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Heart disease, it starts with your genes

By Dr. Brian Chesnie

Categories: Heart & Vascular

For some of us, heart disease begins when we’re still in diapers. That may sound a bit dramatic but thanks to the complexities of cellular biology, some of us start to experience the weathering effects of arteriosclerosis, or hardening of the arteries, while we are infants. By the time we have a heart attack, stroke or a troubling stress test, it is likely that coronary artery disease has been smoldering in our bodies on a molecular and cellular level for decades.

I know this can sound troubling. We like to think we’re in control of things, but genetics and our environment play a significant role in our heart health. When we smoke or make unhealthy diet and exercise decisions, we can further exacerbate a problem that may have been brewing since before we could walk.

Thankfully, we have several weapons in our arsenal that didn’t exist back in the day: Good nutritional information, good information on activity and exercise, good information on the perils of smoking, and statins.

Let’s start with statins. Many people recoil at the word. People don’t want to hear that they need to take a medication for the rest of their lives. Mostly, though, they are resistant to taking a medication if they can’t feel that the drugs are “working.”

When a person takes antibiotics or chemotherapy, there is an immediate sense of what the drug is doing. The medication can make you feel lousy (or worse) for a set amount of time, but then (hopefully) the pneumonia goes away or your cancer slips into remission, and you can get on with your life.

With statins, the drugs work to prevent a coronary event. You only know it is having its desired effect when nothing happens. And that, no pun intended, is a harder pill to swallow.
Taking a pill is important as is all the right life style issues, but still, bad things can happen, and heart attacks and strokes can still occur. This is where genetics plays such a strong role.

Of course, diet and exercise are also crucial to living a long, healthy life, (as is good luck!) There are a lot of fad diets, but instead of eating like a caveman for a month or only drinking lemon juice for three days, I recommend to my patients that they involve themselves on an ongoing basis with the Mediterranean Diet.

Rich in vegetables and legumes, olive oils and Omega-3 fatty acids, the Mediterranean diet stays away from saturated fats, and has been found in multiple studies to lower cholesterol and reduce the risk of heart attack.

Exercise is hard for a lot of people to do. I like to suggest that people find a way to be active. A good daily walk is very helpful. Ease into a stroll and then spend part of the time walking briskly and then slow back down. Keep doing it and you’ll start to feel better.

So while your arteries might start showing signs of trouble when you’re a toddler, don’t despair. Between pharmacology, exercise and healthy eating, there is plenty you can do to stay, literally, young at heart.Brian Chesnie, M.D. is a Cardiologist and Chairman of the Hoag Cardiology Department. He is a Fellow of the American College of Physicians, Fellow of the Royal College of Physicians (Canada), Fellow of the National Lipid Association, and he sits on the Board of the Pacific Chapter of the National Lipid Association