Heart disease is the leading cause of death in the U.S. and in West Virginia. For February, American Heart Month, health officials are reminding folks that there are ways to reduce their risk for heart attack, stroke and chronic heart illnesses.
About 5,000 West Virginians will die annually from some form of heart disease, according to 2019 data from the Centers for Disease Control and Prevention. That means heart disease is killing more people (197 deaths per 100,000 West Virginians) than COVID-19 (152 per 100,000) or drug overdoses (53 per 100,000) in the state.
“The good news is that heart disease is largely preventable,” said Dr. David Goff, director of the Division of Cardiovascular Sciences at the National Heart, Lung & Blood Institute, which is part of the National Institutes of Health. “By taking care of yourself, you can really improve your heart health and reduce your risk of heart disease and stroke, and be more likely to be there longer for your friends and family.”
Goff said quitting smoking, exercising regularly and eating a balanced diet that limits fatty foods is the best way to help your heart.
As a native of North Carolina, Goff understands that these healthy habits aren’t as common in certain regions.
“We have more people who smoke cigarettes. And of course, that’s really bad for your heart health,” Goff said. “We tend to eat a diet that is higher in fat. We put a lot of what we called ‘seasoning’ in our greens, and that was usually some bacon grease or fatback or a piece of ham.”
West Virginians are more likely to have a smoking habit than those living in any other state. Southerners and Appalachians have higher rates of obesity and lower rates of daily physical activity, too.
“The most important thing is to get off the couch and do something,” Goff said. “Anything’s better than nothing. So if you’re somebody who really hasn’t been getting very much activity, you know, walking down to the postbox at the street or walking to the end of the block is a good way to start.”
Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.
A new report shows that West Virginia is one of five states with the highest death rates in the country. The leading cause is heart disease.
In 2017, Alabama, Kentucky, Mississippi, Oklahoma and West Virginia had the highest death rates in the U.S., according to a report released Thursday from the National Center for Health Statistics.
States with the lowest death rates in 2017 were California, Connecticut, Hawaii, Minnesota and New York. Death rate is calculated as the percent of a population that dies within a given time.
Along with heart disease, other leading causes of death were cancer, stroke and lower respiratory diseases like pulmonary disease.
If you were a young or middle aged adult living in one of the five states with the highest death rates in 2017, you were more than twice as likely to die than your peers living in one of the states with the lowest death rates.
Nationwide, deaths among men were higher than women.
The older you get, especially for people in the 85 plus range, the gap between states with the highest rates and lowest death rates closes.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
West Virginia has the highest rate of heart disease in the nation. But a new study has found eating healthy foods — regardless of specific diet — can help reduce the risk for heart disease.
The study, published online in the International Journal of Cardiology, looked at three popular diets that emphasize different macronutrients. One focused on eating healthy carbohydrates, the other high protein intake, the third focused on unsaturated fats. All diets also called for eating four to six servings of fruits and vegetables a day and restricted sugary beverages and sweets.
The team found that all three diets reduced heart cell damage and inflammation within the six-week trial period.
The researchers said the findings suggest that type of diet is less important than eating a healthy, balanced diet rich in fruits and vegetables, lean meats, and high in fiber with few sugary beverages, and sweets.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
A new study has found that for patients with heart disease, exercise may prevent or improve artery stiffening that is associated with heart failure.
Heart disease is the leading cause of death in West Virginia — mostly from heart attacks or heart failure. Heart failure occurs when arteries in the heart become stiff — due to a combination of reduced elasticity and the buildup of harmful chemicals.
But a new study published last month in the Journal of Applied Physiology found that exercise could prevent or improve artery stiffness.
Researchers studied three groups of pigs with heart failure. They were assigned to be sedentary, or put through a continuous cardio routine or interval training. The researchers found that the pigs that were exercised had more elasticity in their arteries than the sedentary pigs. They also had lower rates of the harmful chemicals known to cause artery stiffening.
The researchers say the findings suggest chronic exercise could be a treatment for patients suffering from heart failure.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health and Charleston Area Medical Center.
Doctors at WVU Heart and Vascular Institute have implanted a permanent artificial heart pump into a Maryland man with a failing heart in the first surgery of its kind in West Virginia.
The procedure surgically attached an artificial pump to the heart. That pump was then paired with a power pack worn outside the body. The device helps pump blood through the body when other methods to treat heart failure would not be effective.
Before the surgery, doctors reported the patient had about a 10 percent likelihood of surviving two years. Now those odds are more than 80 percent.
The surgery was part of WVU Medicine’s new comprehensive Advanced Heart Failure Program.
Heart failure is the fourth leading cause of hospitalization and readmission in the U.S., according to the Healthcare Cost and Utilization Project. Depending on its severity, most cases of heart failure can be managed with medications, pacemakers, or surgery. When those treatments are not options, heart transplantation or a heart pump, such as the procedure described, is necessary.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.
The Ohio Valley’s addiction crisis has brought another health problem, as rising numbers of needle drug users are contracting a serious form of heart infection called endocarditis. The rate of endocarditis doubled in the region over a decade, and many patients require repeated, expensive treatment and surgery as they return to drug use and once again become infected.
According to the Centers for Disease Control and Prevention, annual Medicaid spending on endocarditis is more than $700 million, a number likely to rise if treatment does not change to also address the growing health impact of substance abuse.
Doctors at the University of Kentucky are creating a team approach to address endocarditis and the addiction contributing to it. It’s a challenge that has forced them to change traditional practices, break down walls between different medical practices, and get to the heart of the problem.
Credit Mary Meehan / Ohio Valley ReSource
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Ohio Valley ReSource
Sharing or even reusing syringes can build up the bacteria causing endocarditis.
An Emerging Problem
Endocarditis is a result of bacteria accumulating around and infecting a heart valve. It can appear initially as mild, flu-like symptoms or chest pains and extreme discomfort. Emergency surgery to replace heart valves is required in the most extreme cases, but standard treatment involves weeks of sustained doses of antibiotics to make sure the infection is completely cleared.
Credit Mary Meehan / Ohio Valley ReSource
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Ohio Valley ReSource
University of Kentucky researcher Jennifer Havens documented a spike in endocarditis cases.
Since 2008, University of Kentucky researcher Jennifer Havens has tracked the health of hundreds of addicts in Hazard, Kentucky. She said that in the last few years she’s seen a spike in endocarditis cases.
“They may or may not be sharing needles but they’re reusing the same syringes, which accumulates bacteria, which they’re basically shooting into their bodies,” she said.
Havens said traditional cardiac units aren’t designed to treat addiction so the patients frequently return to previous, dangerous habits.
“If you’re not treating their substance abuse issue in the hospital they can potentially go right back out and infect themselves,” Havens said.
According to the CDC, addicts with endocarditis are 10 times more likely than other patients to die or require a second surgery months after initially leaving the hospital. Research has also shown that addicts tend to leave the hospital more often before the weeks-long series of antibiotics that is necessary to complete treatment.
In many cases, the patients are in withdrawal from opiate addiction during treatment. The intense atmosphere of post-surgery care only amplifies the anxiety and pain of withdrawal from opiates, said UK infectious disease specialist Dr. Saritha Gomadam.
“It definitely affects us,” she said. “Our heart just goes out when we see a really young patient in their 20s crying that they want to quit.”
Overall, the median age of endocarditis patients is rising slightly. But at UK and other hospitals treating a large population with substance abuse disorders it is younger patients who are more often returning in need of multiple surgeries. Gomadam said the question of how to treat them most effectively “is something we talk about almost every time we are on service.”
“There is sort of a moment where you both sit there and you know you have to do something,” she said.
There are also physical limitations to how much the body can take.
“Any kind of surgery has its risks,” she said. “There comes a point where there’s only so many times that their body can be opened up.”
The scar tissue from repeated surgeries can make valve replacement difficult and dangerous.
Teachable Moment
When the patient comes into the hospital with endocarditis it offers an opportunity for the team to have a discussion about substance abuse treatment, said Dr. Laura Fanucchi, who specializes in internal medicine and addiction. She is working with Gomadam to create the new treatment method.
“I believe — and our data support this — that coming to the hospital being very sick from a complication from untreated substance abuse disorder or untreated opioid addiction can be a moment where we can really reach that patient and help them start positive changes,” said Fanucchi.
Credit UK Hospital
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UK Hospital
Dr. Laura Fanucchi said addiction treatment “has been siloed from general medical care.”
But addressing the social challenges around addiction requires skills outside of traditional endocarditis treatment.
“If we don’t work together we are not going to be successful because the patient has problems that my antibiotics will not cure,” said Gomadam.
Gomadam and Fanucchi are in the early stages of creating a unique team approach for endocarditis after seeing the same young, addicted patients again and again.
“We are working closely with internal medicine, cardiology, cardiothoracic surgery” Gomadam said, with each group bringing in a particular expertise.
Breaking Silos
Such an approach requires education for both patients and providers.
“A lot of patients with untreated addiction feel very stigmatized by the health care community,” Fanucchi said.
That distrust can result in patients being even reluctant to say they have a problem abusing drugs.
On the other hand, health providers often see the ravages of addiction but very few people in recovery. That takes its own toll, especially on health care providers.
“I think seeing for a long time the complications of untreated substance use disorder some health care professionals start to feel hopeless, and that will engender a culture of frustration,” Fanucchi said.
She said the answer lies in creating communication across medical and addiction services that have traditionally operated independently of each other.
“I think it’s long standing in treatment of addiction that it has been siloed from general medical care,” said Fanucchi. “It’s not historically been part of general medical education and residency. So we’re going to address that.”
The approach has been well received, she said, but it is a big shift that will take time.
Fanucchi said another key in finding the right treatment focus is recognizing the need for sustained medical intervention and recognizing relapse as a part of the disease process.
“Trying to be successful, particularly with opioids, with detox only or abstinence only is part of the reason that we are in this problem that we are in, unfortunately,” she said.
That means bridging the hospital stay with drugs that help with withdrawal, such as naloxone and buprenorphine, plus counseling or treatment.
“The analogy is that someone comes into the ER sick from diabetes and you send them home and tell them not to eat sweets but don’t give them any insulin,” she said. “And we wonder when they come back why their diabetes is a problem again.”
