RX For Readers: Take preventive measures!

What you can do to minimize the chance of a heart attack.

By JUDY SIEGEL-ITZKOVICH
Heart attack cartoon 370 (photo credit: mct)
Heart attack cartoon 370
(photo credit: mct)
A close friend of mine, who was only 40, died recently of a heart attack. Unfortunately he had been a chronic smoker since he joined the military, and I tried to get him to quit, but I didn’t succeed. Despite this, I thought that even with the cigarettes, he died at a very young age.
Who is included in the population at high risk for heart attacks at a relatively young age? Is there a difference between men and women in the risk? What can be done to prevent it? Are there preventive medications that can be taken? M.V., Modi’in
Dr. Ilan Kitzis, a senior cardiologist at Tel Aviv Sourasky Medical Center, replies:
Having one or more risk factors for heart attacks at a young age – including a family history, smoking, high cholesterol, inactivity and poor diet – justifies preventive measures in both men and women, who are usually at higher risk of a heart attack five years later in life than men.
First, it is vital for the person to stop smoking. Second, at-risk people who have excess levels of LDL (low-density lipoprotein, or “bad cholesterol”) over 100 mg%, should lower it. Their blood pressure should be tested regularly, at home or in the clinic, on a regular basis. The normal blood pressure level is 120/80. Sometimes it’s hard to lower the blood pressure levels in hypertensives, but an aggressive effort should be made to lower them.
A younger person at high risk for a heart attack should have and maintain normal weight. In the last few decades, the world’s population – including those in the Western world, in which Israel is included – have been gaining weight. At the same time, there is more diabetes, which is a significant factor for contracting cardiovascular disease. Weight reduction by even a few kilos can improve blood sugar, cholesterol and triglyceride levels and reduce blood pressure.
Regular physical activity, including walking or any other aerobic exercise you like to do, helps prevent heart attacks. You don’t even have to do all the exercise at one time; you can divide it among several parts of the day.
There are a number of imaging procedures, such a cardiac mapping, regular catheterization and virtual catheterization, that can be performed to detect early heart disease.
And finally, taking 75 mg. daily of “baby aspirin,” which can be taken long-term, can prevent clotting in the blood and reduce the risk of heart attacks. Consult your doctor.
My wife and I are 24 years old. We got married a few months ago and are healthy. We are not aware of genetic disease in our families. Happily she is now in her second month of pregnancy.
She went to the gynecologist at our health fund, who recommended all kinds of tests – genetic tests through a blood sample and ultrasound – some of which are not included in the basket of health services.
We were already tested by Dor Yesharim for genetic disorders before we got engaged, and everything was fine. The tests the doctor recommended are quite expensive. As the specialist also works privately, we wondered whether he was recommending these extra tests because he would earn more money.
Can you tell us exactly what tests during pregnancy are necessary and whether there are tests not provided by the health fund that should be done anyway? – L.S., Jerusalem
Prof. Ephrat Levy- Lahad, head of the medical genetics department at Shaare Zedek Medical Center, comments:
It is not possible to give a general recommendation to this couple, but if they are concerned, I recommend that they go for genetic counseling to see what is or isn’t recommended for them. Very broadly, most recommended tests during pregnancy are in the basket of health services covered by the health funds.
As a general comment, it is important to know that the Dor Yesharim organization (which screens young people before they get engaged to determine whether they would be genetically compatible so as not to produce children with genetic diseases) does not perform all recommended genetic tests – specifically they do not test for Fragile X, which is the most common form of mental retardation in males. They do not test for it because it is passed on only through the mother, regardless of the father. The Health Ministry recommends Fragile X testing once for every woman, preferably before conception or, if not, in early pregnancy.
■ Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.