How’s Your HEART?

Pamela Thomas had always received a ­perfect bill of health. At six feet, and 140 pounds, she worked out six days a week–a regimen that included weight training, yoga, and Pilates–and ate a vegetarian diet. To physicians and lay people alike, she didn’t fit the stereotype of someone with heart disease.

But at age 38, Thomas’ life changed. She became one of roughly 5.5 million Americans diagnosed with congestive heart failure (CHF), a cardiovascular condition in which the heart can no longer pump enough blood to the body. Thomas was born with an enlarged heart that never gave her trouble but last fall, she remembers severe swelling of her legs, feet, and abdomen that prompted her to see a doctor. During the visit, her primary physician dismissed her symptoms, telling her that she didn’t look like a candidate for heart problems and to come back if symptoms persist. “I cried all the way back to my office. I felt, at that point, nothing was solved.”

At that point, Thomas began tracking her condition by creating a photo diary of her body. “I would walk out of my house at 140 pounds and come in again at 170,” she says of the swelling. “I started feeling heaviness in my heart. It felt like a board was on my heart.”

Nearly a month later, her primary doctor finally suggested she see a cardiologist. Tests revealed that two liters of fluid had built up around her heart, and she was rushed to the hospital for emergency surgery. Within the past year, Thomas has undergone three major operations to repair her damaged heart. The first procedure to remove the fluid around her heart was done by a inserting a needle in the chest. Two weeks later, the fluid came back. The second procedure, called pericardial windows, required a surgeon to open her chest and insert tubes to drain the fluid. The procedure was successful and fluid hasn’t returned. In the third procedure a surgeon used a robot to repair her heart valves and an atrial septal defect, which is a hole in the heart. Thomas also takes medication for a condition called atrial fibrillation, a disorder in which the heart doesn’t pump at a normal rate. For an adult, a normal resting heart rate ranges from 60 to 100 beats per minute (bpm). For a well-trained athlete, a normal resting heart rate may be as low as 40 to 60 bpm. “My exertion level is completely different now. Any type of stress, I feel now,” says Thomas. “Now I feel it on my heart. I physically feel it.”

Thomas’ condition is just one example among many different types of life-threatening cardiovascular diseases (CVD). In fact, an estimated 80 million Americans–one in three adults–are afflicted with one or more types of CVD, considered the No. 1 killer of men and women worldwide. The condition is often used interchangeably with “heart disease,” a range of ailments that affect your heart including blocked blood vessels that can result in a heart attack, stroke, or chest pain (angina). Other maladies that also fall into this category include ailments related to blood vessels such as coronary artery disease, heart rhythm problems (arrhythmias), and congenital heart defects.

In many cases, such afflictions have gone unnoticed among African Americans due to neglect. In fact, experts say that 80% of heart disease and heart attacks are preventable with knowledge of your risk factors, medication, and lifestyle changes.

A Critical Situation
In the United States alone, heart disease is responsible for 40% of all deaths, more than all forms of cancer combined. The American Heart Association reports that heart disease claimed 864,480 lives in 2005, compared to 559,312 cancer-related deaths; 117,809 death caused by accidents; and 12,543 deaths due to complications from the HIV/AIDS virus.

In 2006, death rates from CVD were 306.6 for white males and 422.8 for black males; 215.5 for white females and 298.2 for black females. (Death rates are per 100,000 population).

According to Dr. Christopher Leggett, director of Cardiology for Medical Associates of North Georgia

and one of BE’s Top Doctors, African American women and men have the nation’s highest prevalence rate related to heart disease at 45.9%, superseding 37.8% and 33.3% rates for white men and women, respectively. The reason blacks represent the greatest at-risk group: A high prevalence of risk factors such as hypertension, obesity, and diabetes. Says Leggett: “For every 10 diabetics, eight are going to die from heart attacks.”

A Preventable Disease
Author of Heart Smart for Black Women and Latinas (St. Martin’s Griffin; $13.95), Dr. Jennifer Mieres, director of nuclear cardiology at the New York University Medical Center and one of be’s Top Doctors, maintains heart disease is preventable and encourages patients to participate in designing their own wellness program. “Heart disease is one of those things that’s sort of silent,” she says. “Plaque builds up in the arteries and you sometimes don’t know anything until you start having chest pains. For the unlucky people, there are no warning signs and they just die of heart attacks.”

Mieres explains the lining of arteries that supply blood to the heart deteriorates over time due to high blood pressure, elevated cholesterol, obesity, smoking, and diabetes. Once the lining weakens, it acts as a foundation for the build-up of fatty plaque which can cause the formation of blood clots. As a result, these clots prevent blood flow to heart muscles, causing heart attacks and other severe problems.

She believes the best protection is maintenance and prevention through four simple lifestyle changes: Exercise or, as Mieres says, “choosing to move” for 30 minutes at least five to six days a week. Exercise increases HDL (good cholesterol) and decreases LDL (bad cholesterol) which, in turn, helps to prevent heart disease.

Avoid smoking. According to the AHA, cigarette smoking is the leading cause of premature death in the United States. Cigarette smokers have a higher risk of developing chronic disorders such as fatty buildup in arteries and coronary heart disease. Also avoid second-hand smoke.

Change your diet. Eat five daily servings of heart-healthy foods such as fruits and vegetables; broiled or baked dishes–skip the french fries; and put down the salt shaker.

Control stress levels. Evidence suggests, according to AHA reports, a relationship between cardiovascular disease risks and environmental and psychosocial factors. Acute and chronic stress may affect other risk factors such as high blood pressure, cholesterol levels, physical inactivity, and overeating.

How Stress Can Be Deadly
For Bernard Tyson, a healthcare executive for Kaiser Permanente in Pleasanton, California, the inability to control stress put his life in jeopardy. Tyson admits work—life balance has always been a struggle. His usual week consisted of 15-hour workdays and constant travel. In 2006, Tyson felt short of breath and thought he was having mini asthma attacks. Actually, he suffered from cardiomyopathy, a disease of the heart muscle that made it difficult to pump blood to the rest of the body. Usually the condition can be treated if caught early. His case, however, was left untreated and after a weekend with friends in Las Vegas, he was hit by a full-blown attack and went into congestive heart failure. During the attack, Tyson, 50, remembers having difficulty breathing, his heart palpitating quickly, and feeling congested. His valve was not closing properly, so blood backed up into his lungs and other parts of his heart. After his friends rushed him to the hospital, he slipped into a coma for three days and had to be flown to San Francisco for open-heart bypass surgery, a procedure that creates a new route for blood and oxygen to reach the heart. “I knew I was dead. But then they woke me up out of my coma and I realized that I was still alive, he recalls. “So everything in me was geared toward the next step to full recovery.”

Since his surgery, Tyson hasn’t had any complications. He needed to make serious changes to his diet and lifestyle though. The first change: Reducing his salt intake. “Sodium is in almost everything we eat. The biggest eye-opener for me is how much salt we use to preserve products that we buy every single day,” says Tyson.

The second change was getting back in shape. “Every day, no matter how miserable I felt, I had to do some type of exercise, whether that meant walking to the corner, around the house, or lifting minor weights” he says. “It was a very deliberate and aggressive program to get me back up to full speed.”

Cultural or Individual Responsibility?
Leggett believes while some cultural differences predispose African Americans to certain behavior, they must be vigilant and exercise self-discipline. “You can say that African Americans culturally like to eat or don’t exercise or are just overweight in general, and I’ll say to you the things we want to do seem to get done,” says Leggett. “African American men will jump in a car and drive 100 miles to play golf, but won’t drive two miles to see a doctor.”

Today, both Thomas and Tyson know their lives will never be the same again. With the help of family and friends, they are both making the necessary individual changes to live healthy and productive lives. “I’m learning how to love my heart more and more every day. I don’t overdo it,” says Thomas. Currently, Thomas is in a 22-week physical therapy program and is up to 17 minutes walking on the treadmill. She decided to also cut her work hours and works only two full-time days and three part-time days as a district sales manager at General Motors in Atlanta. “I enjoy what I do, but the underlying stress of the load will harm you, especially someone like me,” says Thomas.

Both make sure to stay physically active and take medication to help their hearts be as efficient as possible.  “If I’ve learned anything from this heart situation, it’s that I have a different appreciation for life, ” says Tyson. “I don’t sweat the small stuff nearly as much as I used to beforehand.”

This article originally appeared in the February 2010 issue of Black Enterprise magazine.