Infection, snoring, even diet soda may play havoc with your heart
Authors
Marc Gillinov, left, a heart surgeon, and Steven Nissen, a Cleveland
Clinic cardiologist. Among findings, rheumatoid arthritis and lupus,
they say, increase risk of heart disease.
Most
people know that coronary heart disease is firmly linked to five basic
risk factors: high cholesterol, high blood pressure, obesity, diabetes,
and smoking.
But heart disease is a threat to practically everyone, not just hefty couch potatoes who smoke.
As
scientists delve deeper into what causes and contributes to unhealthy
hearts, they are finding an increasingly complex disease process.
Inflammation, infection, and immune dysfunction are key players in the
clogging, narrowing, and "hardening" of arteries that can lead to a
complete cutoff of blood flow - a heart attack.
Researchers are
also identifying a seemingly endless list of potentially dangerous
habits. Last year, for example, a University of Miami study that
followed 2,500 New Yorkers for nine years found that people who drank
diet soda every day had a 61 percent higher risk of heart attacks and
stroke than those who avoided the drinks - even after the researchers
adjusted for age, smoking, exercise, and daily calories.
Critics
quickly noted that the study could not say whether the diet-soda
drinkers were downing Big Macs, fries, and other foods that might be
the real villains.
While many suspected risk factors remain
controversial, some unusual suspects have amassed a convincing body of
evidence. Among them:
Gum disease
If your gums
aren't healthy - and about a quarter of Americans have some periodontal
(gum) disease - then your heart may be suffering along with your teeth.
Large
population studies have consistently found that people with gum disease
are more likely to develop heart disease than those with healthy gums.
This
link is not simple, since people who don't brush and floss tend to have
other bad habits such as smoking and eating junk food.
But the
link "definitely" makes biological sense, concluded leading gum-disease
specialists and cardiologists in a joint 2009 statement.
Gum
disease is a bacterial infection, and infection triggers inflammation.
Chronic inflammation plays a role in the buildup of fatty plaques that
cause atherosclerosis, or hardening of the arteries. What's more,
people with gum disease have elevated levels of C-reactive protein
(CRP), a marker of bodily inflammation that is a risk factor for
cardiovascular disease.
The experts recommend that if you have
gum disease and at least one other cardiac risk factor, such as high
cholesterol, get a medical evaluation. And if you already know you have
heart disease, talk to your dentist about whether your "oral hygiene"
needs brushing up.
Immune problems
Chronic inflammation is also a hallmark of autoimmune diseases, in which infection-fighting cells attack the body's own tissues.
In
recent years, scientists have clearly shown that two autoimmune
disorders - rheumatoid arthritis and lupus - increase the risk of heart
disease.
Of course, you can't simply eliminate these risk factors
if you have them. What's more, corticosteroids commonly used to treat
autoimmune disorders can increase blood pressure.
But you can
control traditional heart disease factors such as smoking and weight.
You can also be on guard for symptoms of heart trouble. In their new
book, Heart 411, cardiologists Marc Gillinov and Steven
Nissen describe a middle-age woman who attributed unfamiliar pain in
her back and shoulder to her rheumatoid arthritis. She was shocked when
she belatedly discovered she'd had a heart attack and needed a
procedure to unblock an artery.
Sleep
Snoring can be even harder on the heart than on a marriage.
Snoring
is now recognized as a classic symptom of sleep apnea - periods when
breathing stops because relaxed throat muscles narrow or block the
airway. These brief sleep interruptions are momentary cardiac mayhem,
decreasing oxygen, increasing blood pressure, altering blood clotting
and heartbeat. Over time, apnea increases the risk of hypertension,
artery blockages, stroke, heart failure, irregular heartbeat, even
sudden death.
Fortunately, awareness and treatment of apnea have
grown.
Unfortunately, most people don't know that almost any sleep
disruption can be hard on the heart if it goes on indefinitely. Shift
work, insomnia, frequent waking, or sleeping six hours a night or less
can have harmful cardiovascular effects - not to mention make you tired
and irritable.
The remedy, experts say, is as simple as it is
difficult to achieve: Get about seven hours of sleep a night. (Go easy
on the alcohol and caffeine near bedtime.)
Irregular periods
Polycystic
ovary syndrome, which affects an estimated 10 percent of women, is a
complex metabolic disorder that varies in severity. The most common
symptom is infrequent or prolonged menstrual periods, a result of
hormonal imbalances.
In many cases, the syndrome goes undiagnosed, or is not treated until a woman has trouble getting pregnant.
Meanwhile, the disorder can wreak havoc with blood sugar, cholesterol, insulin, and other indicators of heart health.
If
you're a woman with a history of menstrual irregularities, think about
your cardiovascular system. Even if you think you're way too young for
heart disease, make sure your doctor runs tests to evaluate blood
glucose, triglyceride, and cholesterol levels.
Contact staff writer Marie McCullough
at 215-854-2720 or mmccullough@phillynews.com.
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