BMI throughout the lifetime is important for reducing the risk of heart failure.”

This is why patients are weighed at the beginning of every appointment or office visit. “If we start seeing 5, 10-pound weight gains between visits, that’s something we need to address.” In the weight history study, the authors noted that “the prevalence of obesity in the United States is strikingly high, seen in 36% of adults.” Experts link obesity as a warning sign for younger generations and a contributor to early heart disease diagnosis. “I think as Westerners, in general, we have become accustomed to living at this higher weight, that we think it’s a commonplace, that’s how the body is supposed to be. Well, no, that’s not the case. We need to reverse the attitudes we have about diet, weight, and healthy living,” said Dr. Healey.

“The goal is that patient’s come in for wellness visits. To talk with them about their lives and all of the wonderful things that they are doing. Helping them minimize medications, then the flip side, seeing them after the hospital visit after they’ve been in for congestive heart failure, after a heart attack, and now we are trying to play catch up.”

Written by Michael Arce, Marketing Coordinator, Capital Cardiology Associates
Any medical information published on this website is not intended as a substitute for informed medical advice, and you should not take any action before consulting with a healthcare professional.

Inside Open Heart Surgery

Inside Open Heart Surgery

PATIENT EDUCATION

Inside Open
Heart Surgery

The steps leading to one of the most common heart procedures: Coronary Artery Bypass Graft

The Texas Heart Institute reports that, “Thousands of heart surgeries are performed every day in the United States. In fact, in a recent year, surgeons performed 500,000 coronary bypass procedures.” Coronary Artery Bypass Graft (CABG, pronounced “cabbage”) Surgery is the most common procedure performed to bypasses a severely blocked artery in the heart with a healthy blood vessel. This surgery restores vital blood flow to the heart muscle.

Since the late 19th century, surgeons have been performing cardiac surgery. On May 6, 1953, the first successful open-heart operation was performed on an 18-year-old woman in Philadelphia with a heart defect. What was once a new, unknown, scary procedure is now one of the best known, most studied and most effective surgeries of the modern age. Today, more than 95 percent of people who undergo coronary bypass surgery do not experience serious complications, and the risk of death immediately after the procedure is only 1–2 percent. The list of famous bypass recipients includes celebrities like Elizabeth Taylor, David Letterman, and Larry King to former President Bill Clinton and Vice President Dick Cheney.

Even with this reassurance, there are still concerns and questions surrounding bypass surgery. Dr. Lance Sullenberger is board certified in Internal Medicine, Cardiovascular Disease, and Advanced Heart Failure/Transplant Cardiology. He regularly consults his patients on CABG surgeries. “I would say there are two major ways a patient would present the need for an open heart surgery procedure or CABG,” he said. “The first would begin with a visit to your cardiologist.”

Doctors can determine when someone needs open-heart surgery by performing specific tests. This would begin with a patient who presents typical warning signs, chest pain, shortness of breath or palpitations. People with coronary heart disease sometimes experience buildups of plaque — a combination of fat, calcium, cholesterol and other cellular junk — on the insides of their arteries. This can restrict blood flow and cause clots. The most common symptom of a clogged artery is chest pain. In this case, the physician would order a stress test.

Doctors can determine when someone needs open-heart surgery by performing specific tests. This would begin with a patient who presents typical warning signs, chest pain, shortness of breath or palpitations. People with coronary heart disease sometimes experience buildups of plaque — a combination of fat, calcium, cholesterol and other cellular junk — on the insides of their arteries. This can restrict blood flow and cause clots. The most common symptom of a clogged artery is chest pain. In this case, the physician would order a stress test.

Testing

The heart performs differently at rest than it does during exercise. An exercise stress test – also known as a treadmill test – is designed to help your doctor learn how your heart performs during exercise or other activities that would make the heart work harder. For patients that are unable to use a treadmill or to get a deeper look, your doctor could order a nuclear stress test to help in the diagnosis of coronary artery disease or other heart conditions.

If the result of the stress test is abnormal, that patient would then be placed on medication and referred for catheterization, performed by an interventional cardiologist. “They do a diagnostic cardiac catheterization to look at the arteries that supply the heart with blood to see if that stress test was accurate,” noted Dr. Sullenberger. Again, with this test, physicians are looking for buildups that cause blockage of blood flow. Typically, arteries that are not blocked over 60 to 70% would be treated with medical therapy (medications, alterations in diets, changes in sleep habits, increased physical activity, stress reduction and more).

There could be one or maybe two arteries that have a blockage in them. “In that case, the decision would be made whether or not to use medicines or perhaps put stents in,” said Dr. Sullenberger. The stenting procedure could occur at that moment at the time of the catheterization. “When you start dealing with more than two arteries that are blocked or if there are special situations, such as the main artery on the left is blocked then you have to take a step back and ask, ‘Is this somebody who would be better served by stents or by bypass surgery?’ This is when the cardiologist and the cardiac surgeon would meet to discuss the options involved,” he shared.

The other major situation in which the decision has to be made between stenting and bypass is when a patient presents with a heart attack. “They are coming in with chest pain, losing heart muscle, most of those patients end up immediately in the Cath lab where an interventional cardiologist will look to see which artery is blocked and causing the heart attack, at that moment,” says Dr. Sullenberger. Most of those patients will receive a stent at that moment. A stent is a tiny wire mesh tube that is inserted inside a clogged artery through a tube procedure that does not require open-heart surgery. It props open an artery and is left there permanently.

The other major situation in which the decision has to be made between stenting and bypass is when a patient presents with a heart attack. “They are coming in with chest pain, losing heart muscle, most of those patients end up immediately in the Cath lab where an interventional cardiologist will look to see which artery is blocked and causing the heart attack, at that moment,” says Dr. Sullenberger. Most of those patients will receive a stent at that moment. A stent is a tiny wire mesh tube that is inserted inside a clogged artery through a tube procedure that does not require open-heart surgery. It props open an artery and is left there permanently.

For patients who present blocked arteries that cannot be corrected with stenting, Sullenberger states that the patient is stabilized in the coronary care unit while the cardiologist and surgeon meet to discuss the next best step. “Most good cardiologists have an idea beforehand if this person is going to end up needing a bypass or if they have valve disease,” he says. The timeline on when to operate depends on the patient’s condition. For an out-patient, surgery is performed within weeks. For heart attack patients, those decisions are made in a day, 48-hours at the most.

Surgical Procedure

According to the Agency for Healthcare Research and Quality statistical brief, published in March 2014, about 213,700 Americans have a CABG procedure every year. When someone has bypass surgery, they are in the operating room for several hours, on average about six hours. Most of that time is spent prepping the patient and getting them ready. The actual bypass surgery itself is about a two-hour procedure which can go longer or shorter based on what needs to be done.

In a typical procedure, the surgeon harvests a healthy blood vessel from a donor site. This is called a graft. The graft is commonly taken from the patient’s leg or arm. The surgeon opens the patient’s chest to expose the heart. The patient’s blood flow is diverted to a heart-lung machine. This machine temporarily takes over the lung’s function of oxygenating the blood and the heart’s function of pumping blood to the body. Medication is administered to stop the patient’s heart and preserve it during the surgery. After the bypass is complete, the surgeon removes the clamp from the aorta and allows the heart to resume beating on its own. The surgeon may insert a temporary pacing wire. This wire can be connected to a pacemaker if needed.

The patient then goes to a surgical ICU for recovery, made especially for cardiothoracic patients that receive specialized nursing care. That’s when cardiologists would see the patient. “In a best-case scenario,” Sullenberger begins, “you stay in the ICU about 48-hours after surgery, then you go to a step-down floor for another five days or so. Expect about a week in the hospital. Then you are discharged to go home and will follow up with your cardiologist within a week, and the cardiothoracic surgeon within a week or two, then you don’t see your surgeon anymore.” Unless there is a problem, you won’t see your surgeon again, but you will continue to see your cardiologist on a regular appointment basis.

Prevention

The need for CABG surgeries is expected to expand by just over 5% in the seven years due to stress, obesity, sedentary lifestyle, and unhealthy habits. “For everyone [reading this] now, you never want to have to see a cardiologist or a cardiothoracic surgeon. The way you avoid that is doing everything you can to keep a healthy lifestyle,” advises Dr. Sullenberger. The American Heart Association strongly recommends eating a balanced diet, maintain reasonable body weight, stay at least moderately physically active (within your limits), and to check your cholesterol level regularly, especially if your family has a history of heart disease. Additionally, quitting smoking significantly reduces your risk of developing heart disease, heart attack, and stroke.

Prevention

The need for CABG surgeries is expected to expand by just over 5% in the seven years due to stress, obesity, sedentary lifestyle, and unhealthy habits. “For everyone [reading this] now, you never want to have to see a cardiologist or a cardiothoracic surgeon. The way you avoid that is doing everything you can to keep a healthy lifestyle,” advises Dr. Sullenberger. The American Heart Association strongly recommends eating a balanced diet, maintain reasonable body weight, stay at least moderately physically active (within your limits), and to check your cholesterol level regularly, especially if your family has a history of heart disease. Additionally, quitting smoking significantly reduces your risk of developing heart disease, heart attack, and stroke.

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Alcohol and Heart Disease

Alcohol and Heart Disease

Heart Health

Alcohol and Heart Disease

Are there safe levels of alcohol consumptions for heart patients?

In August, a study published in The Lancet, suggested there is no safe level of alcohol as beneficial effects against ischemic heart disease. Researchers stated, “Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions.” One of the most common questions heart patients are asked by their doctor is, “How much alcohol do you consume?Dr. Robert Benton, Chief of Cardiology at Samaritan Hospital and Director of the Capital Cardiology Associates, Division of Clinical Research stated, “The alcohol question is always in the initial history of a patient. I often counsel a patient on what’s appropriate for their disease or condition. We have to look at everything, blood pressure, pulse, not having arrhythmia… it’s a big story to put together.”

After a heart attack, cardiac event, or diagnosis of heart disease, heart patients can sometimes be overwhelmed with a list of new rules they must live by. There are new medications to take, lifestyle changes like dieting or exercise, along with doctors appointments and other tests/checkups to schedule. As part of returning to a new normal life, patients will often ask their doctor when and if it’s safe to drink alcohol. Every year, there can be conflicting research on the benefits and risks of alcohol and heart disease. “This paper was in The Lancet and offered a retrospective look at countries around the world to see if there were any safe levels of alcohol,” said Dr. Benton.

Wine being poured into a glass

Dr. Benton summarized The Lancet article as a comprehensive, detailed analysis of “safe levels” in retrospective trials. “This study looked worldwide at the huge health burden related to alcohol use even at very low levels which would be less than one drink a day,” he said. The definition for “one drink” is one five ounce glass of wine, 12 ounces of beer (which in the US has 5% alcohol), and or one and a half ounces of 80 proof alcohol or just one shot. “The upside is that if you looked at the study in totality, you would find cancer, self-harm, and tuberculosis, as the three areas of increased events of the middle age range. Within that, there are going to be people, I would adhere to this opinion myself, who are moderate alcohol drinkers using the definitions I just gave you, who have some health benefits to drinking moderate amounts of alcohol.”

“Let me be clear on this point,” began Dr. Benton. “I would never tell or suggest to anyone to start drinking alcohol for any perceived health benefits.” But the discussion comes up frequently. “I usually have it with people who are new to me, new for primary prevention, or a patient in the hospital after having a cardiac event like a heart attack or stroke or surgery,” he said. “I often counsel a patient on what’s appropriate for their disease or condition.”

Alcohol in moderation

“I think for people who safely consume moderate levels (as outlined) there are some benefits to mildly lowering blood pressure, cholesterol, and preventing ischemic stroke (a dry stroke),” shared Dr. Benton. The Lancet study (funded by the Bill and Melinda Gates Foundation) was not the first to explore alcohol’s complex association with health. The authors of this study estimate that, for one year, in people aged 15-95 years, drinking one alcoholic drink a day increases the risk of developing one of the 23 alcohol-related health problems by 0.5%, compared with not drinking at all. So far, the strongest evidence with heart health has shown that alcohol can increase levels of HDL (good) cholesterol. The Mediterranean Diet (endorsed by the Mayo Clinic)  says one standard 5 oz. glass of red wine at dinner is okay. 

Here are some findings from other studies:
• Agavins, the natural sugar in tequila, is shown to help lower cholesterol and can help you lose weight.
• The active compounds in red wine (polyphenols, resveratrol, and quercetin) have been proven to improve overall heart health.
• Whiskey also contains ellagic acid, which known for fighting off cancer by absorbing rogue cells.
• The polyphenols in rosé have been shown to prevent atherosclerosis, a major contributor to heart disease.

Couple on wine tasting tour

The health risks of drinking alcohol vary widely from person to person

“But as you know we have a lot of problems with the downside and damage caused by overconsumption,” cautioned Dr. Benton. “Too much alcohol can also raise your blood pressure, leading to hemorrhagic stroke, referred to as a bleeding stroke in your brain. Alcohol also has toxicity on the electoral system in your heart which can lead to atrial fibrillation. I certainly have a stable full of people with cardiomyopathy and A-fib related to alcohol and they are still drinking. That is not good. That is the opposite conversation!” Dr. Benton points out that even healthy people can have problems processing alcohol which is why the American Heart Association recommends no more than one drink per day for women and two for men. “There is evidence that heavy alcohol use can cause cardiomyopathy (weakened heart). Even healthy people can develop A-fib or as we call it “holiday heart”, we see that in young people who binge drink at parties or are over served,” he said.

But in terms of moderate alcohol use, for a person who has been drinking, had an event or is being treated for primary prevention, “My own opinion, and I think you’d find the opinion would be pretty solid amongst most cardiologists, that person is safe,” shared Dr. Benton. “That doesn’t mean I’m talking to everybody but I’m talking to probably, most people.” Most importantly, Dr. Benton urges people to talk with their doctor or health care provider. “This whole alcohol issue has many different sides to it.” At best he says, “This is a personal decision, advice is individualized for each patient.”

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.

Why Diabetes Increases the Risk of Heart Disease

Why Diabetes Increases the Risk of Heart Disease

PATIENT EDUCATION

Why Diabetes Increases
the Risk of Heart Disease

How much do you know about diabetes
and the link to heart disease and stroke?

Heart disease strikes people with diabetes at significantly higher rates than people without diabetes. Dr. Jeffrey Uzzilia has a special interest in coronary artery disease treatment and prevention. He offered an explanation for the risk of heart disease and stroke for diabetics, “The end process of blood sugar not being regulated properly, can affect the blood vessels themselves and cause stiffness, not only the bigger blood vessels but also, the smaller vessels and the nerves. This can have far-reaching effects on other organs: the kidneys, eyes, the blood vessels themselves. It can also promote atherosclerosis (plaque on the inner walls of your arteries) which is the process that pre-disposes to both cerebral vascular disease or stroke, heart disease, and heart attack.”

For adults at age 60, having type 2 diabetes and cardiovascular disease shortens life expectancy by an average of 12 years. A campaign has been launched to educate people with type 2 diabetes about heart disease and what they can do to reduce their risk. The new, multi-year awareness and education initiative is called Know Diabetes by Heart.

Type 1 Diabetes

Type 1 diabetes is less common than type 2—about 5% of people with diabetes have type 1. In type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, the body attacks it’s own pancreas. “It’s a production of insulin problem,” noted Dr. Uzzilia. “The body decides for whatever reason, whether it’s a virus or predisposition, to attack the beta cells of the pancreas that produce insulin; eventually, the pancreas can’t provide the insulin that the body needs.” Type 1 diabetics must replace their insulin every day, often with medication or by injections.

Currently, no one knows how to prevent type 1 diabetes, but it can be managed by avoiding excess sugars, carbohydrates (non-starchy vegetables), and trans fat. Because their bodies have fluctuating glucose levels, type 1 diabetics often have to plan their exercise and physical activity – even house or yard work, in advance. Usually, they carry orange juice or glucose tablets in the event of a drop in glucose levels. They will monitor their blood sugar levels, sometimes with a quick hand-held monitor, to avoid blood sugar spikes when their insulin isn’t functioning effectively.

Type 2 Diabetes

If you have a mother, father, brother, or sister with diabetes, you are at risk for type 2 diabetes. “Type 2 is a different problem, in that, insulin is being produced, but it’s not being used properly by the body,” said Dr. Uzzilia. “The process for type 2, while there may be a genetic disposition, is lifestyle related. It’s related to inactivity, carrying excess weight, and dietary choices.” There is no cure for type 2 diabetes, but it can be managed.

Dr. Uzzilia said changes in what we eat plays a significant role in the advancement of type 2 diabetes. “I think over time we have started to eat more and more simple sugars, both sodas and white sugars (like pasta, rice, and potatoes),” he said. “Those types of food sources are predisposed to the development of type 2 diabetes.” Balancing the food you eat with exercise and medicine (if prescribed) can keep your blood glucose in a healthy range.

Living with type 2 diabetes puts you at higher risk for heart disease and stroke. Dr. Uzzilia outlined how over time glucose can lead to increased fatty deposits or clots on the insides of the blood vessel walls. “Just as diabetes can affect the small blood vessels that lead to the heart, it can affect those same vessels that are important for the brain like the carotid arteries and the aorta, that tends to be the major source of stroke in the body,” he said. These clots can narrow or block the blood vessels in the brain or neck, cutting off the blood supply, stopping oxygen from getting to
the brain and causing a stroke.

Talk with your doctor

The American Heart Association and American Diabetes Association are urging that adults talk with their doctor at their next appointment about diabetes and the link to heart disease and stroke. Dr. Uzzilia points out that for a complex disease, testing for it is quite simple. “There is a glucose level (fasting glucose level) that can be checked randomly; we can check a fasting glucose level, sometimes we’ll give a glucose tolerance test where we will give the body some sugar to test their tolerance.” People with diabetes can also take an A1C test to find their average blood glucose level over the past three months. This is different from the blood glucose checks that you do every day. The higher your A1C number, the higher your blood glucose levels have been during the past three months.

The CDC reports that 29.1 million people in the United States are living with diabetes: keyword living. “There are many success stories that I try to share with patients,” shared Dr. Uzzilia. “Most people don’t want to be on a number of medications. The very early on-set, when their sugar or blood pressure first goes up, most patients make a dramatic change in their lifestyle. They quit smoking, they say, ‘I’m going to get that exercise I need, I’m going to set that activity time aside.’ They start modifying their diet. I’ve seen people come full circle, where they were on multiple medications, at risk for heart disease, had high blood pressure, had diabetes, and by the end of reaching their modification goals, they’ve lost weight, and in a lot of cases they’ve come off medications which is fantastic!”

Written by: Michael Arce, Media Specialist
Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.