Making Sense of Medicine

To put it another way, the first day of grief increased the risk of MI by more than twenty times what would be expected on a day without such sorrow.

Over the years I’ve heard of multiple loving couples who have died within a week of each other. I’ve heard people say: “He (or she) died of a broken heart.” The above study, published in the medical journal Circulation, supports those comments.

What I take away from this research is a renewed resolve to do what I can to support people who are grieving. Grief is a painful time. The way “life was supposed to be” has been altered, perhaps abruptly. I was walking purposefully down one path, thinking I could see my goal in the future, and now, suddenly, I am forced to walk down this other path, with no goal visible. The process of adjusting to this new reality is what we call grief. And it’s no fun.

Maybe all a grieving person needs is a wordless hug. I suspect that’s all that person needs. 

A new campaign, named “Million Hearts”, has been launched by the US Department of Health and Human Services to try to prevent one million heart attacks and strokes over the next five years. It uses the four letters “ABCS” to help us all remember key ways to safeguard our blood vessels, particularly the blood vessels that feed our hearts and brains.

“A” is for Aspirin. Million Hearts urges all those at high risk for a heart attack or stroke to take some amount of aspirin – usually a “baby aspirin”, which is 81 milligrams. The tricky thing is to figure out who is at high risk, though there are ways to calculate this if you know your blood pressure and cholesterol levels. If your 10-year risk of heart attack is over 10 percent, aspirin is recommended. The American Heart Association has a calculator you can do online at: https://www.heart.org/gglRisk/locale/en_US/index.html?gtype=health

“B” is for Blood Pressure. Many people are walking around with high blood pressure. This is risky for their blood vessels, which are stressed with each heart beat when the pressure within them is high. People may know they have high blood pressure (also known as “hypertension”), but their medicines aren’t working well, or maybe they aren’t taking them. Many more folks don’t know their blood pressure is high – they’ve never been diagnosed. What are the numbers to shoot for? The top number – systolic – should be below 140, and the bottom number – diastolic – should be below 90.

“C” is for Cholesterol. When I check my patients’ “cholesterol” level, I’m actually checking for several lipids (total, HDL, LDL-C, and triglycerides). The Million Hearts campaign is focusing on the LDL-C level, which is what I call the “really bad cholesterol”. (Hey, I try to make things understandable to my patients!) Everyone should have an LDL-C level below 160, and people at high risk for a heart attack or a stroke should keep it below 100. If eating well (low fat diet) doesn’t get a person to these levels, then cholesterol-lowering medications are necessary.

“S” is for Smoking. Regular readers of my blog know that I harp on the value of stopping smoking. If you’re a smoker, the number one Healthiest Thing you can do is stop smoking. I saw a patient this week who was very anxious – almost frantic, really – about the possibility that he might have cancer. He smokes. I said, “There’s a disconnect here. If you’re so worried about getting cancer, why are you still smoking?” He said he would try to quit. I sighed. I hope he does it. He won’t just be decreasing his risk for cancer, but also his risk for heart attack or stroke. 

May the Million Hearts campaign be successful!