Healthy Living

with Dr. Madelyn Fernstrom

Preventive Medicine for a Healthy Heart

Among the top health concerns of men and women everywhere is that of a "healthy heart". Whether your heart can be healthier or healthiest is based on a combination of both sustained, positive lifestyle habits and quality medical care. It really comes down to the things you can control (daily habits) and things you cannot (genetics).

No one appreciates more than me the contribution that a healthy lifestyle can make to optimizing heart health. I have a strong family history of heart disease, so for my entire adult life, I've worked to maintain a stable weight, exercise moderately, and monitor my total fat intake, among other things. While I believe these steps have contributed to good health, I could not ignore a slow creep in my total cholesterol, coming from an increase in my LDL ("lousy") cholesterol, even with a very high HDL ("healthy") cholesterol.

The good news is that there is an amazing tool available to identify signs of the dreaded "artery clogging", or atherosclerosis, years before it may cause a problem. It's been described as a "mammogram for the heart", and is called an Electron Beam CT scan, or heart scan. Painless, and taking less than 10 minutes, it's a snapshot of the heart, revealing calcium deposits in the walls of blood vessels. Calcium deposits are a marker of "plaque" - an accumulation of cholesterol and cellular debris within the arteries of the heart. This plaque, left untreated, can lead to heart disease, including angina, or even to a sudden heart attack. Depending on the calcium score (how much calcium there is and where), a treatment plan is devised to best treat the appropriate risk factors or to further investigate the arteries themselves.

I visited Dr. Dan Edmundowicz at the UPMC Cardiovascular Institute's Center for Heart Disease Prevention to take this test. He heads the only center in the region with this specific type of machine, which has a much lower radiation exposure than conventional CT scanners. What my scan showed was surprising to me, but was readily explainable by him. While I had a lot of numbers and ratios that indicated good health from my blood work, the picture of my heart was "worth a thousand words"! It told him I had the earliest stages of artery clogging (a tip-off from my increasing LDL cholesterol). On the computer screen with my pictures, Edmundowicz circled some small calcium deposits, explaining this was a result of my vessel vulnerability dictated by my family history. My healthy lifestyle certainly optimized what I could control, but my genetic predisposition appeared clearly on the screen.

I understood at that moment the power of preventive medicine for heart health, and the importance of approaching this problem head on. Talk to your doctor about whether a heart scan should be part of your preventive health plan. What you don't know can be damaging to your health.

If you have a health question for Dr. Fernstrom, e-mail her at fernstrom@wqed.org.

Dr. Madelyn H. Fernstrom, Ph.D., C.N.S., is the founder and director of UPMC's Weight Management Center. She is the diet and nutrition editor for NBC's "Today Show" and is the author of The Runner's Diet. Also visit "Health Journal with Dr. Madelyn Fernstrom," a health and wellness blog at iVillage.com.