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During an average lifetime, a human heart can beat as many as 2.5 billion times — each beat pushing life-giving blood to every part of the body.

Given that critical function, it seems only wise to keep you heart strong and healthy.

Kia Williams M.D., an associate medical director at Blue Cross and Blue Shield of North Carolina, says the social isolation that arrived with Covid-19 can present special challenges to heart health.

“You may be less active, you may not be making the best food choices,” she said. “Don’t give up on your health. We are sure to get to the other side of this, and you want to be able to get out and live your best and healthiest life.”

Research indicates that Covid-19 also can impact the heart and how it functions, so Williams strongly recommends getting vaccinated.

As heart disease continues to be the leading cause of death in the United States, accounting for about 1 in 4 mortalities, according to the Centers for Disease Control and Prevention, QCity Metro spoke with Dr. Williams about the importance of good heart health, especially for Black Americans.

Kia Williams M.D.

Q. How much of heart health is genetic, and how much can we impact?

It’s a little of both. There’s certainly a lot of research underway to look at genetic factors, but primarily heart disease can be prevented and controlled. Our diets have a huge impact. High-salt diets with lots of processed foods contribute significantly to heart disease. Sedentary lifestyle and lack of exercise or physical activity can increase your risk as well. So while there may be some biological or genetic predisposition to heart disease, we have a lot in our control to help prevent it, or to improve outcomes with it.

Q. What are the warning signs that something may be wrong?

The most common form of heart disease is coronary heart disease (CAD) or blockages in the blood vessels that feed the heart. The most common sign of CAD is chest pain. Anytime you have chest pain or squeezing chest pressure that does not go away, that becomes worse with exercise or activity, or is associated with shortness of breath, nausea, fast heartbeat, dizziness or sweating, then you want to go see your doctor or a medical provider right away. Because chest pain can be representative of other conditions, such as heartburn, sometimes people will ignore these symptoms. Unless you have seen your doctor, don’t assume that it’s something you can just ignore.

Q. Yes, but no one wants to go to a hospital emergency room only to be told they have heartburn.

It’s better to know than not know. If you’re having severe, unrelenting chest pain, that would be a sign to seek emergency care. However, if you’re having mild symptoms and are unsure — shortness of breath with your normal activities that resolves quickly with rest, or you’re overall not feeling well — those are definite indicators that you should talk with your doctor.

Q. Is it true that heart disease can yield different symptoms in men and women?

Yes. For men and women, the most common sign of a heart attack is chest pain — an unrelenting elephant sitting on your chest, squeezing, crushing chest pain. However, women more than men can present with what we call atypical or unusual symptoms of a heart attack — extreme exhaustion, nausea, vomiting, neck pain, or pain that travels down the arm. If you’re not feeling well, the best idea is to call your primary care doctor who can help sort out your symptoms.

Q. How does high blood pressure relate to heart disease?

Think of it as you would a garden hose. If there’s a kink or blockage somewhere, then it takes a lot of pressure for the water to get past that blockage. The heart is a muscle that pumps blood through our body, so if there are blockages, then the heart has to work harder to get the blood flowing to important areas like your kidney and your brain. Because that muscle has to work harder, it gets larger, and then it’s not able to function as well. That’s what we call heart failure. With high blood pressure, the pressure in your blood vessels builds up due to blockages in the vessels or stiff walls along the vessels, and over time that can cause damage, not only to your organs that need to receive adequate blood flow, but also on your heart that has to pump against those high pressures.

Q. What about obesity?

Obesity certainly is a contributing factor to heart disease. We know that obesity and excess body fat releases certain inflammatory markers (chemicals) in the body that can have a negative impact on the heart and blood vessels increasing your risk of heart disease. Also, being overweight puts extra strain on your heart which can cause heart failure. It’s important to have a healthy diet, and avoid a sedentary lifestyle. Like any other muscles, the heart needs to be exercised. If we’re not up and moving, that muscle can get weak over time and not work as well as it should.

Q. How much exercise is needed for good heart health?

The recommendation from the American Heart Association is at least 150 minutes per week of moderate-intensity exercise per week. This is equivalent to 30 to 60 minutes of activity most days of the week, and that doesn’t have to be all at one time. Many of us are at home now (because of the pandemic), so hopefully you can fit in 10 minutes a couple times per day here and there to reach this goal.

Q. What constitutes “activity?” Does washing dishes count as activity?

It’s better than sitting on the couch, eating chips, We want to do activities that get our heart rate up and pumping. We consider those cardio activities — walking, moving, jogging, riding a bike, swimming, playing sports outside with your kids — those types of things where you are moving around in an active way.

Q. So what I’m hearing is, we don’t have to sweat inside of a gym to exercise my hearts.

Whatever way you can get the exercise that works for you and your lifestyle and your interests, that’s where you need to focus. Some people love going to the gym, and that brings them joy. The most important thing is finding an activity you like and doing it on a regular basis. If you enjoy tennis or you enjoy swimming, or you enjoy playing softball or jogging — any of those types of activities that get the heart rate up is going to protect you.

Q. What about stress, and how do we avoid it, especially now with Covid-19?

Stress releases hormones in the body called stress hormones, which are helpful if you are in danger. If we are faced with a hungry bear in the forest, then we need to quickly run and get away. However, long-term stress and high levels of those stress hormones, such as cortisol, can have detrimental effects on your overall health, and in particular your heart. So anything that you can do to reduce that stress will help with your heart health — relaxation activities, meditation, deep breathing or engaging in activities that make you happy. Whether a craft or a hobby, when you do the types of activities that you enjoy, they take your mind off your daily grind and help to promote the good hormones, or endorphins, that help to relieve stress.

Q. What is a heart-healthy diet?

A heart-healthy diet is one that is low in refined sugars, low in carbohydrates, and low in fat. But rather than focusing on what not to eat, it’s probably better to focus on what you should be eating — more fresh fruits and vegetables, whole grains and lean meats. Rather than being restricted, a good place to start is for people to focus on increasing the healthy foods in their diets that help to reduce cholesterol and have a protective effect on the health of your heart.

Q. What are lean meats?

Focus on your fish and your chicken, because the fat is primarily in the skin that can be removed. But you also can find some red meats, such as beef or pork, that’s lean as well. The key is that you don’t want too much fat.

Q. So oxtails are out?

It’s hard to get the fat out of oxtails. (Laughs) Every once in a while it’s fine. You don’t want to deprive yourself, but make sure that you’re increasing those healthy options in your primary source of nutrition. That brings me to another point, which is knowing your numbers. I mean knowing your blood pressure, knowing your cholesterol levels, knowing your blood sugar levels Those numbers can be a wake-up call, because heart disease is often a silent killer — you don’t know you have the risk factors until it’s too late. I mean, a heart attack or stroke.

Q. So smoking. What more can be said about the dangers of smoking?

We definitely know that smoking is linked to heart disease, heart attacks, strokes and high blood pressure. So it’s just all around not good for your health. What’s new is that we have a lot of new effective treatments to help you quit. Even vaping can have a detrimental impact on your health. So if you are smoking or vaping or using other tobacco-related products, you definitely want to have a conversation with your doctor about ways to come off of those, and protect your heart.

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