Prevention Helps to Halt Heart Disease



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Jamal Rana, MD, PhD, FACC is an award-winning heart researcher and cardiologist at Kaiser Permanente. He is chief of cardiology at the Kaiser Permanente’s Oakland Medical Center, and president-elect of the American College of Cardiology, California Chapter.

During his research fellowship at Harvard Medical School, Dr. Rana explored the impact of risk factors such as diabetes and obesity on heart disease and stayed involved with research and clinical trials during his clinical cardiovascular fellowship at Cedars-Sinai Heart Institute in Beverly Hills. His continuing involvement in research has led to more than 125 peer-reviewed publications in scientific journals and numerous national and international presentations.

On a personal level, Dr. Rana saw heart disease affect close family members, which is why he feels strongly that prevention efforts for heart disease are critical.

“I’m very proud of the work being done for addressing heart disease at Kaiser Permanente,” he said. “We offer a comprehensive approach from our large-scale integrated prevention programs to exciting new technologies to treat heart disease.”

How can people prevent heart disease?

When we talk about prevention, we need to shift our discussion from the idea of disease to the concept of health. There is actually a checklist from the American Health Association, called Life’s Simple 7, where one can aim to make good lifestyle choices that include not smoking, being physically active, eating a proper diet such as plant-based or Mediterranean diet, and keeping your blood cholesterol , sugar level, weight, and blood pressure in check.

What are some risk factors in heart disease that people may not know about?

People should be aware if they have a family history of premature heart disease. That means anyone who has a first-degree relative, father or mother, who had a heart attack or stroke when they were young. People who have kidney disease and those with South Asian ancestry are now also recognized to have higher risk for heart disease. Similarly, in African-American communities, high blood pressure is more prevalent. To help educate and prevent heart disease in higher-risk populations, Kaiser Permanente offers specialty clinics for different communities.

Why do you think heart disease remains the No. 1 killer in the United States?

A few years ago, we looked at national trends of death due to heart disease and saw that after decades of downward shift, the decline in heart disease is now stalling. Part of the reason for such an alarming trend is that we are seeing an increase in obesity and diabetes across the nation. In another study, we compared trends for members of Kaiser Permanente with the United States as a whole. We found that for middle -aged Kaiser Permanente members, between 2000 to 2015 the death rates due to heart disease and stroke dropped twice the national rates with a 48 percent drop for heart disease and an equally impressive 56 percent decline for deaths due to stroke. It is gratifying to see that our comprehensive approach, starting with prevention and culminating in a coordinated specialty heart disease care, is leading to better outcomes.

Are there any differences between men and women?

The No. 1 killer for women is also heart disease; more women die of heart disease than breast cancer. After menopause, the risk of heart attacks in women starts to equal men. There are certain types of heart disease that are more common in women, such as stress cardiomyopathy or what is commonly known as “Broken Heart Syndrome,” where symptoms can mimic a heart attack. The bottom line is that heart disease does not spare any gender and ethnicity. That is why we all must remain vigilant.  

What is new in heart disease research and treatment?

This is an exciting time in the field of cardiology. We have had success with medications and intervention procedures for heart attacks and stroke. Now we offer imaging services such as heart CT scans with minimal radiation, that when tested on the right patient, can detect plaque buildup or blockages in heart arteries. There are newer medications on the horizon for treating heart failure. With an aging population, more and more people are suffering from narrowed aortic valves and instead of open-heart surgery there is a cutting-edge less invasive procedure called Transcatheter aortic valve replacement, or TAVR. Our expert cardiologists have had a lot of success with this procedure; in fact, at Kaiser Permanente Northern California, we do more of these procedures than most hospital systems in the country and have some of the best outcomes.

 

Kaiser Permanente, kp.org

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