Heart disease remains America's silent killer, claiming more lives each year than any other condition and accounting for 20% of all deaths nationwide. While cardiovascular health becomes increasingly critical as we age, experts emphasize that heart care matters at every stage of life.
This February, as we observe American Heart Month, Michael Horne, DNP, AGNP-BC, shares vital insights on maintaining a healthy heart. As an Assistant Professor of Clinical Teaching at the University of Colorado College of Nursing at Anschutz Medical Campus and a practicing cardiology nurse practitioner, Horne brings both academic expertise and hands-on clinical experience to this crucial conversation. His background in pharmacology and patient care provides a unique perspective on practical steps everyone can take to protect their heart health.
Q: Why Protect Your Heart Health?
A: The stakes couldn't be higher when it comes to cardiovascular health. Beyond the fundamental goal of longevity, a healthy heart is essential for maintaining the quality of life we cherish. When cardiovascular health declines, it impacts every aspect of daily living – from the energy to enjoy time with loved ones to the ability to pursue favorite activities and maintain independence.
What makes heart disease particularly challenging is its gradual development. It often builds silently over years or decades, shaped primarily by our daily lifestyle choices. The good news is that this same characteristic means we have numerous opportunities to intervene and make heart-healthy decisions before serious problems develop.
Q: What age groups or populations are most affected by heart disease?
A: Heart disease affects people of all ages, but certain age groups are at a higher risk. Males are more susceptible than women. One-third of men over 80 have some type of heart disease. But that number drops to 7 percent of men ages 40 to 60. In men (and women) under 40, heart disease is almost non-existent, although the underlying factors for future heart disease may already be present and evolving.
If you add in race or ethnicity, white men have the highest prevalence of heart disease. Interestingly enough, the second highest prevalence is in African-American women. There are theories about that – including stress and diet. People of Asian descent typically have the lowest prevalence of heart disease.
There are also other risk factors – for example, someone in an underserved population might be at higher risk because they might be getting less care or not eating healthy foods because of cost.
Q: What can you do to stay heart healthy?
A: The most important thing – don’t smoke. Hands down. That’s the biggest controllable contributor to heart disease by far.
Ways to Stay Heart Healthy
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Other lifestyle factors including being overweight/obese, drinking excessive amounts of alcohol, not staying active, and having high stress levels can contribute to a higher risk of developing hypertension, high cholesterol, chronic kidney disease, diabetes, and sleep apnea. These chronic diseases increase the risk of heart disease.
Q: What about vaping? How does that affect heart disease?
A: The American College of Cardiology is looking into the impacts vaping has on heart disease. The issue is that there can be nicotine in some vapes. Nicotine is a vasoconstrictor (meaning it narrows blood vessels) and causes stress to the heart.
Q: Are there any symptoms of heart disease to be aware of?
A: There are some common symptoms, but they differ between men and women. For men, it’s chest pain or pressure that lasts up to 15 minutes, particularly if you’re doing some type of intense activity.
In women, they might feel chest pain but they can also have GI system problems, nausea, an upset stomach, or fatigue. Other symptoms men and women should watch out for include:
- Jaw pain
- Shoulder pain
- Shortness of breath
Q: What roles do nurses play in educating patients about heart disease?
A: Nurses and advanced practice nurses like nurse practitioners play very important roles and will continue to be more heavily involved with heart disease management as our population ages.
RN-wise, the most important thing they do is patient education. They also do a lot of screening and monitoring, including blood pressure checks or drawing blood.
Nurse practitioners are involved in primary care, screenings, monitoring, and managing conditions related to heart disease. A cardiology specialty NP might work with a team of cardiologists to help manage conditions and provide care.
Q: How often should your blood pressure be tested?
A: People over 40 should get their blood pressure tested at least once a year during an annual screening by a nurse or a medical provider. People aged 18-39 should get it checked about every three to five years unless they already have high blood pressure. People who have high blood pressure might be told to check it a home once a day or several times a week.
Q: I’ve heard of people taking statins. What are they, and how do they help?
A: Statins are medications that reduce the bad type of cholesterol, known as “LDL cholesterol”, and they’ve been shown to reduce cardiovascular events. They are one way for people to manage their heart disease risk. If your medical provider advises taking a statin, you should do so unless your body can’t tolerate it. They’ve truly saved more lives in terms of cardiovascular prevention than any other drug invented.
Q: Is it too late to make these lifestyle changes?
A: Start making lifestyle changes as soon as possible. If we could manage our lifestyle issues, we wouldn’t have a healthcare coverage cost problem in the US. If people could start managing their weight and lifestyle choices earlier – in their 20s and 30s – our population might be healthier because there’s that long-term impact.
