A UM cardiologist shares his insight on heart disease in the wake of
baseball player Darryl Kile's recent death
Get answers to your heart disease prevention questions.
Heart disease isn't generally thought of as a young person's disease, but being young and physically fit is no guarantee the arteries that keep your heart pumping aren't blocked. As the recent death of 33-year-old St. Louis Cardinals pitcher Darryl Kile illustrates, it is never too young to start taking care of your heart.
Below, Michael Miller, M.D., director of the Center for Preventive Cardiology at the University of Maryland Medical Center and a professor of medicine at the University of Maryland School of Medicine, answers some questions about the nature of heart disease and offers some advice on lowering your risk.
What is heart disease?
Heart disease occurs when the major coronary arteries that carry oxygen-rich blood to the heart narrow or become blocked by a buildup of fatty substances. This narrowing and blockage reduces the flow of blood to the heart muscle.
How prevalent is heart disease among young people?
One out of every 20 people below the age of 40 has heart disease.
What are the risk factors for heart disease?
Some risk factors are congenital, meaning that people are born with them. Congenital risks would include people who have problems with their heart valves, and people who inherit genetic problems that promote hardening of the arteries. Other risk factors include diabetes, smoking, high levels of cholesterol and triglycerides in the blood, hypertension or high blood pressure and physical inactivity.
Is it possible to have heart disease and not be aware of it?
Yes. That is why heart disease is called the silent killer. Unless you have a parent who has developed heart disease at a young age, you may not know that you are at risk.
How is it that a person such as a professional baseball player, who obviously gets plenty of regular exercise, could develop heart disease?
Athletes aren't immune to the ravages of heart disease. Just because they are physically active doesn't mean they are necessarily avoiding foods that can lead to a hardening of the arteries. Sure, athletes burn a lot of calories, but if they are eating a lot of meats and foods high in saturated fats, their cholesterol and triglyceride levels may be high.
What are triglycerides?
Triglycerides are a type of fat found in the blood. Triglyceride levels become elevated in the bloodstream after meals high in saturated fat. These fat particles are normally broken down by enzymes. However, when there are too many triglycerides in the blood to be effectively broken down, then fatty deposits can build up in the blood vessels and lead to atherosclerosis or hardening of the arteries.
At what age would you recommend that people get tested for heart disease?
Everyone's arteries begin to clog in late childhood and early adolescence. But for those with a history of heart disease in their families, it is important to get regular checkups, starting in the teen years. People with a family history should also start monitoring their cholesterol intake. In fact, they should do this even before they reach adolescence.
How can clogged arteries be detected?
A commercially available, ultrafast calcium scan can determine whether you have calcium build-up in the heart arteries and would suggest early hardening of the arteries.
What kind of diet would you suggest for a person trying to avoid heart disease?
You can lower your cholesterol and triglyceride levels by reducing the amount of sweets and saturated fats in your diet. You can do this by not eating too many simple carbohydrates that can be broken down into sugar easily. These kinds of carbohydrates include your white breads, white rice, pastas, and candy bars. Once these are broken down into sugar, the pancreas is stimulated to release insulin into the bloodstream.
On the other hand, food products that have fiber and are broken down into sugar more slowly are much better for the body. That is not to say that people should avoid sugar altogether. There is sugar in fruit after all, and we need some sugar for energy. You need to be careful, however, about the sources of sugar you choose. At least when you eat fruit, you are getting vitamins and nutrients, whereas when you reach for a candy bar, you aren't getting much in the way of nutritional value.
What is more important in preventing heart disease: regular exercise or a heart-healthy diet?
The two are inseparable. They truly go hand in hand. Doing one without the other is only doing half of the job.