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Show The causes and latest treatments for coronary artery disease—the nation’s No.1 killer—-and what you can do to minimize yourrisk: You Can Protect ———] Your Heart By Isadore Rosenfeld, M.D. heart attack occurs whenone of the three coronary arteries that provide nutrition to the heart is suddenly blocked. This is usuallythelast stageofarteriosclerosis (hardening of the arteries), in | Boris Yeltsin Russian president whichfatty plaques progressive- Larry y Kinj ‘Talk-show host ly narrow the coronaryarteries. | The immediate causeof the heart attackis the ruptureof the plaque orthe formation of a fresh clot that totally closes the artery. ARE YOU AT RISK? | T areseveral riskfactors foraheart | attack, and the moreof them youhave. || th eater your Vulnerability. Arterio: | sclerosis becomes evident at about age40 in menandafter menopause in women || and progresses as you get older. The soon er you control theserisk factors, the better & CHOLESTEROL. This » the main | blood fat in the arterial plagues. It has tw main components: “Good” cholesterol called “high-density lipoprotein” (HDL curries cholesterol away from the ar terial wall and deposits it in theliver, which excretes it, The “bad” kind-—“low-density lipoprotein” (LDL)}—deposits cholesterol mio thelining of the coronary arteries eventually forming plaques. Whenyou'r given achoketerol reading, youshould knows | the HDL and LDL levels: Jack Paar Former talk-show host Tommy Lasorda Formerbaseball manager © Theratio oftotal cholesterol to HDL should beless than 4 (the lower the better), # Total cholesterol—no higher than 200 * LDL levels shouldnot exceed 120 @ TRIGLYCERIDE another blood fat, ts also arisk factor Theupper limit of normal, whenfasting. is 200 milligrams ® TOBACCO. Every time youpuff on. 4 Weed, ity nicotine throws arteries (in cludingthe coronaries) into spasm, shut ting down thebloodflow within them. The Richard Pryor Comedian heart disease are overweight. Weighing more than you should raises therisk of a heart attack—especially if the extra poundsarein the waist, not the hips. To determineyour risk, measure your Waist at its narrowest and your hips at their widest, Divide the waist measurement by the hip measurement. Any number high er than 0.95 in menand0.85 in women less of family history, controllingrisk fac- tors will improve your outlook. & MENOPAUSE. Estrogen replacement in Menopausal women reduces their risk meansa higher risk of heart disease of heart attack by athird to a half, ac cording to the American Heart Asso- ® DIABETICS whose blood sugar runs ciation, But recent studies suggest that majority of the 350,000 deaths caused by high. who are overweight and whosecho tobacco every year in the U.S. are due to Vascular disease andheart attacks. @ HIGH BLOOD PRESSURE is silent killer, It speeds upthe processof ar teriosclerosis—but it’s easy to control Even if you've already got heart trouble. normalizing high blood pressure will pro Jong your life substantially lesterol and other blood fats are abnor 8 OVERWEIGHT. Most patients with @ Know the risk factors for heart disease.If you have any, begin at once to reduce them. @Start a regular exercise program—ideally, 30 minutesfive days a week. @ Knowthe “early warning” symptomsof angina pectoris. If you have any, see a doctorfor testing. glf you test positive for angina, take your medications exactly as directed. Take aspirin every day. Know the symptoms of a heart attack.If you think you're having one, get toa hospital as fast as possible. mRemember—successful heart surgery affords you a second chance to get rid of risk factors and live in good health. once a woman has a heart attack, estro- gen maynot beeffective. You shoulddis mal are especially at risk. They should cuss with your doctor the pros and cons of try to keep sugar levels and blood lipids close to normaland maintain ideal weight ® YOUR GENES. It several close blood relatives havehad heart attacks before age 60, you'relikely to have onetoo. But not necessunly: These reltives may have been smokers or had other risk factors. Regard hormonereplacement in your case ® HOMOCYSTEINE is an amino acid normally found in the blood in concen trations of 5-15 micromols. In patients with coronary artery disease, we may find values greater than15. High levels come down with supplements of folic avid Deel peal piped PAGE 16 JANUARY10, 1999 hp Re PARADE MAGAZINE |