Dental Associates of North Virginia

Northern Virginia Health & Life Magazine: January/February 2010
"Heart Smart"

There’s no escaping the facts: Cardiovascular disease is the leading cause of death among adult men and women in the United States. And last month, when the American Heart Association (AHA) released its updated statistical projections for 2010, the news was even more grim: Cardiovascular disease and strokes are expected to cost the United States more than $500 billion this year, an increase of nearly six percent. “Current statistical data show Americans to be on average overweight, physically inactive, and eating a diet that is too high in calories, sodium, fat, and sugar,” the organization stated in a press release. “The risk-factor data we’re seeing now indicate a larger future burden on the healthcare system unless these trends turn around. On the flip side, risk- factor management and maintaining health through prevention is infinitely cheaper than disease management and treating illness.”

To that end, the AHA has set lofty goals for the next decade—by 2020, to help improve the cardiovascular health of all Americans by 20 percent while also reducing deaths from cardiovascular diseases and strokes by 20 percent. To reach those goals, Americans will have to start making healthier lifestyle choices. So why wait? If you begin making a difference today, you can help safeguard many tomorrows.

Understanding Your Risk

Heart disease can strike anyone, and certain factors (like age, genetics, and gender, for example) are beyond your control. But when you have a clearer picture of your personal risk profile, you can take a more active role in making heart-healthy changes. The more risk factors you have, the more likely you are to develop heart disease; this is further influenced by the degree of each risk factor. The AHA recommends paying special attention to these factors:

Blood pressure. Levels that are consistently above 120/80 increase the heart’s workload, which in turn causes the heart to thicken and stiffen prematurely. When this happens, the heart does not work as it should and puts you at higher risk not only for cardiovascular disease but also for a heart attack, stroke, and kidney failure.
Cholesterol. As blood cholesterol rises, so does risk of coronary heart disease. It is recommended that total cholesterol be less than 200, but remember that cholesterol is more than just a single number. LDL, or “bad” cholesterol, should be less than 160 if you’re at low risk for heart disease; less than 130 if you’re at intermediate risk; and less than 100 if you’re at high risk for heart disease. On the flip side, HDL, or “good” cholesterol, yields some protection against heart disease. For women, the goal is an HDL level of 40 or higher; for men, 50 or higher. For a more complete picture, triglyceride levels—the measure of a specific fat found in the blood—also should be considered. The goal for both sexes is a number less than 150.
Age. You can’t do anything about your age, but you should be mindful of it: Your risk of heart disease increases as you get older. This is especially true for women, who demonstrate a precipitous spike in heart disease after menopause.
Gender. Men are more likely to develop heart disease, but women are more likely to die from a heart attack. This is due, in part, to the fact that women’s arteries are smaller, which makes them more vulnerable to blockage—and when a blockage does form, it becomes an issue much faster. Also, women tend to seek help later than men do; on average, they get to the emergency room almost two hours later, when significant damage has already been done.

Exploring the Link Between Your Heart and Your Mouth

Where does heart disease begin? The answer may surprise you. In some cases, it begins in your mouth. As it turns out, people with periodontal disease are twice as likely to have coronary artery disease.

“A lot of concrete information has emerged to link gum disease and heart disease,” says Beverly Fink, RDH, director of dental hygiene for Dental Associates of Northern Virginia and the president and founder of PerioAdvocates. “When an oral infection is present, the same pathogens found in the gums in the mouth may be found in the arteries of the heart. These pathogens gain access to other parts of the body through the bloodstream and are able to travel to other organs and have an adverse effect on them. With heart disease, the pathogens may produce enzymes that cause heart attacks and strokes.”

Explains periodontist Leo Sushner, DDS, also of Dental Associates, “Many times, if a patient has an inflammation of the gum tissue, that serves as an entryway for bacteria to get into the bloodstream. When that happens, the organisms attach to the fatty plaques in blood vessels and contribute to clot formation.” This happens more readily than you may think: When somebody has gum disease, doing something as routine as eating deposits bacteria into the bloodstream. “You’re chewing against an open wound, so to speak,” says Sushner, “and allowing a low-grade type of infection into the rest of the body.”

For someone with a known heart disease, bringing that disease state under control may depend on getting their periodontal health under control as well. “Otherwise, the treatment is not as effective as it would be,” says Sushner. “Patients could be complicating the benefits of their treatment. If you’re diagnosed with a coronary problem, be extra certain to make sure your mouth is as healthy as possible.”

Says Fink, “What we really learned at the end of the twentieth century is that the mouth is connected to the body—what’s happening in the mouth can have a serious effect on the overall health of the body. Oral care affects the whole system and the whole system affects the oral status. It’s quite exciting to see how all of this works together.”

Your Heart is in Your Hands

The good news is that you’re not defenseless in preventing heart disease. By taking an active role in your healthcare and by managing your lifestyle, you can make a difference.
Bring any disease states (periodontal disease, diabetes, high cholesterol, etc.) under control under a doctor’s supervision, and be vigilant about complying with your doctor’s instructions.
Stop smoking now! It’s that simple.
Get up, and get going! Exercising at least three times a week for 30 minutes has been shown to cut the risk of heart attack and stroke.
Maintain a healthy diet, full of fruits, vegetables, whole grains, low-fat dairy products, lean protein, and fish rich in omega-3 fatty acids.
Maintain a healthy weight.
Keep stress manageable, or seek means to help you cope effectively.
Get regular checkups and screenings.

Know the Signs

Many heart attacks start slowly, with mild pain or discomfort. Among women, the symptoms are often vague. Any one of these signs could mean that you are having a heart attack, so be sure to pay attention to your body’s cues if you experience any of the following:

Chest discomfort, often in the center of the chest, that lasts more than a few minutes or that goes away and comes back. This might feel like uncomfortable pressure, squeezing, fullness, or pain.
Discomfort in other areas of the upper body, including one or both arms, shoulders, the back, neck, jaw, or stomach.
Shortness of breath, with or without chest discomfort.
A cold sweat, nausea, or lightheadedness.
A sense of malaise.