Yes, you may suffer heart disease, even in the most fitness-fanatical state of the union

cdcinactivitymap2019-300x265Sure, it can be fun to watch two East Coasters take a long, sharp pin and pop the fantasy bubble that Westerners, especially Coloradans, like to float around in. Mountain state residents may like to tell themselves how the people on the Front Range skew young, educated, and active. How blue skies and open spaces keep folks busy and outdoors. And did they mention super healthy?

Or maybe not.

There’s a bigger takeaway in the recent focus on the Rockies by reporters Betsy McKay and Paul Overberg. As the Wall Street Journal duo found:

“Americans are dying of heart disease and strokes at a rising rate in middle age, normally considered the prime years of life. An analysis of U.S. mortality statistics by The Wall Street Journal shows the problem is geographically widespread. Death rates from cardiovascular disease among people between the ages of 45 and 64 are rising in cities all across the country, including in some of the most unlikely places. In the Journal’s analysis, three metro areas east of Colorado’s Rocky Mountains — Colorado Springs, Fort Collins and Greeley — recorded some of the biggest increases. Death rates in each rose almost 25%. The three cities boast robust access to exercise and health care. There are bike trails, good heart-disease treatment-and-prevention programs and nearby skiing and hiking. They are also part of a booming urban corridor where new subdivisions, shopping centers and big-box stores are pushing into former ranch land and once open roads are becoming clogged with traffic as new residents move in. Like much of America, the region is undergoing changes that foster more stress and sedentary lifestyles. Other metro areas that ranked in the top 10 for death rate increases include Lexington-Fayette, Ky., with the biggest increase; Atlantic City-Hammonton, N.J.; and Kennewick-Richland, Wash.”

McKay and Overberg quote doctors, public health officials, and other experts to warn Americans that the battle against heart conditions, just as with many other chronic and relentless diseases, is neither an easy nor a sure thing. It requires extensive and sustained effort, not only by the trained medical pros and institutions but also by individuals. They also can’t rely on the feel-good notion that because lots of people who surround them are healthy and well, they will be, too — almost by magic.

As the newspaper reported:

“[U]nderlying causes of cardiovascular disease are universal and difficult to address, public-health officials and doctors say. While the South and some other parts of the nation have perpetually high rates of death from heart disease and strokes, middle-aged cardiovascular death rates are rising even in place where those rates have been historically low. ‘It’s everywhere,’ said Judy Hannan, senior adviser at the Centers for Disease Control and Prevention to Million Hearts, a federal initiative to prevent heart attacks and strokes. Health officials cite a number of factors threatening to rob Colorado of its historically healthy status. The state’s adult obesity and diabetes rates, though still the lowest in the nation, have risen over the past several years. High blood pressure, drug and alcohol use, stress and a lack of physical activity — even in an exercise-mad state — also play a role, they say. These factors also increase risk for people who are genetically disposed to heart disease…”

The reporters, without surprise, quote a Colorado Springs cardiologist about ways that patients may protect their heart health:

“He counsels patients regularly about lifestyle changes and managing risk factors. He follows a mostly plant-based diet and extols others to eat healthier — including his colleagues. He once stuck his business card in a biscuit-and-cheese casserole in a hospital doctors’ lounge with the message, ‘If having chest pain, please call’ and a circle around his office phone number.”

Besides diet, experts have reported for some time now that Americans must keep moving if they want to keep up their wellness. And, for as much chiding as Coloradans may be taking over the Wall Street Journal heart story, the federal Centers for Disease Control, separately, has affirmed the state is a leader in its residents staying active.

On the other hand, new CDC data paint a problematic picture about our inactivity (see figure above), with 15% of Americans surveyed reporting to the agency that they failed to participate in “any leisure-time physical activities over the last month – activities such as running, walking for exercise, or gardening.”

Just under half of the respondents in seven states and two territories —Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Oklahoma, Tennessee, Puerto Rico, and Guam — described themselves as inactive. As the CDC reported: “By region, the South had the highest prevalence of physical inactivity (28%), followed by the Northeast (25.6%), Midwest (25%), and the West (20.5%).”

Ruth Petersen, a doctor who directs CDC’s Division of Nutrition, Physical Activity, and Obesity, commented on the survey findings, saying:

“Too many adults are inactive, and they may not know how much it affects their health. Being physically active helps you sleep better, feel better and reduce your risk of obesity, heart disease, type 2 diabetes, and some cancers.”

This is not good. In my practice, I see not only the harms that patients suffer while seeking medical services, but also the benefits that they can enjoy by staying healthy and far away from the U.S. health care system. It is fraught with medical errorpreventable hospital acquired illnesses and deaths, and misdiagnoses.

Heart disease, alas, persists as the leading cause of death in the United States, blamed in about 1 in 4 deaths that occur each year. Too many Americans struggle and die from heart conditions, including coronary artery disease, strokes, arrhythmia, and heart attacks.

Experts long have known and have identified key risk factors for heart problems including: High blood pressure, high blood cholesterol, and smoking. The CDC says that 47% of Americans have at least one of these three risk factors. Other medical conditions and lifestyle choices can also put people at a higher risk for heart disease, including: Diabetes; overweight and obesity; unhealthy diet; physical inactivity; and excessive alcohol use.

We’ve got to do better to protect ourselves from heart problems — and it may not be as tough as we think. We may need to, as a shoe company slogan advises, just do it.  Recent research from the independent, nonpartisan RAND Corporation scrutinized Americans’ detailed reporting of their daily lives, finding that many of us have far more free time than we suspect. As the experts reported:

“But instead of being physically active during their free hours, Americans report they spend most of that time looking at screens (televisions, phones or other devices) with no gender or economic group spending even 7% of their free time on physical activity. ‘There is a general perception among the public and even public health professionals that a lack of leisure time is a major reason that Americans do not get enough physical activity,’ said Dr. Deborah Cohen, co-author of the study and a physician researcher at RAND…’But we found no evidence for those beliefs.’”


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