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Insights & Expertise
One person dies every 34 seconds in the United States from cardiovascular disease, according to the CDC, and yet, 80% of premature heart disease and strokes are preventable. February is recognized as American Heart Month and a time for people to focus on their cardiovascular health.
Saint Joseph's University physical therapy professors explain the main symptoms of heart disease, the importance of behavioral modification in preventing it and how to recover from heart-related issues.
Professor Natalie Goldberg is a Board-Certified Clinical Specialist in Cardiovascular and Pulmonary Physical Therapy. She says the biggest risk factor is developing hypertension.
"[Hypertension] is probably your first warning that things are going on that could lead to the development of coronary heart disease,” says Natalie Goldberg, PT, DPT, clinical assistant professor of physical therapy.
Lora Packel, PT, PhD, professor and chair of the Department of Physical Therapy, says many people deal with symptoms like high blood pressure. However, those people are considered asymptomatic until it "reaches a critical level" where it could be causing vessel or organ damage.
"One of the main things that we can do is to help people understand their risk factors,” says Packel. “Also, [we suggest] preventative medicine to make sure that they meet with their primary care physician even when they are young and to do it consistently so someone can monitor and watch."
In addition to hypertension, Packel says other symptoms include, but are not limited to, chest pain, shortness of breath, pressure above the waist, nausea, indigestion, jaw pain or shoulder pain.
"Any unusual or new symptom above the waist should be evaluated," says Packel.
Any unusual or new symptom above the waist should be evaluated.
According to the CDC, heart disease has been the leading cause of death in the United States since 1950. In 2020, about 697,000 people in the United States died from heart disease. However, there are ways to prevent it.
"There are a number of risk factors that are modifiable, meaning we can do something about them," says Packel. "There are [other] structures in place that make it difficult to change behaviors. I think that as time has gone on, it has gotten easier to eat prepared and processed foods. It has gotten easier to sit in Zoom meetings and not exercise. It has become harder and harder to meet the guidelines that we know have been shown to reduce our chances of getting heart disease."
Professor Melissa Lesser is also a Board-Certified Clinical Specialist in Cardiovascular and Pulmonary Physical Therapy. She suggests some simple modifications while noting the importance of risk factors.
"So obviously, diet and exercise are the big ones," says Melissa Lesser, PT, DPT, clinical assistant professor of physical therapy. "We can recommend all the physical activity in the world ... but, to our patients or the general population, it does not mean a whole lot if they still have these other risk factors going on."
Lesser points to a research article on the importance of "exercise snacks."
"Taking a walk, climbing up and down a flight of stairs, just the 30 seconds it might take and then coming back to our desk job is something within people's power to help improve their risk factors,” she says.
The ultimate key to preventing heart disease is behavioral consistency.
"A lot of what we see is yo-yo dieting and exercise," says Goldberg. "You have a month where you do really well and then you get off the bandwagon. It is actually worse for you."
Goldberg also says preventing heart disease is not just a "personal" problem, but also a "societal" problem. According to a survey in 2020, 31.6 million people in the United States did not have health insurance.
"There are structures and systems in place that make it even more challenging to be able to exercise, have access to [healthy] foods, or be able to have access to medical care and preventative medicine," says Goldberg.
The recovery process from a heart-related issue can vary from patient to patient. However, their advice is to go to a cardiac rehabilitation program.
"That is a consistent program where you are monitored, you exercise, you receive education about your heart disease, your risk factors, diet, medications, and it really starts someone off on the right path to that lifelong change," says Packel.