Reducing the Risk
of Heart Attack
By Allan R. Handysides and Peter N. Landless
This is a good question and one you need to ask your doctor to determine for you. The British Medical Journal reported in their September 8, 2007, issue that evaluation of family members could pay dividends.
In a study of 130,000 families, those having one or more family members with documented heart disease accounted for 70 percent of the study participants who experienced early onset heart attacks and 80 percent of premature strokes. They represented only 14 percent of the general population, however. This means that family predisposition to heart disease is a serious matter. The researchers estimated that up to 50 percent of the predicted heart attacks could have been prevented by appropriate intervention.
The first evaluation by your doctor will be of your current indicators of risk. What are your cholesterol levels, your weight, blood pressure, and lifestyle practices? Do you exercise? How much fat and what proportion of saturated fat are in your diet? Do you eat sufficient nuts and omega 3 fatty acids?
Although your mom will probably be on medication, the best thing she could do is go through a cardiac rehabilitation program. The Harvard Heart Letter recommends that if a patient has had a heart attack, undergone angioplasty, had bypass surgery or a valve replacement, received a heart transplant, or has stable angina, they should undergo cardiac rehabilitation. Insurance companies will usually cover the cost of such a program.
The lifestyle promoted by Adventist Health Ministries will also reduce the risk of heart attack. But it’s only you who can choose to do the right thing.
I have fibroids. I declined surgery because I was afraid of a hysterectomy becoming necessary, and I want children. I am 33 years old. Can you advise?
Fibroids are smooth muscle balls that grow predominantly in the uterus, and for the vast majority are benign tumors. They interfere with the blood flow in and through the uterus, and often cause disturbances in menstrual flow, making it heavy. They can interfere with fertility, and occasionally may cause the loss of a pregnancy.
Fibroids vary in size from barely detectable, peanut-size tumors to some as large as a soccer ball. When large, they may cause pressure and pain as well as abdominal distension. But recent advances have enabled gynecologists and interventional radiologists to utilize a new range of approaches to fibroids.
Many women carry successful pregnancies despite fibroids, though a pregnancy can be associated with the rapid growth of fibroids and a degeneration of the center of the fibroid called “red degeneration,” which can be quite painful.
Small fibroids that may hang within the cavity of the uterus or just beneath the endometrial (lining) surface may sometimes be removed through the use of a hysteroscope, which is a small telescope inserted through the cervix.
When surgery is envisioned to remove fibroids in a procedure called a myomactomy, the patient is always cautioned that a hysterectomy could become urgently required. This is because on rare occasions bleeding can be difficult to control, or the fibroids may be so numerous that there is little uterus to reconstruct back to normal.
In practice, however, because the use of vasopressin solutions injected around the fibroid can minimize bleeding, and because fibroids are generally detected while smaller, the risk of a hysterectomy being needed is much less. Perhaps at age 33, one of the larger dangers to your having children is the rapid passage of time and your declining fertility.
I advise that you attempt pregnancy as soon as appropriate to your situation. Problems of fertility require urgent identification. If the fibroids are felt to be the cause of infertility, you must seriously consider their removal. Many women, or their doctors, procrastinate―only to find age has left them childless. We recommend you seek care from a concerned and involved gynecologist who takes your aspirations for motherhood very seriously.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG,
is director of the General Conference Health Ministries Department.
Peter N. Landless, M.B., B.Ch., M.Med., F.C.P.(SA), F.A.C.C.,
is ICPA executive director and associate director of Health Ministries.