Evanston doc says patients more pro-active about health care
By RHONDA ALEXANDER For Sun-Times Media
Still No. 1: The American Heart Association reports that heart disease remains the leading cause of death — for both men and women — in the United States. | File photo
After working as an emergency room physician for more than three years, Dr. Jamie Harlan has seen the gamut
of heart disease.
Harlan, who is a physician with Presence Saint Francis Hospital in Evanston, says he sees at least three to five patients per shift with chest pain. But it’s not all bad news.
“I think the population knows a lot more about it [heart disease] now, so they are more aware [and this] actually helps us,” Harlan said.
Patients are being more proactive about their symptoms, he said. Rather than waiting and seeing what happens, they take action by coming to the ER where tests can be done. This has resulted in earlier diagnoses, which leads to improved survival rates.
“There’s been a 25 percent decrease in the instance of death and morbidity from cardiovascular disease in the last 10 to 15 years,” Goodwin said.
Nevertheless, heart disease, which is an umbrella term for several heart conditions including coronary artery disease, remains the No. 1 killer in the United States — for both men and women — according to the American Heart Association. Yet the prevailing majority of Americans don’t see heart disease as their greatest health threat.
The Centers for Disease Control and Prevention reports that heart disease accounts for 25 percent of all U.S. deaths and it is a leading cause of disability.
Sandy Mickulich, nurse practitioner at Advocate South Suburban Hospital’s Heart Failure Clinic in Hazel Crest, says coronary disease and stroke are the leading cause of death in south suburban Cook County, and women there are disproportionately affected.
The American Heart Association reports that one in three women is living with cardiovascular disease, including nearly half of all African-American women and 34 percent of white women. The CDC reports that 64 percent of women who die suddenly from coronary heart disease have no previous symptoms. Mickulich says women — even though they have chest pain or they have symptoms of heart disease — often will not go and get help until it’s too late.
“Women tend not to access healthcare because they are the care givers,” Mickulich said.
Goodwin notes that the face of heart disease also looks a lot younger than in previous years.
“It’s not uncommon for us to see people [with heart disease] in their 40s and even someone in their 30s,” Goodwin said.
Limited access to information about treatment and prevention can also play a role.
“Certain groups are possibly underserved and under-treated which creates a prevalence of heart disease,” said Dr. Matthew Sorrentino of University of Chicago’s School of Medicine.
In addition, many people who have heart disease have another major health issue, such as diabetes or kidney disease.
“[High cholesterol, obesity, heart disease, diabetes] … it’s all intertwined,” Mickulich said.
Prakash Makam, cardiologist and medical director of the Peripheral Arterial Disease Center at Community Hospital in Munster, Ind., is quick to affirm that the presence of kidney disease makes some more prone to poor heart health.
“People with kidney disease are prone to PAD [peripheral arterial disease] … as it is a disease of the arteries,” Makam said.
Doctors recommend you know where you stand with lab values such as blood pressure, cholesterol, blood sugar, height, weight and body mass index. And put your bad habits in neutral.
“Bad habits accumulate over time like the plaque in our arterial walls … over time, we are more likely to develop heart disease,” said Jean Owen Alves, registered nurse and nutritionist for the Rush Nutrition and Wellness Center in Chicago.
Smoking, high blood pressure and high LDL cholesterol are key risk factors for heart disease.
“If a patient stops smoking, they can significantly reduce their risk,” Sorrentino said.
Owen Alves believes prevention is always better than treatment.
“Nutrition and physical activity are both key to preventing heart disease,” Owen Alves said.
And in fact, taking care of your heart can reduce your risk for diabetes.
“If you lose 10 percent of your body weight, you can decrease your blood pressure … and if you lose weight, you decrease your risk of developing diabetes,” Mickulich said.