Ticker Shock

By staff January 1, 2008

In the 1960s, boyish-looking, athletic President John F. Kennedy took one look at his fellow Americans and decided it was time for them to get in shape.

“We are under-exercised as a nation,” he said. “We look instead of play; we ride instead of walk.” Kennedy wrote an article for Sports Illustrated called “The Soft American” and created the President’s Council on Physical Fitness (adapting it from Eisenhower’s President's Council on Youth Fitness) to get the Pepsi Generation moving. Which means baby boomers must be the fittest generation of all time, right?


The sad truth is boomers are the softest Americans of all time. It’s more than just embarrassing. Despite all the hype about boomer fitness, statistics show that boomers are sicker than people of comparable ages in times past. Nearly half of all Americans aged 55 to 64 have hypertension; more than 35 percent are obese. Boomer deaths from heart disease alone are projected to increase 130 percent by 2050.

“That’s probably a conservative estimate,” says Dr. Kenneth Pfahler, a board-certified invasive cardiologist at The Cardiology Center of Englewood. “Yes, boomers have embraced fitness—recently. But when they were young, many weren’t raised to exercise regularly and control their cholesterol. Smoking was prevalent. In these cases, the damage has already been done. Once heart disease is established, it’s harder to control.”

Pfahler doesn’t relish his role as the bearer of bad news. But he doesn’t sugarcoat it, either. “Heart attack and stroke are going to kill this generation,” he says.

Pfahler isn’t a pessimist, just a realist. More than 15 million Americans suffer from coronary heart disease. Each year, more than eight million Americans experience heart attacks—nearly 400,000 people die from the experience. So what’s a boomer to do?

First thing? Find out if you’re at risk. And if you think you don’t want to know, your thinking is dead wrong.

“Cardiovascular disease can’t be cured, but it is completely manageable,” says Pfahler. “That’s true no matter how advanced your condition is. You can turn things around, but you have to be proactive and aware of how your heart is working.”

Let’s define a few terms. Cardiovascular disease comprises a host of heart conditions, including abnormal heart rhythms or arrhythmias, heart valve disease, congenital heart disease, aortic disease, vascular disease and coronary artery disease. The latter is the top killer of Americans, so let’s be more specific.

In coronary artery disease, plaque and fat deposits plug the arteries feeding oxygen-rich blood to the heart, causing the heart to work harder for its nutrients and oxygen. If you’re lucky, this extra strain will result in chest pain (angina) and other symptoms. But almost half of the people suffering from this disease show no obvious symptoms. And that’s a problem.

Bad habits lead to bad hearts—but the reverse is also true. According to Pfahler, learning heart-smart habits can turn your life around. So put down that cigarette and listen up. It’s not that complicated. Here’s Pfahler’s three-fold path to heart health:

First step: Buy a blood pressure testing kit and test yourself weekly. It’ll cost you around $65, and it just might save your life. “Be aggressive,” Pfahler says. “There’s tremendous benefit in knowing your blood pressure.” What’s ideal for a 55-year-old? “120 over 80 is good; 120 over 70 is better,” says Pfahler. If it’s over the line? Tell your doctor.

Step two: Test your cholesterol level annually, or more frequently if it’s been high. (The American Heart Association reports that 107 million Americans have borderline high or higher cholesterol levels.) Lowering cholesterol can reduce risk of heart attack by as much as 40 percent. Don’t wait until you’re 50, says Pfahler. “It’s never too early to develop healthy habits; if you have a family history of high cholesterol, then start getting tested in your 20s.” In general, the lower your LDL (bad) cholesterol, the lower your risk of heart attack and stroke. Under 100 mg/dL is optimal. Higher HDL (good) cholesterol levels are better, and should range from 50 to 60 mg/dL for woman and 60 mg/dL or higher for men. The bottom line? You want high HDL and low triglycerides and LDL.

Pfahler’s third step is (as he puts it), “Get off your butt and exercise! Exercise is better than any medicine I can give. Exercise trains your body to be more energy-efficient. It lowers your blood pressure, lowers bad cholesterol and raises good cholesterol. It increases the efficiency of extracting nutrients and oxygen from the blood.” You don’t have to run marathons (although he does), he says, but you do have to keep up at least 20 minutes of aerobic exercise every day. Exercise alone isn’t enough; it has to be aerobic. That means at least 40 minutes of total exercise; 20 to get your heart to the target aerobic rate; 20 to sustain that rate.

To summarize: Work your heart. But know your heart first.

Pfahler’s steps towards heart knowledge depend on two basic heart health indicators—blood pressure and cholesterol level. The diagnostic tools are simple. But medical technology hasn’t stopped there.

The 21st century has seen cutting-edge advancements in diagnostic tests to identify early signs of stroke, heart disease, and plaque build-up. One exciting new tool is computed tomography, commonly known as a CT scan. This heart-imaging test uses digital processing to visualize heart anatomy, coronary circulation and vessels. It detects coronary calcification caused by atherosclerosis (arterial narrowing), often before symptoms develop. Knowing the build-up is there can help you know when to change your lifestyle and seek out preventive medical therapies.

Stephen Miley, M.D., FACEP, is the managing director of Axcess Diagnostics, a Sarasota-based, state-of-the-art outpatient imaging enterprise. He’s a true believer in the 64-slice CT scanner, the Maserati of heart scanners. “The device is fast,” he says, “So fast, it actually records images of the heart between beats.” There’s a hint of awe in his voice. Indeed, Miley sounds like an evangelist when he talks about the scanner’s lifesaving capabilities.

He launches into an anecdote about a casual acquaintance he was chatting with one day. The man, who was in his 50s, asked about new diagnostic technology. Miley told him about the 64-slice CT scanner.

“I suggested he have a scan of his heart—to make sure all was in working order,” Miley explains. “But he assured me he was fine; had no heart problems. He was trim, fit and previous CAT scans showed no problems. For the heck of it, I convinced him to have a CT scan. Within five minutes after the test, we saw that he had a 93-percent narrowing in one of his arteries. A subsequent cardiac catheterization confirmed the presence of profound coronary artery disease. Within a few weeks, his cardiologist performed stent surgery to open that artery. He’s fine now.”

Miley’s point? “Simply put, this test saved his life,” he says. “Fifty percent of people with coronary artery disease exhibit no symptoms at all. This is the single best tool for diagnosing heart disease: It’s quick and inexpensive and should be available to everyone who is over 45.”

Dr. Michael Mollod, an invasive cardiologist with The Sarasota Heart Center, suggests adding a few more routine diagnostic tests if you’re past 45, including an EKG and a stress echocardiogram. To further investigate abnormalities discovered during a stress test or CT scan, he may recommend a cardiac catheterization to examine the condition of the blood vessels in even closer detail. If blockage is discovered, he may treat it with medication and/or an angioplasty with stent placement, a procedure in which a catheter-guided balloon opens up a narrowed coronary artery. For extensive and widespread coronary artery disease, Mollod may perform the more invasive coronary graft bypass surgery.

Mollod is quick to point out that surgery isn’t a solution—not of the underlying problem, at any rate. “Just opening the blockage doesn’t halt the disease process,” he cautions. “You have to treat the underlying disease.” Mollod does this by using anti-platelet therapy (such as aspirin or Plavix), statins (such as Lipitor) and an ACE inhibitor (such as Altace), and dietary and lifestyle changes. Like Pfahler, Mollod is bullish about the need for healthy diet and exercise. And, in case you’re wondering, Mollod practices what he preaches. He’s an acclaimed marathon runner.

“Stenting and bypass surgery establish better coronary blood flow,” he says. “That helps the heart and makes the patient feel better, but it doesn’t halt the process of atherosclerosis. A healthy lifestyle, including daily exercise, is vital in maintaining the health of your heart. There’s no other way around it—no magic procedure or pill. Heart disease doesn’t have to be the number one killer in America. It’s up to each one of us to be responsible for our health.”

Or, to paraphrase the fit-conscious President Kennedy: Ask not what your doctor can do for your heart. Ask, rather, what you can do for your heart. 

To reduce your risk of heart disease, it remains important to decrease your risk factors using more proven methods than vitamin supplementation. Some of the best methods include:

· Quit smoking and using tobacco products

· Have your doctor check your lipid profile

· Get treatment, if necessary, to reach a lipid goal of LDL less than 100 (those at high risk should reach a goal of less than 70) and HDL greater than 45

· Eat foods low in saturated fat and cholesterol and rich in fiber and nutrients (including antioxidants)

· Be active and exercise regularly

· Control high blood pressure and diabetes

· Achieve and maintain an appropriate weight

· Ask your doctor to do a blood test to detect high-sensitivity C-reactive protein, a general marker of arterial inflammation and indicator of heart disease

· Have regular check-ups with your doctor

· Ask your doctor about taking aspirin (between 80 and 160 mg once a day)

SOURCE: Cleveland Clinic

Reduce Your Risk of Heart Disease

· One person in five suffers from some form of cardiovascular disease, including the following:

· High blood pressure: 72 million 

·  Coronary heart disease: 15.8 million


·  Angina pectoris: 8.9 million


·  Myocardial infarction (heart attack): 7 million


·  Stroke: 5.7 million

· Congenital cardiovascular defects: 1 million


·  Congestive heart failure: 4.7 million

Filed under
Show Comments