Communications: Patient Education

Patient Education: Avoiding a Heart Attack

Monday, November 22, 2004  
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Family Physicians Urge Minnesotans to Know Their Risk Factors

Family physicians say former president Bill Clinton’s quadruple coronary bypass surgery this fall is a prime example of why every patient should understand their risk for heart disease. While no one can predict who will actually have a heart attack, it is important for people to know they’re at risk so they can work to reduce the chances of it happening and take immediate action should they experience symptoms (chest pain, discomfort in other areas of the upper body, shortness of breath, nausea, cold sweats or lightheadedness).

"After the former president’s experience, we had a lot of people coming into our offices wanting to talk heart disease,” said Amy Bonifas, M.D., a Brooklyn Center family physician and member of the Minnesota Academy of Family Physicians. "People were amazed that someone who had received presidential health care for so many years could have been so close to a heart attack. But that’s the problem; heart disease sneaks up on you."

According to the American Heart Association, 64 million Americans have been diagnosed with heart disease. Millions more are at risk, but don’t know it. That’s why Minnesota family physicians hope an increased concern about heart disease will be a long-term trend, even though the former president’s ordeal is now out of the public spotlight.

"Some people visit their doctor regularly to have their blood pressure and cholesterol checked, but others haven’t been to a clinic in years,” Dr. Bonifas said. "We want everyone to stay on top of ‘their numbers’ because heart disease is largely preventable.”

And while there are certain precursors for the disease that are uncontrollable, such as age, heredity and gender, there are other risk factors that can be managed. First, quit smoking. Using tobacco greatly increases your risk of having a heart attack. Second, work with your doctor to control medical conditions like high blood pressure, high cholesterol and diabetes. Many of the things necessary to help control these conditions also help reduce your risk for heart disease. These include sticking to a healthy diet by avoiding foods high in saturated fat, trans fat and cholesterol; watching your weight; reducing stress levels; and getting regular exercise. You should aim for 30 minutes of moderate-intensity exercise everyday.

Doctors say one of the biggest problems is getting people to realize that heart disease is a real issue for them. The executive vice president of the Minnesota Academy of Family Physicians, Virginia Barzan, would rather have ignored the discomfort in her chest and arm this summer, but instead decided to go to the emergency room believing she might be experiencing the early signs of a heart attack.

"I didn’t want to admit that it might be happening to me, but I knew I had to,” Barzan said. "I was embarrassed about going to the ER at first, but everyone there took me very seriously.” While Barzan did not suffer a heart attack, she did learn more about her personal risk factors and is taking steps to change her lifestyle.

"Knowing that you’re at risk is scary, but it was a wakeup call that helped me change my course.” Barzan said.

A simple way to assess your personal risk for heart disease from home is to use an online checklist. (You will need to recent blood pressure and cholesterol readings to get results.) These can be found on the American Heart Association website ( or on the National Heart, Lung and Blood Institute website ( Both of these risk assessments use information from the Framingham Heart Study to predict a person’s chance of having a heart attack in the next ten years. But these online tests in no way should be a substitute for a visit to your family doctor. The best way to stay alert to the possibility of heart disease is to schedule regular checkups with your doctor.

"Finding a medical home with a physician who knows you and knows your family history is crucial to tracking heart conditions that develop over time,” added Dr. Bonifas.

The Minnesota Academy of Family Physicians is a professional association of approximately 3,000 family physicians, family medicine residents and medical students organized to assist family physicians in providing quality medical care in Minnesota. The MAFP is the largest medical specialty organization in Minnesota and is a state chapter of the American Academy of Family Physicians, one of the largest national medical organizations in the United States with more than 103,000 members.

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