Heart health depends on healthy behaviors

Everyone knows that the heart health of Americans is dismal. Obesity, diabetes, and high blood pressure are all on the rise.

For now, technological advances in cardiac care continue to maintain, or in some cases, lower the death rate from heart disease. Squishing blockages, ablating abnormal heart tissue, and installing cardiac devices have successfully kept the abysmal lifestyle habits of so many at bay. Despite all the fury of modern technology — or maybe because of it — many continue to fail miserably on the front end, that is prevention.

A recent article in the Wall Street Journal, from a noted Ivy league prevention expert, purports vascular age as another means to tell patients of their poor blood vessel health. On a positive note, this piece educates us on the role of the blood vessel, particularly the seemingly inert, but highly susceptible to inflammation inner lining, known as the endothelium. Correctly proclaiming the endothelium as the crux of heart health is a good thing.

Also, telling an unhealthy 40-year old that he has the artery health of a 64-year old is certainly a novel idea that is more elegant and maybe a bit more eye-opening than just telling him he is fat, out of shape and now has diabetes. As far as educating goes, the vascular age thing is quite good, but it is still only education, not motivation.

In 2010, can anyone American not know about heart healthy behaviors? Education on heart disease is ubiquitous; even substituted for smart policy decisions, like Louisville’s chief doctor who opposed banning toxic trans-fats in favor of educating the public on their danger.

As is the case with most able-bodied, non-dabbling electrophysiologists, I can ablate SVT, atrial flutter, and implant pacemakers and ICDs with greater than 95% efficacy. Even PAF can be successfully eliminated two-thirds of the time. Yet, despite trying hard (really hard), I fail more than 90% of the time to get patients to change their heart healthy behaviors. Nine in ten patients return just as fat and sedentary as they were at the time of my previous lecture on heart health.

In heart health, getting people to know is not the issue, rather the issue is in implementation of the plan. The treasure at the end of the rainbow, is a mechanism or strategy that affects people’s lifestyle choices. Somehow, something. or someone needs to find a way to motivate people to change their lifestyle. This is the holy grail of heart health. The solution is before us in clear view.

Politicians, MPAs, MPHs and the like all talk about health care savings of this plan or that plan, but can you imagine the savings if there was a major change in population behavior. Imagine the savings if masses of people stopped smoking, started carving out time for 30 minutes of exercise, leaving the table still able to walk upright, and going to bed on time. Imagine the health of our youth if we had mandatory gym class every day, healthy food in the cafeteria and healthy parent role models.

John Mandrola is a cardiologist who blogs at Dr John M.

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