According to the American College of Cardiology, Metabolic syndrome has been called the “perfect storm” when it comes to heart disease risk. It’s a combination of health problems—for example, carrying too much fat around your waist, high blood pressure, elevated blood sugar levels and abnormal cholesterol levels—that often occurs together and raises your risk of heart disease, stroke and diabetes. This clustering of risk factors happens because the body has a hard time regulating cholesterol (lipids), certain proteins and sugars (glucose).
It can be worrying to learn that you or a loved one has metabolic syndrome. The upside is that if it is found early, it can serve as an important warning and help put you on a heart-healthier path. Many lifestyle changes, including weight loss, can prevent and even reverse metabolic syndrome, or delay the development of serious health problems.
At Ohio Heart Group, we offer a specialty clinic to specifically address Metabolic Syndrome, where the patient receives a personalized care plan. If we can catch these risk factors early on through tests and a physical exam, and offer a meaningful plan that the patient can reasonably follow, we can help reduce the risk that these patients will go on to develop heart disease and diabetes.
Metabolic Syndrome: The Plain Facts
Long term hypertension caused by salt can lead to many cardiovascular diseases such as heart failure, atrial fibrillation, aneurysms, and osteoporosis.
Heart Failure is a syndrome defined by the inability of the heart to maintain an output necessary to meet metabolic demands at normal intracardiac pressures. Excessive salt intake will lead to hypertension followed by diastolic dysfunction. Cholesterol buildup from longstanding hypertension will lead to heart attacks, loss of muscle, and finally, systolic dysfunction.
Elevated blood pressure over time turns arteries, which start out more straight/direct, into twists/bends. Frequently, there are steep bends like hairpin turns. The blood is flowing through these twisting arteries at an even higher pressure. So at every turn there are shearing forces in play. In due time, the inside lining of the arteries is damaged at all these friction points. Cholesterol is prone to deposit wherever there is damage to the inside lining of the arteries blocking the flow of blood.
The extra blood pressure caused by eating too much salt puts extra strain on the insides of your arteries. To cope with the extra strain, the tiny muscles in the artery walls become stronger and thicker. Yet this only makes the space inside the arteries smaller and raises your blood pressure even higher. This cycle of increasing blood pressure can ultimately lead to the arteries bursting or becoming so narrow that they then clog up entirely.
Lets’ look at the Yanomami Indians in the Brazilian amazon jungles as they have never been exposed to salt and therefore never added salt to their diet. The only salt consumed was what is NATURALLY present in their food. If salt is never added to food from birth, adult blood pressure is likely to be 90/60 on average instead of 120/80, which is generally considered normal. The blood pressure is likely to remain in the same range instead of increasing with advancing age. Middle-age weight gain, which we take as part of the normal aging process would not occur, either. The Yanomami Indians are on the number of tribes who live in isolation without exposure to salt and who remain slender through advancing age (1). Lifetime probability of hypertension is 90% with processed foods contributing to 77% salt consumption in the U.S. (2).
It is not only a matter of living longer; it is the quality of life in later years. As a consequence of adding salt to your food, you will have many medical, financial, and social difficulties in later years. Just about everybody will be affected, starting as early as age 50. The disabilities will be prolonged, painful, and costly. You are really not going to enjoy your later years as much as you expect to.
Secondly, most people are prescribed some dietary restriction from about the age of 50 anyway, some even earlier. They have great difficulty in adhering to such restrictions and do so begrudgingly. Transition to food with no added salt, however, is not that difficult. Once you make this successful transition, you will not miss all that excess salt. You will still enjoy the food (without salt) and be healthier as well as more functional in the long run.
Is there such a thing as eating too little salt? The body needs only a small amount of sodium (less than 500 milligrams per day) to function properly. That’s a mere smidgen — the amount in less than ¼ teaspoon. Practically no one in this country even comes close to eating less than that amount. Plus, healthy kidneys are great at retaining the sodium that our bodies need.
There’s no reliable evidence that eating less than 1,500 mg per day of sodium is a risk for the general population. There is some evidence that this may be harmful to certain patients with CHF, but those people make up only a small part of the population (American Heart Association). For these reasons, reduction in salt intake is calculated to have the most impact in reducing these avoidable deaths worldwide-more so than reduction of tobacco use.
1. Jairo de Jesus Mancilha-Carvalho, Nelson Albuquerque de Souza e Silva. 2003. Arquivos Brasileiros de Cardiologia 80:295-300.
2. Havas S et al. 2007. Journal of the American Medical Association 298(12):1439-1441
Habits are hard to change. Activities that you do every day come naturally and easily. Think about your routine when you wake up in the morning. Often, we find comfort in the daily routine of putting on slippers, having that first cup of coffee and reading the newspaper or checking emails on our phone. Habits can bring true comfort, except if those habits are actually doing us more harm than good.
Often, my patients admit to me the anxiety and fear that they have surrounding giving up smoking. Know that, because we each have habits that bring us comfort, we can understand how giving up one of those habits might be a scary concept.
People verbalize a fear of giving up something that helps them cope with boredom, loneliness or stress. They associate smoking with friendship, socializing, driving or relaxation. Although most people know and understand the risks of smoking, including cancer, heart disease, lung disease, fertility problems, insomnia and premature aging, many people find it difficult to bridge the gap between knowing these dangers and taking action to quit this dangerous habit.
As your healthcare providers, our job is to support you on your journey to better health. Dr. Katapadi as well as the physician assistants and nurse practitioners of Ohio Heart Group can counsel you on ways to tackle your smoking habit. These include lifestyle changes, medications, nicotine replacement and reaching out to supporting organizations in our community. We encourage you to replace an unhealthy habit like smoking with a habit that could improve your health like going for a walk, playing with your children or grandchildren, cooking a healthy meal, calling a friend, volunteering your time in the community or learning a new skill.
By giving up the habit of smoking, you can gain your health back, as well as money in your pocket. An average pack of cigarettes in Ohio costs more than $6/day. That is more than $2,000/year. For less than $2,000, you can take two people on a 7 day cruise from Florida to the Caribbean. Now THAT is something to strive for!
Summer is right around the corner, and with each change of the season, so follow your habits. It's time to treat yourself to better health!
Hypertension, high blood pressure, or HTN, no matter the name you use, is a problem you should not ignore. HTN will not present with symptoms most of the time, therefore it is important to have your blood pressure checked regularly.
HTN can be caused by a multitude of offenders, ranging from things that are out of your control such as family history, age, gender and race to those you you can control, such as high-sodium diet, obesity and lack of physical activity.
HTN can lead to stroke, heart attack, vision loss, heart failure, kidney damage and sexual dysfunction. Now what can you do about it? Focus on the things you can control:
What can you look forward to? A healthier life!
The summer months are upon us and it is time to get outside and move. Take advantage of all that Columbus has to offer outdoors. Take a walk with a friend, go for a bike ride, or head out for a jog. No matter your activity level, get out there and move. Local metroparks are a great opportunity to relax and enjoy your surroundings.
Another opportunity that the summer presents is fresh fuit and vegetables. Now is the time to introduce new fresh foods into your diet. You will be surprised what you enjoy!
Tips for a successful summer:
One of the questions many of our patients have is “do I have congestive heart failure?” We can sense the patient’s concern, especially with the word “failure.” When you’ve only got one heart, “failure” sounds scary.
After understanding the patient’s symptoms, doing a physical examination, and getting the necessary test results, our next step is to assess the patient’s heart. There are three primary types of heart conditions that can lead to failure:
Our goal in heart failure treatment is first to understand what stresses your heart is under and then deal with them. In the case of a weakened heart, for example, we often prescribe medications to manage blood pressure, reduce the forces against which the heart has to pump blood, and also help the heart to physically get stronger, if possible. We also counsel patients limit their fluid and salt intake – as well as take a daily weight -- so that the heart pumps blood and not extra fluids. Other advice includes avoiding alcohol, which can cause a weak heart to get even weaker, and to exercise prudently.
What are the effects of treatment? In some cases – such as a partially blocked coronary artery – placing a stent or another type of intervention may solve the problem. In some cases, medications and changes in personal habits may strengthen your heart. In other cases, the heart impairment is permanent, however medications and behavioral changes can lead to “compensated” heart failure, where you can continue to lead a near-normal lifestyle.
When should you be suspicious of having heart failure? The most common symptom of congestive heart failure is shortness of breath with exertion. In fact, if you don’t have this symptom, research tells us that you are 84% likely not to have the condition. If you wake up in the middle of the night gasping for air, there is an 84% change that you do have the condition, though we would also have you tested for sleep apnea.
Heart failure is a serious condition, but one that we can work on together. If you have any questions regarding your symptoms and treatment, please let us know.
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