Coastside cardiologist fears for future as Americans ignore warning signs

Dr. Colman Ryan sounds concerned when he says that the preventative measures taken against cardiovascular disease in the United States are not adequate. It’s a situation that assures him a certain job security — he’s a specialist in clinical hypertension and the chief of cardiology at Seton Medical Center — but Ryan’s heart is heavy with despair for the future of the human heart. “Here we are in 2007, trying to control risk factors for heart disease and doing a lousy job,” Ryan said with an Irish accent. “People are getting fatter and blood pressure and hypertension are rising.”

Cardiovascular disease — CVD for short — includes heart diseases, high blood pressure and stroke. Together they are the leading cause of mortality in the United States. In particular, coronary heart disease is the leading cause of death in women.

Ryan’s most recent scholarly paper focused on the deterioration of heart conditions across different ethnic groups in a study that considered 10,000 patients. His studies proved every major risk factor except smoking increased over time. Ryan’s research showed the increases are most prevalent in Hispanics, Caucasians, Asians and Filipinos. Filipinos showed an increasing propensity toward obesity, which increased threefold in the population between 1994 and 2004, according to his research.

The developments in heart disease are leading to cultural changes in language and vocabulary. Ryan believes Americans should become familiar with the term “metabolic syndrome” because the American Heart Association estimates more than 50 million Americans currently have the syndrome.Metabolic syndrome is characterized by a group of metabolic risk factors that result in heart disease in a given individual. They include abdominal obesity, blood fat disorders, insulin resistance and elevated blood pressure. All of these conditions can be related to lack of exercise.

Ryan, who lives in Burlingame and is the doctor of many Coastsiders, says diet, stress and exercise are the main risk factors for CVD. Medical professionals say these risk factors are sweeping across the country like an epidemic and that the risk factors begin to appear early. In fact, childhood obesity is blooming in the United States. Obesity is caused by an imbalance between energy intake and expenditure and is present in children and adolescents when body mass index is greater than 30 percent. TV, video games and the resulting lack of exercise lead to excess weight gain that causes diabetes and hypertension later in life. The other culprit — fast food — must not be ignored, Ryan said.

Heart disease in women is on the rise. In 2006, more women than men died of heart disease and stroke. He attributes the rise in CVD among women to several factors. Unlike men, women generally have little to no chest pain. Their most common symptom is shortness of breath. Ryan claims this symptom may go unspoken because women are embarrassed to appear out of shape. Secondly, women don’t respond to treatment as well as men. “They have smaller coronary arteries, so surgery isn’t as effective,” said Ryan.

Menopause is another risk factor that affects women. Hormones offer women protection up until the onset of menopause, but this natural defense system disappears later in life.Women are also more likely to have a heart attack over a highly stressful situation. Ryan has noticed that infidelity or death of a spouse are the most profound stressors that lead to heart attacks in women.

Currently, women are expected to live to age 82 and men are to live to 78 on average. Because people are not taking care of their hearts, a dramatic increase in coronary artery disease is predicted in the next 10 to 15 years. Along with that increase will be a decrease in life expectancy, Ryan said.

Plenty of effective medications and treatments are available for heart disease, but Ryan begs people to exercise, to eat a reasonable diet and to check their blood sugar, blood pressure and cholesterol levels. In addition, Ryan persuades parents not to allow their children to become obese.

Small changes to diet and exercise make a profound difference.

To cut out excess salt, Ryan suggests removing the saltshaker from the dinner table. He said most people eat three times the amount of sodium needed per day. He also warns about trans fat, which is prolific in junk food such as French fries and many baked goods. Trans fat can cause heart disease and can significantly increase levels of bad cholesterol, yet many people do not take that risk very seriously. “If you were to squeeze a muffin in your hand, trans fat is the residue that would be left on your palm and fingers,” Ryan said. “Do you really want to eat that?” Ryan also says people should work  out a minimum of half an hour every other day to maintain proper cardiovascular health. The Coastside hospital can help here as well.

Movin’ on the Coast, a partnership of the Half Moon Bay Recreation Division, Seton and the Coastside Health Committee, encourages Coastsiders to be active and enjoy the benefits of physical fitness. “It encourages people to find activities through the recreation division and local fitness suppliers to improve their cardiovascular health,” said Cheryl Sinclair, manager for community outreach and business development for Seton Coastside. Last year the organization won California Parks and Recreation’s statewide excellence award for health and wellness.

It all began with a fitness day four years ago that grew into a fitness week and then a fitness month. This year is deemed a “fitness year” by the organization. The fitness club hosts a walk along the Coastal Trail on the first Saturday of every month. Participating in such events can protect your heart and promote longevity. Since February is deemed American Heart Month, the walk on Feb. 2 included a number of medical professionals and representatives who were on hand to address heart disease and related issues. Dirk Alvarado, recreation coordinator for the Half Moon Bay Recreation Division, said the walk was an active and informal way to gain access to medical information.

The club’s focus in March will be healthy eating.

“We will cover issues such as how to make healthy choices while eating out,”Alvarado said.Movin’ on the Coast will encourage local restaurants to feature healthy food items on their menus and help restaurant diners select those options. Ryan encourages everyone to take advantage of the resources that are available to them. “Everything is fine in moderation, but people need to be aware of what they put in their bodies and how they treat  themselves,” reminds Ryan.