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The Importance of Understanding Blood Pressure

Throughout modern medical history, the focus surrounding blood pressure has been heavily skewed towards combating the epidemic of high blood pressure (hypertension) due to its significant health risks. Hypertension can critically damage organs and blood vessels, leading to severe complications like the rupture of a blood vessel, which can result in catastrophic bleeding or other complications.

It is a commonly accepted principle that “within certain limits, the lower your blood pressure reading is, the better.” However, dangerously low blood pressure is also a significant health concern, as it may herald serious conditions, including severe allergic reaction and even heart disease.

Low blood pressure occurs when inadequate blood volume flows through the blood vessels, depriving the body’s tissues of oxygen and nutrients. This can lead to damage to the heart, which acts as a blood pump, and other organs.

On the other hand, high blood pressure can damage the blood vessels and lead to serious complications. Lifestyle changes such as maintaining a healthy diet, exercising regularly, and reducing stress can help maintain healthy red blood cells and treat high blood pressure.

What is Blood Pressure?

Blood pressure is the measure of the force that blood exerts against the artery walls as the heart pump blood. It is an essential indicator of cardiovascular health. A blood pressure reading comprises two numbers: the systolic (top number), indicating the pressure during a heartbeat, and the diastolic (bottom number), which shows the pressure when the heart is resting between beats.

An irregular heart rhythm can significantly impact blood pressure. When the heart muscle does not contract effectively, it can lead to a severe drop in blood pressure, resulting in hypotension. This can cause symptoms such as dizziness, fatigue, and fainting.

In some cases, low blood pressure may indicate an underlying condition affecting the nervous system or cardiovascular health. Monitoring heart rate and blood pressure regularly can help detect any abnormalities early on.

If hypotension is observed, it is essential to consult a healthcare professional to determine the underlying cause and develop an appropriate treatment plan. Managing factors such as stress, dehydration, and certain medications can help regulate heart rate and maintain healthy blood pressure levels.

The Importance of Maintaining Healthy Blood Pressure

Maintaining a healthy blood pressure is crucial for overall well-being. Low blood pressure, also known as hypotension, can occur when there is insufficient blood volume circulating in the body. This can lead to symptoms such as dizziness, fatigue, and fainting.

In severe cases, low blood pressure can cause organ damage and may require immediate medical attention. On the other hand, high blood pressure can strain the heart and damage blood vessels over time.

Lifestyle factors, such as maintaining a balanced diet rich in nutrients that support the production of healthy red blood cells, engaging in regular exercise, and managing stress, can help keep blood pressure within a normal range.

In extreme cases, such as end-stage heart failure, a heart transplant may be necessary to restore proper heart function and maintain healthy blood pressure.

Defining Low Blood Pressure

Blood pressure is considered low (hypotension) if the systolic reading is below 90 millimeters of mercury (mm Hg) or the diastolic reading is under 60 mm Hg. Specifically, it is considered low blood pressure when these thresholds are met or surpassed, highlighting the importance of identifying the underlying causes to determine if treatment is necessary.

It is essential to note that while a single low reading may not be cause for concern, consistently low systolic BP readings can indicate an underlying health issue that requires medical attention. Healthcare professionals often consider factors such as age, overall health, and the presence of symptoms when evaluating the significance of low blood pressure readings, as some individuals may naturally have lower blood pressure without experiencing any negative effects on their well-being.

The Dual Threat: High and Low Blood Pressure

While high blood pressure is well-recognized for its role in increasing the risk of heart attacks, strokes, and kidney disease, low blood pressure is less commonly discussed but can be equally dangerous. Hypotension may lead to insufficient blood flow to the organs, which can cause symptoms such as dizziness, fainting, and in severe cases, shock.

A severe drop in blood pressure can occur due to various factors, such as dehydration, blood loss, or certain medications. This can lead to a significant decrease in blood volume, which can cause an irregular heartbeat and damage to vital organs.

People with chronic conditions, such as diabetes or heart disease, have an increased risk of developing low blood pressure. In some cases, making lifestyle changes, such as increasing fluid intake, adjusting medication dosages, or taking steps to lose weight, can help manage low blood pressure and reduce the risk of complications.

To treat high blood pressure effectively, doctors often recommend lifestyle changes and medications to reduce the risk of associated health problems. Systolic blood pressure, the top number in a blood pressure reading, indicates how much pressure your blood is exerting against your artery walls when the heart beats.

In cases of hypotension, increasing blood volume can help maintain sufficient pressure and improve blood flow to vital organs. If the heart cannot pump blood effectively, a person may develop heart failure, a serious condition where the heart is unable to meet the body’s needs for blood and oxygen.

Cardiac Conditions Linked to Low Blood Pressure

Many underlying cardiac conditions, such as bradycardia, heart valve disease, and heart attacks, can manifest as low blood pressure, which can significantly impact the heart’s ability to pump blood effectively and maintain adequate circulation throughout the body. These include:

• Bradycardia: This condition involves a resting heart rate below 60 beats per minute, which can significantly affect how effectively the heart pumps blood. Due to a slower heart rate, the overall output of the heart is reduced, leading to potentially lower blood pressure. Bradycardia can be influenced by aging, certain medications, or irregular heart rhythms, and is particularly concerning if it contributes to the development of heart failure.
• Heart Valve Disease: Conditions like mitral valve prolapse can interfere with the heart’s ability to manage blood flow efficiently. When the valves are not functioning correctly, the heart must work harder to pump blood, which can complicate the management of heart failure. People with valve diseases may experience orthostatic hypotension—dizzy spells or fainting when they stand up quickly due to a sudden drop in blood pressure.
• Heart Attack: A heart attack occurs when a blockage in the coronary arteries restricts blood flow to the heart muscle, impairing the heart’s ability to pump blood effectively. This reduction in pumping capacity can lead to a sudden drop in blood pressure. Heart attacks can also provoke a vasovagal response, which is the body’s mechanism to decrease blood pressure and preserve blood flow to vital organs, critical in heart failure patients.

In all these cases, a heart failure diagnosis might be considered if symptoms persist or worsen, emphasizing the importance of timely intervention and management strategies for heart failure. Monitoring and managing these conditions are crucial to prevent complications and assist heart failure patients in maintaining a stable quality of life.

The Profound Impact of Heart Failure

Heart failure is perhaps the most significant cardiac condition that can lead to chronically low blood pressure. Conditions like severe congestive heart failure, chronic heart failure or systolic heart failure result from the heart’s diminished capacity to pump blood, leading to chronically low blood pressure.

Advanced heart failure particularly signifies a grave prognosis as the heart struggles to meet the body’s demand for oxygen-rich blood.

In left-sided heart failure, the left ventricle is unable to pump blood effectively, leading to a backup of blood in the lungs and other organs. This can cause symptoms such as shortness of breath, fatigue, and heart palpitations.

As the heart pumps less blood, the body may compensate by constricting blood vessels to maintain blood pressure, which can further strain the heart and worsen clinical outcomes.

Left-sided heart failure can have a profound impact on an individual’s quality of life and overall health. As the left ventricle struggles to pump blood efficiently, the body may not receive the oxygen and nutrients it needs to function properly.

This can lead to a range of symptoms, including shortness of breath, fatigue, and heart palpitations.

In severe cases, the heart may pump less blood than the body requires, leading to organ damage and other serious complications. Prompt diagnosis and treatment are essential to improve clinical outcomes and prevent the progression of heart failure.

Lifestyle changes, such as adopting a heart-healthy diet, engaging in regular exercise, and managing stress, can help support heart health and improve overall well-being for those living with left-sided heart failure.

Heart failure symptoms can range from mild to severe and may affect daily life, with some individuals experiencing no symptoms, while others may have symptoms that are constant or intermittent.

Symptoms of Low Blood Pressure

Patients with hypotension might experience a range of symptoms from mild, such as lightheadedness and blurred vision, to severe, such as chest pain and heart palpitations. These symptoms can indicate the heart’s inability to sustain adequate blood circulation, especially during episodes of severe heart failure or in conditions like diastolic heart failure where the heart does not fill properly.

In some cases, low blood pressure may cause no noticeable symptoms, making regular check-ups and monitoring crucial for those at risk of developing hypotension or heart failure. When symptoms do occur, they can significantly impact a person’s daily life and overall well-being, underscoring the importance of timely diagnosis and appropriate management strategies to maintain cardiovascular health and prevent the progression of heart failure.

When Low Blood Pressure Becomes Critical

It is imperative to recognize the symptoms of low blood pressure early. Symptomatic hypotension, where low blood pressure causes noticeable symptoms, is particularly concerning as it may indicate underlying severe medical issues requiring immediate attention. This includes conditions like shock, where the body’s organs are not receiving enough oxygen-rich blood, which can be life-threatening if left untreated.

In such critical situations, prompt medical intervention is crucial to stabilize blood pressure and restore adequate blood flow to vital organs. Ignoring or dismissing symptoms of low blood pressure can lead to serious complications, such as organ damage, heart attack, or stroke, emphasizing the importance of regular monitoring and open communication with healthcare providers to ensure timely and effective management of hypotension and its underlying causes.

Comprehensive Treatment Approaches for Low Blood Pressure

Treating high blood pressure is crucial in managing heart failure and preventing further heart damage, as it helps improve the heart’s ability to pump more blood effectively without extra stress. The treatment for hypotension depends significantly on its underlying cause. Here are some treatment modalities:

• : Medications such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers are used to manage various heart conditions that could be causing low blood pressure. These medications work by improving the heart’s ability to pump blood more efficiently or by relaxing the blood vessels, allowing for better blood flow. Additionally, these drugs can help manage heart failure by controlling irregular heart rhythms and ensuring that the pulmonary veins facilitate the optimal movement of blood into the heart.
• Fluids and Blood Products: In emergency situations such as shock-induced hypotension, prompt administration of fluids and blood products is critical to increase blood pressure and stabilize the patient’s condition. This intervention helps restore proper blood flow to vital organs and prevent further complications by ensuring that more blood reaches essential areas.
• Lifestyle Adjustments: Simple measures like maintaining a healthy weight, engaging in moderate physical activity, and making dietary adjustments can help manage or prevent low blood pressure. Additionally, reducing or avoiding alcohol consumption and nonsteroidal anti-inflammatory drugs can be beneficial, as these substances can exacerbate hypotension in some individuals. These lifestyle changes not only support blood pressure management but also contribute to overall heart health, aiding in the management of heart failure.

Preventing Low Blood Pressure: A Proactive Approach

Preventing low blood pressure primarily involves managing and monitoring its underlying causes, which may include chronic health conditions, medications, or lifestyle factors that can impact cardiovascular health and blood pressure regulation:

• Regular Check-ups: Regular monitoring of blood pressure can help catch hypotension before it causes problems. This allows healthcare professionals to identify any concerning trends or patterns and adjust treatment plans accordingly.
• Education and Awareness: Understanding the risks associated with both high and low blood pressure can motivate individuals to seek timely medical advice. Recognizing the potential consequences of unchecked hypotension can encourage patients to be proactive in their healthcare.
• Managing Risk Factors: Addressing risk factors such as heart conditions, diabetes, and other health issues is crucial in preventing low blood pressure episodes. By controlling these underlying conditions, individuals can reduce their chances of developing hypotension and its associated complications.

The Role of Specialized Care

Patients concerned about their blood pressure should not hesitate to contact health professionals. Looking for a Cardiologist near me? Dr. Beheshtian, an interventional cardiologist at Avicenna Cardiology, has vast experience in treating over a thousand patients with mild to complex cardiovascular issues in New York and beyond. Avicenna Cardiology offers comprehensive evaluations and personalized treatment plans to manage and prevent the complications of low blood pressure and associated cardiac conditions.

With a focus on patient-centered care, Dr. Beheshtian and his team work closely with individuals to develop tailored strategies that address their unique needs and goals, combining cutting-edge medical techniques with a compassionate approach to help patients achieve optimal cardiovascular health and quality of life.

By seeking specialized care from experienced professionals like those at Avicenna Cardiology, patients can benefit from expert guidance and support in navigating the challenges of low blood pressure and related heart health concerns.

Seeking Professional Guidance

Cardiologist near me? Please feel free to contact our office with any questions, or schedule a telehealth appointment or an in-person visit to discuss your concerns about low blood pressure or heart disease. Early intervention and proper management can make a significant difference in maintaining optimal cardiovascular health and preventing potential complications.

Our dedicated team of healthcare professionals is committed to providing you with the highest quality care and support, ensuring that you receive the guidance and resources needed to make informed decisions about your health.

Whether you are experiencing symptoms of low blood pressure or simply wish to take a proactive approach to your cardiovascular well-being and looking for a cardiologist near me, we are here to listen, assess your unique situation, and develop a personalized plan that helps you achieve your health goals. Don’t hesitate to reach out and take the first step towards a healthier, more vibrant life.

FAQ: Low Blood Pressure and Heart Attack: A Sign of Heart Disease

Over the course of the past several decades, the harmful effects of cigarette smoking have been a regular topic of discussion. Advertisements on television and radio featuring doctors’ endorsements and cartoon mascots are a thing of the past, having been banned in 1971. And in 2006, a federal court decision “concluded that the major U.S. cigarette companies had violated the federal racketeering laws, in part by fraudulently claiming that ‘low tar’ and ‘light’ cigarettes were less harmful when, in fact, the tobacco companies knew they were not.” With the potential to cause unparalleled damage to an individual’s cardiovascular health, smoking is responsible for nearly “1 in every 5 deaths in the United States each year.” Moreover, smokers “are 2 to 4 times more likely to get heart disease than nonsmokers,” and smoking “doubles a person’s risk of stroke.” However, it is worth noting that this is can all be largely mitigated by quitting smoking or not partaking in this harmful habit to begin with.

Although harmful to nearly every organ in the body, even the smallest amount of cigarette smoking can be particularly harmful to the heart and blood vessels. The chemicals in tobacco smoke not only damage your blood cells but also “the function of your heart and the structure and function of your blood vessels” — putting patients at higher risk of developing atherosclerosis. Atherosclerosis is a condition in which plaque builds up in the arteries, which is also known as hardening of the arteries. Over time, this plaque hardens and narrows the arteries, limiting “the flow of oxygen-rich blood” to one’s organs and other parts of the body.

Equally important, secondhand smoke — “the smoke that’s breathed out by a person who is smoking” or “that comes from the burning end of a cigarette, cigar, or pipe” — can cause its own harm to the heart and blood vessels. Containing many of the very same dangerous chemicals inhaled by those who do smoke, secondhand smoke can damage the hearts and blood vessels of nonsmokers, greatly increasing “adults’ risk of heart disease.” Also harmful to children and teenagers; specifically those with asthma — secondhand smoke lowers good cholesterol, raises blood pressure, and damages heart tissues.

Furthermore, smoking can cause plaque to build up in the coronary arteries — “arteries that supply blood to the heart” — in turn, causing patients to develop ischemic heart disease. Heart disease is often correlated with “chest pain, heart attack, heart failure, arrhythmias, or even death.” Compounded by additional risk factors like bad cholesterol, high blood pressure, and overweight or obesity, a smoker’s risk of heart disease can escalate immensely.

As a major cause of cardiovascular disease, smoking is a leading cause of stroke. With the potential to result in permanent brain damage, disability or death, “a stroke occurs when the blood supply to the brain is blocked or when a blood vessel in the brain bursts.” Strokes can be avoided by quitting or refraining from smoking, managing cholesterol, and controlling blood pressure.

Additionally, smoking puts patients at an increased risk for peripheral arterial disease. This is a condition in which “plaque builds up in the arteries that carry blood to the head, organs, and limbs.” Individuals living with peripheral arterial disease are at high risk for “heart disease, heart attack, and stroke.” Peripheral arterial disease may also result in “vascular amputation”. And smoking is very closely linked to the development of peripheral arterial disease, with “approximately 90 percent” of peripheral arterial disease patients having had a history of smoking. Individuals who smoke “even half a pack of cigarettes a day may [be at] increase[d]… risk of having [peripheral arterial disease] by up to 50 percent.” However, it is important to note that “up to 40 percent” of peripheral arterial disease patients are asymptomatic, often leaving the condition misdiagnosed. Additional risk factors for peripheral arterial disease include high blood pressure, atherosclerosis, diabetes, high cholesterol, and being over the age of 60.

All in all, smoking results in lasting and unhealthy effects to a patient’s cardiovascular health. Causing an instant and long-term rise in blood pressure and in heart rate, reducing blood flow from the heart and the amount of oxygen that reaches the body’s tissues, doubling the risk of stroke, damaging blood vessels, and increasing one’s risk for blood clots, smoking unnecessarily and avoidably harms the body. And although a difficult feat, quitting smoking — according to the AHA — “reduces the risk for heart disease, the risk for repeat heart attacks, and death by heart disease by half.” Moreover, quitting smoking can help patients significantly to manage “many key contributors to heart attack” like atherosclerosis, blood clots, and abnormal heart rhythms. After overcoming the physical nicotine addiction and habit of smoking, an individual’s smoke-free life can help to set them on the necessary path for better cardiovascular health.

Researchers and medical professionals have discovered a strong link between diabetes and peripheral arterial disease on a global scale. Patients with diabetes are incredibly prone to developing atherosclerosis — the build-up of plaque in the arteries. Commonly referred to as hardening of the arteries, atherosclerosis “limits the flow of oxygen-rich blood to your organs and other parts of your body.” Consequently, many patients with diabetes develop peripheral arterial disease, as atherosclerosis is the disease’s most common cause.  Thus, a peripheral vascular specialist and endocrinologist partnering with one another can have a powerful positive impact on the health and longevity of their patient by addressing underlying causes which may inhibit their ability to get treatment.

Peripheral arterial disease most typically “occurs if plaque builds up in the major arteries that supply oxygen-rich blood to your legs, arms, and pelvis.” And “numbness, pain, and, sometimes, dangerous infections” can result from the reduction or blockage of blood flow to those body parts.  Peripheral arterial disease is also “a major risk factor for lower-extremity amputation.”

In short, “people who have diabetes do not make enough insulin in their pancreas to metabolize food for energy,” which in turn “causes sugars to build up in their blood and leads to complications.” There are two types of diabetes: Type 1, insulin-dependent diabetes — which comprises 10% of all diabetics,  and Type 2, non insulin-dependent diabetes. Patients with diabetes or those who smoke are at the highest risk of developing peripheral arterial disease. Diabetic individuals often experience sped up atherosclerosis, “accounting for as much as 44% of all-cause mortality.”  And to make matters worse, peripheral arterial disease is accelerated by diabetes, “making these patients more susceptible to ischemic events and impaired functional status compared to patients without diabetes.”

As of 2015, “over 170 million people worldwide [had] diabetes… and the worldwide burden is projected to increase to 366 million people by 2030.”  And although individuals living with diabetes are already considered high-risk for the development of peripheral arterial disease, there are additional risk factors. Obesity, physical inactivity, smoking, hypertension, and bad cholesterol put these patients at “an even greater chance of developing the condition.” Moreover, a family history of cardiovascular disease, stroke, or peripheral arterial disease, as well as the individual’s previous history of coronary artery disease, immensely increases the risk of developing peripheral arterial disease.

In order to ensure that patients are receiving thorough and adequate care, it is imperative to be mindful of the fact that more peripheral arterial disease patients “are asymptomatic rather than symptomatic.” Specifically, of all patients living with peripheral arterial disease, “over one-half are asymptomatic or have atypical symptoms.” Due to a lack of reporting of symptoms from this vast population of asymptomatic patients, the true link between diabetes and peripheral arterial diabetes has been historically difficult to assess. Peripheral arterial disease in patients with diabetes is more commonly asymptomatic due to “the distal territory of vessel involvement and its association with peripheral neuropathy.”  So, patients living with both conditions “may present later with more severe disease and have a greater risk of amputation.”

Treatment Methods for Diabetics

Unfortunately, treatment for peripheral arterial disease patients is often “expensive, owing to [the] need for a variety of diagnostic tests, therapeutic procedures, and hospitalizations.” As a result, routine screenings have been recommended by the American Diabetes Association “for all patients over 50 years of age”. And it should be noted that ABI (Ankle-Brachial Index) screenings are enormously productive for peripheral arterial disease patients who also have diabetes, with “routine screening[s] of individuals over 50 years of age… expected to identify PAD in nearly one-third of individuals.”

In order to minimize the adverse effects of both diabetes and peripheral arterial disease, specialists are advised to initiate and maintain “aggressive treatment of underlying risk factors including optimizing glycemic control, using HMG CoA reductase inhibitors to reduce LDL cholesterol, tobacco cessation, and blood pressure control.” Furthermore, antiplatelet therapy has often been suggested for peripheral arterial disease patients, both with and without diabetes. And therapies geared towards improving limb perfusion — like exercise and weight loss — are encouraged.

Revascularization methods, like traditional bypass surgery and endovascular approaches, are also an often prescribed treatment. However, “the available data suggest that, as in the coronary arteries, patients with diabetes have higher rates of restenosis following angioplasty or stenting.” Although, “history, clinical exam, and the ABI (Ankle-Brachial Index) are simple and effective methods of detecting major restenosis,” they are not foolproof and “may miss silent lesions that may progress to sudden thromboses if uncorrected.” Today’s resources, data, and technology sometimes necessitate major amputations, most typically of a foot or lower extremity, as a result. In an attempt to decrease the number of amputation procedures that take place, specialists have tightened their criteria — operating “only when there is [an] overwhelming infection that threatens the patient’s life, when rest pain cannot be controlled, or when extensive necrosis secondary to a major arterial occlusion has destroyed the foot.”

Overall, it is absolutely crucial for the longevity and health of their patients that peripheral vascular specialists “diagnose [peripheral arterial disease] in patients with diabetes to elicit symptoms, prevent disability and limb loss, and identify a patient at high risk of [heart attack], stroke, and death.” The American Diabetes Association suggests a two-fold care approach for patients with both diabetes and peripheral arterial disease. Endocrinologists and peripheral vascular specialists alike should work with their patients to modify primary and secondary cardiovascular disease risk factors, like hyperglycemia and cigarette smoking. In addition, via a combined effort on the part of both a patient’s endocrinologist and peripheral vascular specialist, peripheral arterial disease symptoms like critical limb ischemia and claudication can be treated to limit the progression of the disease. Understanding the pathophysiology of atherosclerosis in diabetic patients is the key to mitigating and minimizing the cardiovascular risks that are emphasized by peripheral arterial disease. And when specialists “function cooperatively and effectively… in the management of this complex patient population, with the common goal of reducing vascular events that too often result in disability, social decline, and death,” better care can be achieved for patients around the world.

At Avicenna Cardiology, we understand the complexities of diagnosing Diabetes related cardiovascular disease, as well as finding both lifestyle modification and clinical approaches to optimal treatment. Come see us for a screening and consultation today by making an appointment or calling our offices at (347) 558-4094.

Can You Get Heart Attack In Your 20s and 30s – Avicenna Cardiology

Stress does not age discriminate, and neither do heart attacks. Unless they have a specific reason to do so, most individuals in their 20s and 30s may not feel the need to be concerned about heart health. Unfortunately, however, rates of heart disease are increasing for people in this age range, with many experiencing heart disease in their 20s. The American Heart Association [“observed a significant increase in patients [who experienced heart attacks]… who were <55 years of age from 1995 to 2014.”](LINK 2) In order to achieve holistic bodily health, individuals — even younger adults — must be vigilant about monitoring and bettering their heart health.

”Acute myocardial infarctions,” or heart attacks, have increased among those in their 20s and 30s, especially among women. To borrow some wisdom from an older generation, “an ounce of prevention is worth a pound of cure,” and this is certainly applicable to heart health.

Although many of us view acute myocardial infarctions as a worst-case scenario, the conditions that lead to heart attacks often develop gradually. “Usually the result of a blockage in one or more of the coronary arteries,“ heart attacks most typically occur “when blood flow to the heart muscle is abruptly cut off, causing tissue damage.” The signs of heart attack are not always blatant or obvious, and can also be provoked by drug use or underlying health conditions.

To prevent severe problems associated with poor heart health, there are several steps that young people can take to mitigate, manage, or avoid cardiovascular health issues entirely. Young people are advised to visit a cardiologist as needed. Moreover, young adults should be aware of pre-existing factors or elements of their daily life that put them at greater risk of cardiovascular problems, specifically:

• Obesity
• Poor diet and lack of exercise.
• Type 2 diabetes.
• High blood pressure.
• High cholesterol.
• Smoking.
• Family history of cardiovascular disease.

Mental Health Translates to Physical Health

In a busy, iconic city with a particularly high cost of living and fast-paced culture, young people living in New York City work hard. And whatever the underlying reasons — whether “internal needs, external factors, underlying personality traits,” etc. — young New Yorkers may not think about the adverse, long-term effects that their work-consumed lives can on their health.

Medical studies show that work — at extreme amounts — takes a toll on mental and physical health, including heart health. A  2011 study on “7,095 British civil service workers” revealed that long work hours contribute to heart disease. With that being said, stress experienced by individuals in their 20s and 30s can have several root causes. Stress is defined as “any intrinsic or extrinsic stimulus that evokes a biological response is known as stress.”

Every person is different, and as such, individuals may deal with unemployment, financial difficulties, transitions, insecurities, life decisions, relationships, etc. in different ways. At this current moment, the COVID-19 pandemic is a major root of stress and brought about numerous secondary stressors that affect daily life.

Our mental health and physical health are quite dependent on one another. As a result, individuals may experience physical symptoms of anxiety, depression or other mental health concerns. And unfortunately, research has shown that stress affects our bodies negatively, and can be “either a triggering or aggravating factor for many diseases and pathological conditions.”

Stress affects the cardiovascular system by increasing the heart rate and the body’s demand for oxygen. Therefore, stress contributes to painful peripheral arterial disease (PAD) — which occurs “when plaque builds up in the arteries,” causing them to narrow and harden over time. This all, in turn, increases one’s risk of myocardial infarction.

Moreover, chronic stress, experienced repeatedly or over a long period of time, can cause the arteries to become inflamed. Those under chronic stress are at greater risk of hypertension. Chronic stress also contributes to developing high blood pressure, which is a significant risk factor for cardiovascular diseases.

However, the good news is that there are things you can do to manage stress in young adulthood:

• Be compassionate and accepting of yourself.
• Take moments for deep breathing with an app during your day.
• Note and challenge your own anxious thoughts against reality.
• Exercise should be viewed not as something you “should” do, but as a strategy to reduce stress.

Replace Risky Behaviors with Healthy Behaviors – Lower Risk of Heart Attack and CVD

A vast amount of best practices for managing stress for better cardiovascular health are closely linked to the whole body. When under stress, individuals may engage an uptick in what physicians consider risky behaviors.

By risky behavior, cardiologists refer to practices like smoking or even vaping, eating foods high in fat, sodium, calories, or cholesterol, consuming more than one to two alcoholic drinks per day, stimulant drug use, and physical inactivity. All of these factors can contribute to hypertension, “bad” cholesterol, obesity, diabetes, or all of the above. And in turn, these conditions are linked to a higher incidence of heart disease and heart disease risk factors.

But heart health can be achieved with just a little effort and care. There are a number of things you can do to invest in your heart and overall health in your 20s and 30s. And if you have more than one lifestyle factor to address, keeping a task-list that is broken into smaller, manageable goals will help you to feel less overwhelmed.

Choose one specific goal each week to focus on, for example:

• Eat plenty of vegetables, fruits, lean proteins, whole grains, and “healthy” fats. Make time to cook or prepare your own meals or buy from restaurants that use simple, whole ingredients. Work to limit yourself to one portion of fat per meal. Good nutrition can stave off diabetes, obesity, and bad cholesterol.
• Use up at least as many calories as you take in daily. Exercise to beat stress and have a healthy body. Find new ways to build movement into your day, or select a physical activity you really enjoy.
• Visit your primary care physician at least once a year. They are your first stop to prevent and receive help with chronic conditions related to your heart health.

The UPenn Medicine Cardiac Risk Profiler is a wonderful resource for those in their 20s and 30s interested in better understanding their own heart health.

See a Cardiologist

However, even the best efforts at lifestyle changes are not enough to avoid cardiovascular health issues for some patients. Dr. Beheshtian is an interventional cardiologist who has treated over 1000 patients, in New York and elsewhere. She is extremely knowledgeable about treatment paths for various types of cases, mild or complex.

Please feel free to contact Avicenna Cardiology’s office with any questions. Schedule a telehealth appointment or come in soon to see Dr. Beheshtian, who will work with you to create a care plan.

FAQ: Heart Attacks in Your 20s and 30s

Across countless studies globally, it has been found that individuals with chronic kidney disease are more likely to develop or show signs of peripheral arterial disease than individuals with normal or average kidney function. Nephrology clinical practice of today is often adversely affected by peripheral arterial disease diagnostic challenges, all while patients with kidney disease typically tread a slow path to treatment for peripheral arterial disease. For these reasons, a peripheral vascular specialist and nephrologist partnering with one another can have a powerful positive impact on the health and longevity of their patient by addressing underlying causes which may inhibit their ability to get treatment.

How are Kidney Disease and PAD related?

It is vital to understand the pathology of these diseases in order to properly advance both of their treatments. Peripheral arterial disease is a progressive circulatory condition “caused by narrowing and blockages of the arteries, usually in your legs.” This disease affects “approximately 10 million adults in the United States and more than 200 million adults throughout the world,” and is most commonly brought on as a result of atherosclerosis — the build-up of plaque on the inner walls of the artery. However, chronic kidney disease also contributes to atherosclerosis. Atherosclerosis recognized as a “frequent cause of morbidity in patients with end-stage renal disease.”

Moreover, patients dealing with peripheral arterial disease often experience complications, such as a reduction of blood flow to the extremities, which in turn leads to the slowed or stunted healing of wounds. As a result, individuals living with peripheral arterial disease are prone to infections that may ultimately result in the amputation of limbs. Conversely, chronic kidney disease manifests itself in the form of reduced kidney function.

Risk Factors and Population Trends

Classic risk factors of peripheral arterial disease, such as age, smoking, diabetes, hypertension, and hyperlipidemia are incredibly common in patients with kidney disease. And the presence of peripheral arterial disease in patients “is a strong independent risk factor for increased cardiovascular disease mortality and morbidity, including limb amputation” in individuals with chronic kidney disease. On the other hand, kidney disease also “imposes additional unique risk factors that promote arterial disease,” like “chronic inflammation, hypoalbuminemia, and a pro-calcific state.”

The presence of peripheral arterial disease in individuals afflicted by chronic kidney disease “markedly increases the short term risk of heart attack and stroke, and serves as the key cause of limb loss and mortality, with such rates being much greater than that of the general population.” And the prevalence of both symptomatic (i.e., intermittent claudication and critical limb ischemia) and asymptomatic peripheral arterial disease is greater in individuals with chronic kidney disease, in comparison to the general population as well. In order to properly detect peripheral arterial disease, “health care providers should be aware of the importance of evaluating feet, especially when patients have any symptoms or signs indicative” of peripheral arterial disease. Nevertheless, regular screenings are necessary as many peripheral arterial disease patients are asymptomatic.

As of 2014, the prevalence of peripheral arterial disease amongst American individuals was high, afflicting nearly 4.3% “of the general adult population over 40 years of age.”  Moreover, peripheral arterial disease rates are often significantly higher in patients with chronic kidney disease, specifically end-stage renal disease, who require dialysis.

Additionally, in a 2005 study conducted by the joint efforts of researchers at Johns Hopkins, Duke University, and the University of Minnesota that examined more than 14,000 patients over an average timespan of about 14 years, it was found that patients with chronic kidney disease developed peripheral arterial disease at nearly double the speed of those without chronic kidney disease. This allowed these researchers to confidently conclude that patients with chronic kidney disease are, in fact, at a higher risk for peripheral arterial disease.

There are many hurdles that come along with managing to serious comorbid diseases. Individuals with chronic kidney disease “are less likely to be provided recommended ‘optimal’ PAD care,” but nephrologists can serve as a force for positive change.

Overall, peripheral arterial disease continuously goes undiagnosed and untreated, making it one of the “potent risk markers for cardiovascular morbidity and mortality in patients with kidney disease”. The widespread presence of peripheral arterial disease, combined with the “significant mortality, morbidity, and quality-of-life reduction associated with both diseases,” shines a light on the unavoidable need for nephrologists around the world to comprehend the prospective advantages of both early diagnosis and dynamic management of both diseases. However, although early detection and treatment are imperative to avoiding infections and amputations and to achieving the best outcomes for patients, it is vital to note that “nearly half of all peripheral arterial disease patients have no apparent symptoms, it can be very difficult to know if someone has the disease.”

Nephrologists and Cardiologists make a great Care Team

The teaming up nephrologists and peripheral vascular specialists is the clearest route to more accurate, higher-quality treatment for patients that are affected by both chronic kidney disease and peripheral arterial disease. According to the American Journal of Kidney Diseases, “aggressive risk-factor modification, including treatment of diabetes, hyperlipidemia, and hypertension and smoking cessation, should be mandatory in all patients.” The American Journal of Kidney Diseases also strongly recommends that future investigation be completed to properly evaluate the benefit of “earlier treatment strategies” within the population of chronic kidney disease patients, who are often at high risk for cardiovascular diseases like peripheral arterial disease. Early detection of asymptomatic peripheral arterial disease in patients with chronic kidney disease may also “improve both patient and clinician awareness of the potential significance of future exertional leg symptoms or signs of more advanced” peripheral arterial disease. By working together to increase early-stage detection and care, as well as to better understand how to properly treat the two comorbid diseases concurrently, nephrologists and peripheral vascular specialists worldwide may hope to bring better care and quality of life to their patients.